Nail Disorders

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Dermatology at Swift Access Health

Nail Disorders

Nail disorders are a common dermatological concern, affecting the fingernails or toenails and ranging in cause from fungal infection and psoriasis to inflammatory conditions, trauma, and systemic disease. Changes in the colour, texture, thickness, or shape of the nails can be the first sign of an underlying medical condition — making accurate assessment by a consultant dermatologist important. Common presentations include thickened or discoloured nails, pitting, onycholysis (nail separation), ridging, brittle nails, and nail psoriasis.

At Swift Access Health, our dermatologists assess nail disorders comprehensively — using dermoscopy of the nail unit, nail clippings for mycology, and clinical examination — to reach an accurate diagnosis and recommend effective treatment. Many nail conditions can be treated with targeted medical therapy, and early intervention prevents complications such as permanent nail changes and dystrophy.

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Info

Time

30-minute appointment with a consultant dermatologist

Results

Depends on cause; fungal infections resolve with treatment; inflammatory conditions managed effectively

Risks

Untreated nail disorders can progress to permanent dystrophy; secondary infection if nails are broken

Recovery

Nails grow slowly — allow 3–6 months to see improvement after treatment is started

Treatment

Topical or oral antifungals, steroid injections, topical nail psoriasis treatments, or medical therapy

Aftercare

Keep nails trimmed, clean, and dry; protect from trauma; follow-up to confirm resolution

Why Choose Swift Access Health

Benefits of Specialist Nail Assessment

Accurate diagnosis and targeted treatment of nail disorders by a consultant dermatologist prevents progression, resolves distressing symptoms, and restores healthy nail appearance.

  • Dermoscopic nail unit examination (onychoscopy) for detailed non-invasive assessment
  • Nail clippings sent for mycological analysis to confirm or exclude fungal infection
  • Diagnosis and management of nail psoriasis, lichen planus, onycholysis, and brittle nail syndrome
  • Intralesional steroid injections for inflammatory nail conditions including nail psoriasis and lichen planus
  • Prescription oral antifungal treatment for confirmed onychomycosis
  • Identification of nail changes as a marker of systemic disease where relevant
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Your Patient Journey

1. Your
Consultation

Your dermatologist will examine the affected nails closely — including with a dermatoscope — and take a history covering onset, any associated skin conditions such as psoriasis or eczema, systemic health, and medications. Nail clippings may be taken for laboratory analysis. A diagnosis is reached and treatment options are discussed.

Your Patient Journey

2. Your
Treatment

Treatment depends on the underlying diagnosis. Fungal nail infection is treated with oral terbinafine or itraconazole. Nail psoriasis may benefit from topical treatments, intralesional steroid injections, or systemic therapy for patients with concurrent skin disease. Inflammatory nail conditions such as lichen planus are managed with anti-inflammatory therapies tailored to the severity of involvement.

Your Patient Journey

3. Aftercare

Good nail hygiene is important throughout treatment and beyond — keep nails trimmed short, dry, and protected from trauma. Footwear that allows airflow reduces recurrence of fungal infection. Follow-up appointments confirm clearance and assess nail regrowth, with treatment extended or adjusted as needed.

Frequently Asked Questions

  • Yellow or brown discolouration is most commonly caused by fungal infection (onychomycosis), but can also result from psoriasis, frequent use of nail varnish, smoking, or rarely subungual melanoma. White patches or bands can indicate trauma, nutritional deficiency, or systemic illness. Accurate diagnosis determines the right treatment.

  • Nail psoriasis affects up to 50% of people with skin psoriasis and can occur in isolation. It causes pitting (small dents in the nail surface), onycholysis (nail lifting from the nail bed), thickening, and discolouration. It can be effectively managed with topical treatments, steroid injections, or systemic therapy for more severe cases.

  • Brittle nails are very common and are often caused by repeated wetting and drying, frequent use of nail polish remover, or ageing. However, they can also be associated with iron deficiency, hypothyroidism, or other nutritional deficiencies. If brittle nails are accompanied by other symptoms, blood tests may be advisable.

  • Rarely, a dark streak running the length of a nail (melanonychia) can indicate subungual melanoma — a form of melanoma beneath the nail. Any pigmented nail streak — particularly if new, widening, or associated with pigmentation of the surrounding skin — should be assessed by a dermatologist without delay.

  • Nails grow approximately 3–4mm per month for fingernails and slightly slower for toenails. This means visible improvement following treatment takes months — typically 3–6 months for fingernails and up to 12 months for toenails. Treatment must be continued for the full prescribed course to achieve clearance.

  • Nail polish is generally not recommended during treatment for nail infections or inflammatory conditions, as it can trap moisture and obscure monitoring of the nail during recovery. Your dermatologist will advise based on your specific treatment plan.

Related Concerns

Concerns

Fungal Skin & Nail Infection

Concerns

Psoriasis