Nail disease can be caused by many different factors including fungal infection (onychomycosis), bacterial infection, or trauma to the nail. Here are the four most common nail problems treated by dermatologists:


This infection is usually caused by the same species of fungus that is responsible for ringworm and jock itch. When tinea occurs under the nail, it typically causes yellowing and the presence of a crusty material under the tip of the nail. If you tend to get athlete’s foot, you may be at increased risk for a fungal infection in your toenails. Use of acrylic fingernails can also create an environment that is conducive to fungal infestation.You may attempt to treat this nail disease with prescription strength topical anti-fungal creams. However, since these do not penetrate under the nail bed, an oral anti-fungal medication is usually needed to clear the infection. Lamisil and Fluconazole are two oral drugs that may be recommended. You may need to have a blood test to confirm normal liver function prior to taking these medications. Some patients choose to use Penlac Lacquer over the course of a year to clear up nail fungus.


This is separation of the nail from the underlying flesh. It usually appears near the tip of the nail as a white area that shows no sign of redness or inflammation. Allergies, psoriasis, and nail fungus are all potential causes. Trauma to the nail such as forceful removal of acrylic nails can also cause this condition. If there is an underlying cause for nail separation, this should be addressed. Otherwise, the nail may recover on its own over time.


This benign condition appears as a splitting of the tip of the nail. It shouldn’t get worse unless you pick at it or otherwise further traumatize the nail. If you have fragile nails that are splitting, your dermatologist may prescribe a daily dose of oral Biotin vitamin to restore strength to your nails.


This condition involves an inflammation of the skin creases surrounding the nail and under the cuticle. It is usually red and can be quite painful. The area may ooze pus if the cause is bacterial. If the inflammation is persistent and accompanied by thickening and cracking of the skin around the nails, it is often a fungal infection. The recommended medication will depend on whether bacteria or fungus is the cause. In addition to anti-biotics and anti-fungals, this condition may sometimes be treated with topical steroids or a thymol solution. You should avoid irritants, allergens, and prolonged contact with water if you have paronychia.

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