Nail & Skin Disorders

The Nail Doctor

This month, our Nail Doctors team up to talk about bacteria spots, perimenopause, toenail fungus, and working after surgery.

Q: My client of eight weeks suddenly developed two bacteria spots on her nails. As a school teacher, she developed an allergy to chalkboard dust. Her doctor prescribed medicated lotion. Can this be part of the problem? I have heard that other conditions can cause bacteria, such as antibiotic medication, thyroid problems, chronic yeast infection, and psoriasis of the skin. Is this true?

A: Dr. Phoebe Rich: You are correct that the green discoloration of the nails is usually a bacterial problem called pseudomonas. It is a common bacterium that lives in water, especially hot water. Pseudomonas is often a secondary bacterial infection, which means it infects a nail that is already damaged, perhaps by psoriasis or onycholysis. Pseudomonas will often spontaneously disappear when the underlying nail problem is cleared up. There are several home remedies that will treat pseudomonas very effectively. The simplest treatment is to use diluted white vinegar soaks (1 part vinegar to 2-4 parts water) for several weeks. You can store the solution in a dropper bottle and apply one drop under the nail twice a day. To remove the discoloration, the nails can be rinsed in a diluted bleach solution (1 part bleach to 4 parts water) once or twice, but not for prolonged periods. If these simple remedies fail, a doctor can prescribe antibiotics for resistant cases.

Doug Schoon: Bacterial infections account for almost all green discolorations on the surface of the nail plate (under the enhancement). That they are mold and mildew is a myth, and fingernail fungal infections are also pretty rare. The vast majority of green bacterial infections are caused by improper preparation and/or application. Improperly cleaning the nail leaves it contaminated with bacteria that can grow after the enhancement is applied. Improper application can lead to lifting, which can allow bacteria to get under the area where the product has separated. The problems you listed cannot cause these infections.

Q: I am a 51-year old female. I’m perimenopausal and my nails will not grow. I take regular calcium supplements of 1200 mg every day plus nonfat milk and nonfat soy milk. My diet is high in soy, vegetables and fruits, and carbohydrates, with a limited number of proteins. All my life, I’ve had beautiful, long nails, but within the last two or three years my nails will not grow. I have tried everything possible, yet my nails are paper thin, split, and peel all of the time. Do you have any information or suggestions that might help?

A: Dr. Rich: It may seem like your nails won’t grow, but actually all nails grow. However, if your nails are brittle, peeling, or easily broken, it will seem like they are not growing at all. The calcium that you are taking is very good for your bones, but it will not help your nails. The strength of nails depends on proteins and amino acids rather than calcium. Water content is also important, because nails that are dehydrated will chip and peel more easily. You don’t say whether you are taking an estrogen replacement. Sometimes women in menopause notice a change in their nails and estrogen replacement may help. There is no scientific proof of this, however. Another thing that is sometimes helpful with brittle nails is the vitamin biotin. The correct dosage is 2,000 to 3,000 micrograms a day. You can ask your pharmacist for a product called Biotin Forte (which contains 3,000 micrograms) that should be taken once daily.

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