Nail Health Checkup Program

Less than 30% of nail abnormalities are related to systemic diseases. Most of the rest are caused by local trauma, infection or external stimulation, so there is no need to be overly anxious.

I treated a sophomore girl last week. She rushed in clutching the "Nail Health Comparison Chart" issued by the nail salon, saying that the white spots on her nails were due to "liver toxin accumulation" and that she needed a full physical examination. I took her hand and took a look. It was the mechanical damage left by the nail root when I opened the kettle last week. It would be gone in two weeks until the fingertips were cut off. She cried all night in vain. In fact, you can do a preliminary nail screening at home every day. Just wash your hands and wipe them clean and face the natural light. You don’t even need to prepare tools. You can touch the nail surface first. A normal nail surface is smooth with a slight natural curvature. If you feel densely packed small pits, don’t directly look at the symptoms of “psoriasis nails” as popularized by popular science. Now the dermatology circle actually has different opinions on this symptom. Nearly 40% of nail pits are simply artificial damage caused by excessive manicure and long-term nail biting. They do not have any other underlying diseases. As long as you don’t torment the nail surface, most of them will grow back in about 3 months.

Speaking of which, we have to mention the crescent moon issue that everyone is most concerned about. This is also an issue where the views of Chinese and Western medicine differ greatly. According to the traditional understanding of Western medicine, lunula refers to the nail matrix that has not been completely keratinized. The number and size have nothing to do with health. Some people are born without lunula because their nail matrix is ​​posterior, so there is no need to worry at all. ； However, in clinical practice, traditional Chinese medicine does regard drastic changes in the crescent moon in a short period of time (for example, there were 10 fingers in the past, and suddenly only 2 were left within half a month, accompanied by fatigue and cold sensitivity) as a reference indication for changes in qi and blood. The current consensus in the industry is that there is no need to use the crescent moon alone as a health indicator. If the above-mentioned drastic changes occur, just do a routine physical examination. If there is no abnormality, there is no need to hold on to it. Some people panic when they see vertical lines on their nails, saying they are "signs of aging." In fact, physiological vertical lines similar to skin wrinkles will naturally appear on the nail surface of people over the age of 25, just like you have canthus wrinkles.

If you really find that the nail abnormality has not subsided for more than 2 months, or is even getting thicker, discolored, and painful, then don’t search for it yourself. It is better to get a dermatology number than anything else. When you arrive at the clinic, the doctor will usually scan all ten of your fingernails and toenails. They will also ask you whether you have taken special medicines recently, whether you have athlete's foot, and whether you are exposed to chemical reagents for a long time at work. Previously, an uncle's nails were yellow and thick for half a year.

If you suspect a fungal infection, also known as onychomycosis, there are three available examination methods, each with its own advantages and disadvantages. There is no absolute "best": traditional fungal microscopy can produce results in 15 minutes, but the positive rate is only about 50%, making it easy to miss the diagnosis.； Fungal culture has a high accuracy, but it takes 2-4 weeks to get the results. Impatient people may not be able to wait. ； The latest PCR test can produce results in a few hours and is highly accurate, but the price is almost twice as much as the previous two. You can choose according to your own needs, and you don’t have to listen to anyone to say that a certain one is absolutely better. If symptoms such as spoon-shaped nails (that is, the nails are raised like a small spoon), repeated periungual ulcers, sudden blackening of the nails and rapid expansion of the nail are found, the doctor may prescribe blood routine, thyroid function, dermoscopy or even pathological biopsy. This is not an indiscriminate examination. After all, a small number of spoon-shaped nails are indeed related to iron deficiency anemia and thyroid abnormalities, and rapidly expanding nail black spots should rule out the possibility of malignant melanoma. It is always right to be cautious.

I have been practicing dermatology for almost 8 years, and 90% of the people who come for nail check-ups are just false alarms. Either the nail surface is worn out by too much manicure, or the nail surface is scratched and I have no impression. Nail changes that are really related to systemic diseases are almost always accompanied by other physical symptoms, and the nails are not the only problem. By the way, I would like to remind those who often get manicures that it is best to give your nails a week's rest every 2-3 months, and don't stick to the nails all the time. I have seen too many girls grind their nails so thin that the underlying nail bed can be seen, and all kinds of abnormal symptoms will appear. It is purely to scare themselves. Anyway, nails are just a small window that can reflect some physical problems. It is definitely not a health fortune teller. Don’t just stare at it and read popular science to understand the symptoms. If you are really unsure, you can see a doctor. It will be much more effective than just thinking about it for three days.