Abnormal nails

What’s it all about?

Having normal nails is important, and something most of us take for granted. When nails are abnormal, they can have an impact on the quality of life both from a mechanical point of view and a cosmetic point of view.

For both of these reasons, understanding what is going on in the nail is vital to taking the next step, and that is planning the management of that nail problem.

The integrity of the nail can be influenced by a number of different things including the age of the individual, their hobbies and occupation, and their general health, as well as disease of the nail unit itself.

Common diseases affecting the nails include psoriasis and eczema, usually thought of as skin diseases; however, the nails are specialised parts of the skin and can be included in the disease process along with the skin itself.

Other causes of nail abnormalities include congenital conditions (ones you have inherited from your parents), although these are generally rare; and other acquired conditions like lichen planus, alopecia areata and fungal nail infections.

What are the common nail abnormalities?

Brittleness: increases with age and can be associated with iron deficiency in some people.
Roughness: common and usually of little significance.
Pits: classical feature of psoriasis, but also found in eczema and in alopecia areata.


Lifting of the nail from the underlying nail bed, which can be found in psoriasis, fungal infections, overactive thyroid, lesions under the nail, associated with some medications, and sometimes without cause.
Discoloration: white marks are common and normal, generally white nails can be found in liver disease, pale nails in anaemia, yellow nails in fungal infections, green-blue ones in pseudomonas infection, black-brown with bruising, moles or melanoma.

These are just some of the abnormalities that can be found in nails, and some of the associated causes. Other abnormalities include ridging, washboard nails, thickening, scarring and loss of nails, all with a variety of causes.

How are abnormal nails treated?

Firstly, before any therapy, a diagnosis is needed. From the information above, it becomes clear that a full history of the problem is needed, plus examination, and then blood tests, nail samples and an X-ray, if indicated.

Once the picture is clear as to the cause(s), treatment can be planned as appropriate. This may be treatment with antibiotics or anti-fungal agents to combat infection; therapy aimed at the eczema or psoriasis; or surgery to a lesion of some sort.

For some nail abnormalities, there may be no effective treatment available, however, beautifying the nails, especially for women, can be advised upon.

Having abnormal nails is not pretty, and being able to disguise them may be the only short-term solution. We have access to the Consultant Dermatologist for the best advice and a beauty therapist with the necessary skills to help in the disguising department, as needed.

To find out more or to book an appointment, call us on 01227 472288 or Book Now using the online booking system

Fungal Nail Infection

Also known as onychomycosis, fungal nail infection is most commonly found in the toenails and is usually caused by a dermatophyte. There are 4 patterns of nail involvement, with differing clinical considerations. It is very important to confirm the diagnosis before considering any treatment strategies going forward.

Topical therapies can be useful in some circumstances, but systemic treatment is typically needed to cure the disease. Having said that, there are potential side effects from the oral drugs that are usually used, and laser therapy has become increasingly popular as this can kill off the fungi allowing the nail to recover, but without risk of systemic side effects at all.

Proof of nail infection is required before embarking on any treatment. Some GPs will carry out this test for you. Alternatively this test can be carried out in the clinic with us at the same time as your initial consultation. The test results can take up to 3 weeks to come back.

We usually carry out laser treatments at 4 week intervals and 3 treatments are initially undertaken. A topical agent is usually prescribed at the same time, partly to reduce the risk of re-infection occurring.
Consultation with nail sampling/mycology £350
Laser treatments  £250 session.