Question: I have a client who had previously worn artificial nails without problems, but one day she reported that both the artificial and natural nails on one of her thumbs had completely fallen off, which was very painful for her. She wears artificial nails again now, but about every two months we remove her artificial nails for a few weeks because the natural nail on the same thumb starts to lift. The only medication she takes is synthyroid. Can you suggest what may be causing this and what we can do to stop it?
Dr. Kechijian: Artificial nails can cause separation of the nail plate from the nail bed for a number of reasons. Sometimes the client becomes allergic to the product. An allergy to any nail product can cause irritation of the nail bed and can affect the nail plate’s adherence to the nail bed. However, this client doesn’t appear to be allergic to the nail product because an allergy to a nail product usually affects all 10 nails.
A more likely cause of the separation is an infection of the nail bed. Artificial nails tend to trap moisture under the nail plate. If the moisture remains trapped for a prolonged period, it can lead to overgrowth of yeast and bacteria, which in turn leads to infection. The infection is what causes the nail plate to separate from the nail bed. The fact that artificial nail wearers tend to have longer nails compounds the problem because the length makes the nails more likely to tear from the nail bed and more easily caught on objects that are grasped between the thumb and other fingers. A nail infection in conjunction with tearing is the most likely cause of nail separation in your client, particularly in light of the pain she experiences when the separation occurs.
It is noteworthy to mention that patients with thyroid abnormalities often develop slight nail separation. Because your client is taking the medication synthyroid for this condition, I assume her thyroid problem is controlled. The severity of her separation is greater than normally occurs in patients with thyroid disease.
I would suggest that your client not wear any nail cosmetics for six months. If her nails remain normal during this time, it: is reasonable to assume that the problem was caused by the artificial nails and she should not wear them.
Q. I am a nail technician and I love my job, but I have a problem. When I was born my nails we’re cut and damaged and now they don’t grow. They are indented and very short. Do you have any suggestions on how I can wear my nails so that they look natural? I wear artificial nails, but I would like to get my natural nails to the point that I can wear a fiberglass wrap without polish.
A. Your nail problem apparently started at birth. It is highly unlikely that having your nails cut at an early age caused your nails to be short and indented. Cutting the nails will not cause the nails to be deformed unless the nail matrix was injured in the process of cutting. The fact that all your nails are involved indicates that your problem is one in which the nail matrix is not properly forming a nail plate.
If you hope to ever grow your nails long, you first have to determine the underlying problem. To do this, you should consult a dermatologist who is knowledgeable about nail disorders. After a diagnosis has been formulated, you and your doctor can determine the best method for correcting the condition if a cure is possible to attain.