Nail disorders

What are common nail disorders?

Nails can be affected by a wide range of conditions, including:

• Fungal nail infection (onychomycosis) — causing thickened, discoloured, or crumbling nails, most common on the toenails
• Psoriatic nail disease — nail pitting, separation of the nail from the nail bed, discolouration, and thickening, occurring in people with psoriasis
• Paronychia — infection orinflammation of the skin around the nail, which can be acute (sudden, often bacterial) or chronic (ongoing, often related to repeated wet work or irritation)

• Ingrown toenails (onychocryptosis) — where the edge of the nail grows into the surrounding skin, causing pain, redness, and sometimes infection
• Lichen planus of the nails — an inflammatory condition that can cause thinning, ridging, or, if untreated, permanent nail loss
• Brittle or splitting nails — often related to ageing, frequent wetting and drying, or nail product use
• Nail pigmentation changes — a dark line or patch under the nail, which can be entirely benign but occasionally needs urgent assessment

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How is a fungal nail infection treated?

Fungal nail infections can be stubborn to clear, and treatment depends on how much of the nail is affected:

• Topical antifungal treatments — lacquers or solutions applied directly to the nail, generally suited to milder infections affecting less of the nail, though cure rates are lower than oral treatment
• Oral antifungal medication — typically more effective for more extensive infection, taken over several weeks to months, with monitoring for side effects during treatment
• Nail care measures — keeping nails trimmed, dry, and wearing breathable footwear, to support treatment and reduce reinfection

Because fungal nail infections can look similar to psoriatic nail changes and other conditions, confirming the diagnosis — sometimes with a nail clipping sample — before starting treatment helps ensure the right approach is used.

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