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1 Scotts Road #04-15/16 Shaw Centre Singapore 228208

Nail Problems

What are nail problems?

Nail abnormalities can arise from various causes, leading to issues like yellowing, brittleness, black streaks, swelling, bleeding, and pain. Neglected nail problems can escalate into infections. Sometimes, they may signal an underlying health condition or skin issue.

Various nail problems can arise; these include but are not limited to:

Ingrown toenails

Ingrown toenails occur when the edges of nails grow into the adjacent skin, causing discomfort, inflammation, and the occasional infection. This often leads to pain, redness, and swelling. Various factors contribute to its development, including trauma, infection, improper nail trimming, ill-fitting shoes, underlying bony spurs, and genetic predisposition to pincer nails.

Ingrown toenails vary in severity and are often categorised into different grades to guide treatment approaches.

  • Grade 1: nail border is slightly inflamed and swollen. Conservative treatment methods are often effective.
  • Grade 2: nail border is more inflamed and swollen with discharge or pus.
  • Grade 3: due to chronic inflammation, a lump forms at the site of the ingrown nail. At this point, the nail is often exquisitely painful.

Conservative treatment methods are often effective for Grade 1 ingrown nails. A more proactive approach may be employed for Grade 2 and 3 ingrown nails. At Lumine Dermatology & Laser Clinic, we offer topical and oral antibiotics for infection management. Our dermatologist performs partial nail avulsion under local anaesthesia for cases requiring surgical intervention—a quick, 10-15-minute procedure that significantly alleviates pain.

For patients needing matricectomy to prevent recurrence, we utilise either:

  • Phenol ablation: a chemical method with high success rates to safely remove the problematic nail matrix.
  • Carbon dioxide laser ablation: a precise laser treatment that targets the nail matrix.

Our comprehensive care ensures the resolution of the current issue and focuses on prevention and education to avoid future occurrences. At Lumine Dermatology & Laser Clinic, your comfort and health are our top priorities. Our team is dedicated to providing personalised care, from the initial consultation through treatment and follow-up.

If you're experiencing discomfort or signs of an ingrown toenail, don't wait for the condition to worsen. Contact us to schedule your appointment and take the first step towards relief.

Longitudinal melanonychia

Longitudinal melanonychia, characterised by brown, black, or grey streaks along the length of the nail, is a condition that may concern many due to its appearance and potential implications. These pigmented nail streaks originate from the activation of melanocytes within the nail matrix and can vary significantly in cause and severity.

At Lumine Dermatology & Laser Clinic, we understand the anxiety that can accompany changes in nail pigmentation. Our approach begins with a comprehensive clinical and dermoscopic evaluation to accurately assess each case of longitudinal melanonychia. Causes range from benign conditions like familial predisposition, trauma, or fungal infections to more serious concerns such as melanoma-in-situ or melanoma.

Navigating nail pigmentation with the ABCDEF mnemonic

We utilise this mnemonic to systematically evaluate various cases of longitudinal melanonychia for the risks associated with melanoma-in-situ or melanoma of the nail apparatus. The risk factors associated with melanoma or melanoma-in-situ of the nail apparatus include:

  • A- Age (over 35) and ancestry (Asian/African American)
  • B- Broad or blurred brown-black pigmentation >3 mm
  • C- Change in the nail band appearance or persistence despite adequate treatment
  • D- Digit affected is the thumb of the dominant hand
  • E- Extension of pigmentation onto the skin surrounding the nail
  • F- Family history of dysplastic moles or melanoma

Tailored treatment strategies for longitudinal melanonychia

Our strategy includes vigilant monitoring for cases of longitudinal melanonychia deemed low risk. This involves regular follow-ups supported by clinical and dermoscopic photography to carefully track any changes over time.

For higher-risk lesions, we may recommend a nail matrix biopsy. This procedure takes about 30 minutes and is performed under local anaesthesia in our clinic. This step is crucial for accurate diagnosis and determining the appropriate action.

At Lumine Dermatology & Laser Clinic, our priority is your health and peace of mind. Our team, equipped with specialised surgical experience in nail conditions, is here to guide you through diagnosis and treatment with the utmost care. Whether monitoring a low-risk condition or addressing a more serious concern, our approach is always personalised to ensure the good outcomes for our patients.

If you notice changes in your nail colouration or have concerns about longitudinal melanonychia, contact us at Lumine Dermatology & Laser Clinic.

What causes nail problems?

Nail problems can stem from numerous sources, including diseases (like lupus, eczema, psoriasis, diabetes, anaemia, thyroid disorders), nutrient deficiencies, ageing, environmental exposure, hormonal changes, improper nail care, manicures, infections, trauma, occupational hazards, hygiene practices, and certain medications. These factors can lead to various nail conditions, impacting their health and appearance.

How are nail problems diagnosed?

Our goal is to thoroughly understand your nail health and provide the most effective treatment plan.

  • Medical history: your dermatologist will ask about your medical history, including symptoms, existing health conditions, family medical background, and medication history.
  • Clinical examination: the nails and surrounding skin are thoroughly examined to assess their overall condition, including any visible abnormalities or signs of infection.
  • Laboratory tests: in some instances, laboratory tests, such as fungal cultures and blood tests to check for nutritional deficiencies, may be required to confirm the diagnosis and identify underlying causes.
  • Nail bed or nail matrix biopsy: in some cases, a biopsy of the nail apparatus may be required to establish the diagnosis.

What are the treatment options for nail problems?

We offer diverse treatment options at Lumine Dermatology & Laser Clinic. These include:

  • Topical or intralesional steroid treatments: help reduce inflammation and enhance the appearance of the nails.
  • Biologic treatments: for severe nail psoriasis, we offer biologic treatments, such as risankizumab, ixekizumab, and ustekinumab, which are known for their effectiveness in stubborn nail conditions.
  • Oral antibiotics or antifungal medications: these targeted treatments for bacterial or fungal infections ensure that the root cause of nail problems is addressed.
  • Surgical nail avulsion with or without matricectomy: for cases involving significant discomfort due to trauma or ingrown nails, surgical nail avulsion may be necessary. In certain conditions, matricectomy may also be performed to prevent nail regrowth.
  • Chemical nail avulsion: our specialists are skilled in chemical nail avulsion techniques for treating persistently thickened and dystrophic nails.
  • Lifestyle adjustments: we emphasise the importance of nail care and hygiene, advise on reducing nail polish and chemical exposure, and guide medication adjustments to promote optimal nail health.

Lumine Dermatology & Laser Clinic provides comprehensive and personalised care for all nail conditions.

Frequently asked questions

Can I prevent nail problems?

Yes, you can prevent nail problems by practising good nail hygiene, avoiding excessive exposure to water and chemicals, wearing proper footwear, and maintaining a balanced diet rich in essential nutrients.

Is it necessary to seek professional help for minor nail issues?

While minor nail issues may be resolved independently or with basic home care, it's advisable to consult a dermatologist for persistent or recurring problems, as they may indicate underlying issues that require medical attention.

Can nail problems affect people of all ages?

Yes, nail problems can affect individuals of all age groups, from children to older adults. While certain conditions, such as fungal infections or brittle nails, may be more prevalent in older individuals due to ageing or specific lifestyle habits, it's important to recognise that anyone, regardless of age, can experience nail issues. Our clinic is committed to diagnosing and treating nail conditions with personalised care for patients at every stage of life.

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Operation hours
Mon-Fri - 9am to 6pm | Sat - 9am to 1pm | Closed on Sundays & Public Holidays
Contacts
1 Scotts Road #04-15/16 Shaw Centre Singapore 228208





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