Nail Disorders

ALTERNATIVE DOCTOR, LLC

Nail Disorders

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 regrow into healthy nails.

Signs and Symptoms

Nail disorders are accompanied by the following signs and symptoms.

	Discoloration or spotting
	Painful, red swelling
	Pits, ridges, scars
	Lesions
	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 self-induced.

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
	Diabetes
	Skin diseases
	Tumors
	Overmanicuring
	Habits involving picking at the skin surrounding a nail
	Soil contamination
	Human immunodeficiency virus (HIV), the virus that causes AIDS

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.

Treatment Options

Prevention

	Keep your toenails cut short.
	Make sure your shoes fit properly.
	Avoid walking barefoot at public showers and swimming facilities.
	Throw out old, worn footwear.

Treatment Plan

The infected nail may be removed, and medication you take by mouth as well as medication you apply to the nail is usually prescribed.

Drug Therapies

Your provider may prescribe the following antifungal or antibacterial medications.

	Terbinafine
	Itraconazole
	Fluconazole
	Steroids
	Antibiotics

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.

Nutrition

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 foods.

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)
	Digestive enzymes and/or free-form amino acids may help with compromised digestion or malabsorption.

Herbs

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 parts.
	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.

Homeopathy

Some of the most common remedies include calcarea carbonica, graphites, and sulfur. Acute dose is three to five pellets of 12X to 30 C every one to four hours until symptoms are relieved.

Acupuncture

Acupuncture may be help to enhance immune function, normalize digestion, and address disease conditions.

Massage

Massage can help stimulate circulation, which aids the transport of nutrients to the nail bed.

Prognosis/Possible Complications

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.

Following Up

Follow-up with your health care provider may be needed in the case of drug side effects or interactions.

Supporting Research

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. 20^th ed. Philadelphia, PA: W.B. Saunders; 1996.

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. 14^th ed. New York: McGraw-Hill; 1998.

Habif TP. Clinical Dermatology. 3^rd ed. St. Louis, MO: Mosby-Year Book; 1996.

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. Saunders; 1999.

Roberts JR, ed. Clinical Procedures in Emergency Medicine. 3^rd ed. Philadelphia, PA: W.B. Saunders; 1998.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2^nd ed. Durango, Colo: Kivaki Press; 1994: 40.

Scher RK. Novel treatment strategies for superficial mycoses. J Am Acad Dermatol. 1999; 40(6).

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 herein.