Onychomycosis: It Doesn’t Make You a Big Hit In The Bedroom

How often do we look at a person’s nails? Not as often as we cast an eye at other parts of the anatomy. But nails reveal much about a person’s general health. So the next time you’re invited to a dinner party, scan the nails. But if want to be invited back, wait for another time to announce a guest is suffering from onychomycosis.

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Is the person sitting next to you a bartender, lawyer, politician, nurse or homemaker? The clue may be brittle, split nails, the result of frequently having hands in water day after day. Water passes through nails 100 times faster than through skin. This causes swelling of nails and then when the hands are out of water, the nails become dry and shrink. This repeated accordion effect weakens nails, making them more susceptible to splitting. The best solution is the wearing of rubber gloves when hands are frequently exposed to water. Have any of the dinner guests made the common mistake of slamming a drawer or door on their fingers? If so, see if you can spot Beau’s lines, depressed horizontal marks that run across the nail. Unexpected trauma of this kind causes sudden interruption of nail keratin synthesis. The width and extent of depression varies according to the degree of trauma. But if you’re lucky enough to be invited back for dinner in a year’s time, you’ll discover Beau’s lines are gone. Nails grow at about one-tenth of a millimeter a day or about one inch every eight months. But there’s an off chance Beau’s lines are not due to injury. Local disease at the base of the nail can also cause these depressions. In fact, the dinner guest may have suffered a generalized disease. Nails are very sensitive to an acute illness, may stop growing and cause a fine groove to appear across all 10 fingernails in the same location. So if the horizontal depressions are half way down the nails, you can look like a genius by asking if the guest had a serious illness four months ago. Is another of the guests an uptight nail biter? Chronic trauma of this kind to the nail often results in what’s called “paronychia”. It’s an infection in which bacteria get underneath tissue at the side of the nail causing swelling and irritation. Constant picking of the thumb nail cuticle can also cause this condition. So look for a localized infection at the margin of the skin and nail. Take a look around the table to see if there’s a silent heavy drinker present? Cirrhosis of the liver causes an abnormally opaque, white nail instead of the usual pink colour produced by blood in the skin under the nail. Skin disease can also make its presence known at the dinner table. For instance, those who have psoriasis may have small, round pits in the surface of the nails. And if anyone is suffering from a chronic iron deficiency, you’ll notice spoon-shaped somewhat concave nails rather than the usual rounded surface. There’s a chance you may spot a dinner guest with the ugly nail syndrome, “onychomycosis”. This fungus infection affects 2.5 percent of the population and causes much embarrassment and misery. Infection begins at the nail plate, the hard protective surface which is most visible and gradually spreads up the nail. This person is often someone who wears heavy boots such as policemen and construction workers. Such footwear provides heat and moisture that fosters fungal infections of toenails. And ironically, the sufferer is often someone who frequents a health club. This diagnosis is usually easy. Yellowish-brown nails become thickened, cracked, and deformed, and eventually the nail may separate from the nail bed. It’s much more than a cosmetic problem. People with severely thickened, twisted nails find it impossible to button shirts or pick up something from the table. Others can’t type or wear regular shoes. And as a patient of mine said, “It doesn’t make you a big hit in the bedroom.” But if your host or hostess has onychomycosis and you wish to be invited back, wait until another time to tell him or her that drugs such as Lamisil murder the fungi.