There are a variety of types of nail disorders, and fungal infection is the
most common. In 80 percent of cases of fungal infection, the toenails are
affected. With proper treatment, most damaged nails can re-grow into healthy
|Signs and Symptoms|
Nail disorders are accompanied by the following signs and
- Discoloration or spotting
- Painful, red swelling
- Pits, ridges, scars
- Brown-black band
|What Causes It?|
Nail disorders are caused by infections, skin diseases, benign or malignant
tumors, or certain system-wide diseases. They also may be
|Who's Most At Risk?|
The following are risk factors for nail disorders.
- Genetic predisposition
- Excessive exposure to water, heat, and humidity
- Tight-fitting shoes
- Chemical damage
- Skin diseases
- Habits involving picking at the skin surrounding a nail
- Soil contamination
- Human immunodeficiency virus (HIV), the virus that causes
|What to Expect at Your Provider's Office|
If you are experiencing symptoms associated with a nail disorder, you should
see your health care provider. A combination of a physical exam, lab tests such
as fungal or bacterial cultures, and imaging procedures in the case of a
suspected tumor are used for making a diagnosis.
- Keep your toenails cut short.
- Make sure your shoes fit properly.
- Avoid walking barefoot at public showers and swimming
- Throw out old, worn footwear.
The infected nail may be removed, and medication you take by mouth as well as
medication you apply to the nail is usually prescribed.
Your provider may prescribe the following antifungal or antibacterial
|Surgical and Other Procedures|
Lesions may be removed or drained, blood clots may be drained, and sometimes
the nail must be surgically removed.
|Complementary and Alternative Therapies|
A comprehensive treatment plan for nail disorders may include a range of
complementary and alternative therapies.
Consume adequate protein and minerals for general nail health. Increase the
amount of nuts, seeds, whole grains, legumes, fresh vegetables, sea vegetables,
and cold-water fish that you eat. Avoid sugars, alcohol, caffeine, and refined
Potentially beneficial supplements to counteract nutrient deficiencies
include the following.
- Vitamin A (10,000 IU per day)
- Zinc (15 to 30 mg per day)
- Essential fatty acids (i.e., flax, borage, or evening primrose oil)
1,000 to 1,500 mg twice a day
- Iron (ferrous glycinate 100 mg per day)
- Vitamin B12 (1,000 mcg per day)
- Vitamin C (250 to 500 mg two times per day)
- Vitamin E (400 IU per day)
- Digestive enzymes and/or free-form amino acids may help with
compromised digestion or malabsorption.
Herbal remedies may offer relief from symptoms. Herbs are generally available
as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol
extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. per cup of
water steeped for 10 minutes (roots need 20 minutes).
- With nutritional deficiencies, take 15 to 20 drops of the following
tincture three times per day or drink two to three cups of tea daily: ginger
(Zingiber officinalis), nettles (Urtica urens), dandelion herb
(Taraxecum officinalis), horsetail (Equisetum arvense), spearmint
(Mentha spicata), and hawthorn (Crataegus monogyna) in equal
- With bacterial or viral infection, combine equal parts of coneflower
(Echinacea purpurea) and goldenseal (Hydrastis canadensis) with
one-half part of ginger. Take 20 drops tincture four times per day.
- With fungi, molds, or yeast infection, combine equal parts of
coneflower, oregano (Origanum vulgare), spilanthes (Spilanthes
acmella), usnea (Usnea barbata), Oregon grape root (Mahonia
nervosa), and myrrh (Commiphora molmol). Take 20 drops tincture four
times per day.
- Apply undiluted grapefruit seed extract or tea tree oil to affected
nail. Do not allow contact with skin.
There have been few studies examining the effectiveness of specific
homeopathic remedies. A professional homeopath, however, may recommend one or
more of the following treatments for nail disorders based on his or her
knowledge and clinical experience. Before prescribing a remedy, homeopaths take
into account a person's constitutional type. In homeopathic terms, a person's
constitution is his or her physical, emotional, and intellectual makeup. An
experienced homeopath assesses all of these factors when determining the most
appropriate remedy for a particular individual.
- Calendula — for reddish, scaly rashes
- Graphites — for cracking skin and
nails with oozing fluid caused by fungal infections; symptoms improve with open
- Sulphur — for fungal disorders that
itch, particularly if warmth worsens
Acupuncture may be help to enhance immune function, normalize digestion, and
address disease conditions.
Massage can help stimulate circulation, which aids the transport of nutrients
to the nail bed.
Toenail regeneration generally takes 8 to 12 months, while fingernail
regeneration takes half as long. Relapses or permanent damage sometimes occur.
Complications may include cellulitis (tissue inflammation) and the embarrassment
caused by unsightly nail appearance.
Follow-up with your health care provider may be needed in the case of drug
side effects or interactions.
Burton Goldberg Group. Alternative Medicine: The Definitive Guide.
Tiburon, CA: Future Medicine Publishing, Inc.; 1997: 951,952.
Cecil RI, Plum F, Bennett JC, eds. Cecil Textbook of Medicine.
20th ed. Philadelphia, PA: W.B. Saunders; 1996.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines.
3rd ed. New York, NY: Penguin Putnam; 1997: 270-271.
Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore,
MD: Lippincott Williams & Wilkins, Inc.; 1999.
Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles
of Internal Medicine. 14th ed. New York: McGraw-Hill; 1998.
Habif TP. Clinical Dermatology. 3rd ed. St. Louis, MO:
Mosby-Year Book; 1996.
Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New
York, NY: Warner Books; 1996: 259.
Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms.
Albany, Calif: Hahnemann Clinic Publishing; 1993.
Rakel RE, ed. Conn's Current Therapy. 51st ed. Philadelphia, PA: W.B.
Roberts JR, ed. Clinical Procedures in Emergency Medicine.
3rd ed. Philadelphia, PA: W.B. Saunders; 1998.
Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed.
Durango, Colo: Kivaki Press; 1994: 40.
Scher RK. Novel treatment strategies for superficial mycoses. J Am Acad
Dermatol. 1999; 40(6).
|Review Date: March 2000|
|Reviewed By: Richard A. Lippin, MD, President, The Lippin Group, Southampton,
Copyright © 2004 A.D.A.M., Inc
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed