Nails are affected by many factors just like the hair. Past disease, trauma, drug use and inadequate nutrition affect the growth and appearance of nails. The deficiency of a wide variety of vitamins and minerals and especially iron deficiency can disrupt the structure of nails and cause them to break easily. Besides, various skin disorders (psoriasis, lichen planus, etc.) and especially fungal diseases, bacterial infections and skin cancers such as melanoma can affect the nails. These findings are generally seen as thickening, easily breaking, ridging, collapse and color change in the nails and can improve with the elimination of the underlying cause. However, the treatment of and improvement in nail disorders require a long time. Fingernails grow about 3.5 mm per month and toenails 1.6 mm per month and the nail growth rate is further reduced in winter months. Deformities that affect the nail matrix can be resistant to treatment.
The diagnosis of nail problems is made with the examination, laboratory tests, dermoscopic examination, fungus search and/or nail biopsy. Once the diagnosis is made, the appropriate treatment is selected. In general, topical treatments are sufficient if there is involvement of less than a third of the nail while systemic treatment is required for more widespread involvement of the nail by a fungus. Sweating and humid environment are suitable conditions for nail fungi and patients should therefore be careful to keep their feet dry. If the nail disorders have developed due to an underlying skin disease, appropriate treatment for the indication should be selected. Topical and systemic antibiotics are preferred in the presence of infection. In case of melanoma, the lesion should be totally removed and the necessary evaluations performed, followed by cooperation with the Department of Oncology.