Nail Conditions

Nail Conditions

Changes to your fingernails or toenails can provide important clues about your overall health. Nail problems may result from skin diseases, infections, injury, autoimmune conditions or, in some cases, internal medical conditions.

At Mermaid Beach Dermatology, our Specialist Dermatologists diagnose and treat the full range of nail disorders. Early assessment is important, as many nail conditions can appear similar but require very different treatments.

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About Nail Conditions

  • Common nail conditions

    We diagnose and treat a wide variety of nail disorders, including:

    • Fungal nail infections (onychomycosis)

    • Nail psoriasis

    • Eczema affecting the nails

    • Lichen planus of the nails

    • Chronic paronychia (inflammation around the nail)

    • Ingrown toenails

    • Traumatic nail injuries

    • Nail dystrophy

    • Thickened nails

    • Brittle or splitting nails

    • Slow-growing nails

    • Nail discolouration

    • White nails (leukonychia)

    • Dark streaks or pigmentation within the nail (melanonychia)

    • Nail infections

    • Nail abnormalities associated with autoimmune diseases

    • Nail changes related to ageing

    • Benign and malignant tumours affecting the nail unit, including nail melanoma

  • What causes nail problems?

    Nail abnormalities can develop for many different reasons.

    Common causes include:

    • Fungal infections

    • Psoriasis

    • Eczema

    • Trauma or repeated injury

    • Autoimmune diseases

    • Bacterial infections

    • Ageing

    • Nutritional deficiencies

    • Certain medications

    • Less commonly, skin cancer affecting the nail unit

    Because many nail conditions have a similar appearance, an accurate diagnosis is essential before treatment begins.

  • Common symptoms

    You should consider seeing a dermatologist if you notice:

    • Thickened nails

    • Yellow, white or brown nail discolouration

    • Crumbling nails

    • Nails lifting away from the nail bed

    • Splitting or brittle nails

    • Painful or swollen nail folds

    • Recurrent infections around the nail

    • A dark stripe developing within a nail

    • Distortion of the nail shape

    • Slow nail growth

    • Persistent changes affecting one or more nails

  • Nail psoriasis

    Up to half of people with psoriasis develop changes affecting their nails.

    Symptoms may include:

    • Small pits in the nail surface

    • Thickening of the nail

    • Separation of the nail from the nail bed

    • Yellow or orange discoloration ("oil spots")

    • Crumbling nails

    • Build-up of scale beneath the nail

    Treatment may include prescription topical medications, injectable therapies, oral medications or biologic treatments depending on the severity of the psoriasis.

  • Fungal nail infections (onychomycosis)

    Fungal nail infections are one of the most common causes of thickened, discoloured toenails.

    Typical symptoms include:

    • Yellow or white discoloration

    • Thickened nails

    • Brittle or crumbly nails

    • Distortion of the nail shape

    • Nail lifting

    Diagnosis is important because not all thickened nails are caused by fungal infection. Laboratory testing may be recommended before commencing oral antifungal treatment.

    Treatment options include:

    • Prescription topical antifungal medications

    • Oral antifungal medications

    • Nail care advice

    • Treatment of contributing skin fungal infections

  • Pigmented nail lesions

    A new dark line or patch within a nail should always be assessed by a Specialist Dermatologist.

    While many pigmented nail lesions are harmless, they can occasionally represent subungual melanoma, a rare but potentially serious form of skin cancer.

    Early diagnosis is extremely important.

  • Autoimmune nail disorders

    Several autoimmune conditions may affect the nails, including:

    • Psoriasis

    • Lichen planus

    • Alopecia areata

    • Connective tissue diseases

    These conditions may cause nail thinning, ridging, splitting, scarring or nail loss. Early treatment may reduce the risk of permanent nail damage.

  • How are nail conditions diagnosed?

    Diagnosis begins with a detailed history and examination of the nails and surrounding skin.

    Depending on the suspected condition, your dermatologist may recommend:

    • Nail clippings for fungal microscopy and culture

    • Skin or nail biopsy

    • Dermoscopy (specialised examination of the nail)

    • Blood tests where indicated

    Obtaining the correct diagnosis is often the most important step in successful treatment.

  • How are nail conditions treated?

    Treatment depends entirely on the underlying cause.

    Our treatment options include:

    • Prescription topical medications

    • Oral antifungal medications

    • Oral anti-inflammatory medications

    • Injectable medications for selected conditions

    • Biologic therapies for nail psoriasis

    • Nail surgery where appropriate

    • Management of associated skin diseases such as psoriasis or eczema

    Because nails grow slowly, improvement often takes several months, even after successful treatment has commenced.

  • Why choose Mermaid Beach Dermatology?

    Our Specialist Dermatologists have extensive experience diagnosing complex nail disorders and distinguishing between conditions that often look similar.

    We provide:

    • Accurate diagnosis

    • Investigation of difficult nail disorders

    • Management of fungal nail infections

    • Treatment of nail psoriasis and autoimmune nail disease

    • Assessment of pigmented nail lesions, including investigation for subungual melanoma

    • Nail biopsies when indicated

    • Individualised treatment plans

    Our goal is to restore healthy nail growth while identifying any underlying skin or medical conditions contributing to your nail changes.

Frequently Asked Questions

  • The most common cause is a fungal nail infection, although psoriasis, repeated trauma and ageing can produce a similar appearance. An accurate diagnosis is important before starting treatment.

  • Because fingernails and toenails grow slowly, visible improvement usually takes several months. Toenails often require 9–18 months to completely grow out.

  • No. Many thickened nails are caused by psoriasis, trauma, eczema or other inflammatory conditions. Laboratory testing may be recommended before prescribing oral antifungal medication.

  • Yes. Although nail psoriasis can be difficult to treat, many effective treatments are available, including prescription topical medications, oral therapies and biologic medications for more severe disease.

  • A new or changing dark streak within a nail should always be assessed promptly by a Specialist Dermatologist. While many pigmented nail lesions are benign, some may represent subungual melanoma and require urgent investigation.

  • Yes, particularly if your nail changes are persistent, painful, worsening, involve only one nail, or have not improved with over-the-counter treatments. Early diagnosis often leads to more effective treatment and can occasionally identify serious underlying conditions.

  • Occasionally, a nail condition cannot be diagnosed by examination alone. In these situations, a nail biopsy may be recommended to help determine the underlying cause and guide the most appropriate treatment.

    At Mermaid Beach Dermatology, we work with an experienced visiting surgeon who can perform nail biopsies when your Specialist Dermatologist considers this necessary. Nail biopsies are generally reserved for selected cases, such as persistent nail disorders, unexplained nail dystrophy, suspected inflammatory nail disease or when there is concern about a tumour or melanoma affecting the nail unit.

    Your dermatologist will discuss whether a nail biopsy is appropriate, explain the procedure in detail and coordinate your care if further investigation is required.

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