Nail Disorders
Nail problems are easy to ignore and easy to misdiagnose. A thick yellow toenail is not always fungus, and a swollen, painful finger tip is not always something antibiotics will settle. At Venus Aesthetics, nails are handled as medical dermatology: the diagnosis is confirmed first, usually with a laboratory test, and treatment is built around the result. Dermatology appointments are by appointment only and cost Rs 3,500.
Understanding Nail Disorders
Nail disorders cover disease of the nail plate, the nail bed and the skin folds around the nail. This category at Venus Aesthetics includes onychomycosis, the fungal infection that thickens, discolours and crumbles nails; nail psoriasis, which pits and roughens the nail and lifts it from the bed, often alongside skin or joint disease; nail dystrophies, where the nail grows abnormally because of trauma, tight footwear, eczema, lichen planus, thyroid disease or iron deficiency; and paronychia, infection or inflammation of the nail fold, which can arrive suddenly and painfully or settle in as a chronic problem in hands that are constantly wet. More than one of these can affect the same nail.
Come in if you recognise any of these
- A toenail or fingernail that is thickened, yellow or brown, and crumbling at the free edge
- Small pits or dents in the nail surface, or an orange brown patch showing through the nail
- The nail lifting away from the nail bed, leaving a visible gap or a hollow you can feel
- Sudden redness, throbbing pain and swelling in the skin beside a nail, sometimes with pus
- Skin around the nail that stays puffy and sore, has lost its cuticle, and flares every time the hands are wet
- Nails that have become ridged, split, brittle or spoon shaped over several months
- A single dark streak in one nail, or any nail change that keeps worsening despite treatment, which should be seen promptly
Your plan, step by step
A full nail examination, not just the nail you are worried about
The doctor looks at all twenty nails, the skin, the scalp and the joints, because the answer is often outside the nail itself. You will be asked how long the change has been there, what you have already applied, what shoes you wear, whether your hands stay wet at work or at home, and whether you have diabetes, thyroid disease or anaemia. Bring any old photos of the nail if you have them.
Testing before treatment, not after
Thick yellow nails are not automatically fungal. A small clipping or scraping is usually taken and sent for microscopy and culture, and the nail may be examined under dermoscopy. If you have been using an antifungal cream or lacquer, the doctor may ask you to stop it for a period before the sample is taken so the result is reliable. Nobody should be on months of antifungal tablets without a confirmed reason.
Treatment matched to the actual diagnosis
Confirmed onychomycosis may be treated with topical nail therapy, oral antifungal medicine, or both, depending on how much of the nail is involved and whether the root is affected. Nail psoriasis is treated on its own lines, which may include topical therapy, injections into the nail fold, or systemic treatment when the skin and joints are also involved. Acute paronychia may need drainage and antibiotics. Chronic paronychia is managed mainly by keeping the hands dry and protected.
Dealing with the damaged nail itself
Medicine kills infection and calms inflammation, but the damaged part of the nail still has to grow out. Where a nail is very thick, painful or pressing into the skin, the doctor may thin it, soften it chemically, or remove part of it in selected cases. Ingrown and repeatedly traumatised nails are assessed at the same visit, since footwear and nail cutting habits often keep the problem going.
Follow up while the nail grows out
Progress is judged by the new, clear nail appearing at the base, not by how the old damaged tip looks. Review appointments are arranged so treatment can be stopped, continued or changed on evidence. If oral antifungal tablets are used, the doctor may request liver function testing before and during the course, and will check your other medicines for interactions.
Preventing the next episode
Recurrence is common in our climate, so prevention is part of the plan: drying the feet and the web spaces properly after wudu and after bathing, breathable footwear in Lahore and Karachi humidity, treating athlete's foot on the skin at the same time as the nails, using your own instruments at the salon, gloves for wet work, and no random steroid creams bought over the counter, which make fungal infection worse. Nail appointments are available at all eight Venus Aesthetics branches in Lahore, Karachi, Islamabad, Faisalabad and Gujranwala on 0311 111 7546.
Nail Disorders, answered honestly
How do I know if my nail problem is fungus or something else?
Can fungal nails be treated with cream alone, or do I need tablets?
How long before my nail looks normal again?
Are antifungal tablets safe, and do I need blood tests?
What does nail psoriasis look like, and can it be cured?
Why does the skin around my nail keep swelling and hurting?
Can I wear nail polish or get a pedicure while I am being treated?
What happens at the first nail appointment, and what does it cost?
Worried about your skin?
Bring it to a dermatologist. Diagnosis first, honest plan second, treatment only when it genuinely helps.