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Nail biting infections pictures: Girl’s Nail Biting Infection Nearly Leads To Fingertip Amputation

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Nail Infection, Bacterial (Paronychia) in Adults: Condition, Treatments, and Pictures – Overview

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Images of Paronychia

Overview

Paronychia, commonly known as bacterial nail infection, is inflammation of the region of the finger or toe from which the nail plate originates, which is called the proximal nail fold (PNF). This inflammation may occur in the short term (acute) or may be a long-term problem or one that keeps coming back (chronic).

Acute paronychia develops along a break in the skin and is usually seen at the side of the nail. This type of nail infection is often caused by a bacterial infection but may also be caused by herpes, a type of viral infection.

Chronic paronychia occurs most often in people whose hands are constantly or often exposed to moisture. This disorder often results from contact dermatitis, a type of skin inflammation caused by exposure to chemicals that are irritating to the skin. People with chronic paronychia may have periodic, painful flare-ups. This type of nail infection may be complicated by the addition of a fungal infection, commonly due to a type of yeast called Candida, or bacterial infection, and this may lead to abnormal nail growth.

Who’s at risk?

Acute paronychia may occur at any age but is particularly common in children. Viral paronychia occurs more often in adults and may be seen with genital herpes infection or in people who work in the health care industry.

Chronic paronychia is most common in adult women and those who work in places where their hands are kept moist, such as food handlers.

Signs and Symptoms

Bacterial nail infection most often affects the proximal nail fold of the fingers and less commonly affects the toes.

  • Acute: The proximal nail fold is red, swollen, painful, and may contain pus. Usually one nail is affected.
  • Chronic: The proximal nail fold is swollen, red, and has no cuticle (the strip of hardened skin at the base and sides of a fingernail or toenail). One or more nails may be affected.

Self-Care Guidelines

  • Try soaking the nails in warm water for acute paronychia.
  • Avoid water and chemical exposure to prevent symptoms of chronic paronychia.

When to Seek Medical Care

See your doctor for an evaluation if you notice signs of bacterial nail infection.

Treatments Your Physician May Prescribe

For acute paronychia, your doctor may:

  • Puncture and drain the affected area and test for bacteria or viral infection.
  • Prescribe antibiotics for a bacterial infection or an antiviral medication for a herpes infection.

For chronic paronychia, your doctor may:

  • Prescribe a topical steroid.
  • Prescribe a topical antifungal medication.
  • Prescribe an oral antifungal medicine or antibiotics.

Trusted Links

MedlinePlus: Nail DiseasesClinical Information and Differential Diagnosis of Paronychia

References

Bolognia, Jean L. , ed. Dermatology, pp.263-264, 1072. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.660, 2590. New York: McGraw-Hill, 2003.

How Nail Biting Causes Infections

Nail biting is more than just a bad habit. It can cause diseases. Most of the serious diseases associated with nail biting is a result of infections. It is not just the fingers that can become infected. Nail biting may lead to infections anywhere on the surface of the body and even internally. Most nail biters do not realize just how unhygienic the practice can be but more so how dangerous it may be. Some of these infections that arises with nail biting can be very serious and even lead to severe diseases that may be fatal without the proper treatment.

Contamination of the Nails

Biting your nails has a host of effects beyond the visible aspects.

  • Biting causes a jagged surface on the tip of the nails. It may not be clearly visible but the roughness can often be felt.
  • The teeth may also injure the nail bed and the skin on the sides of the nails. It may lead to breaks in the skin that is not always evident.
  • In the process of nail biting, bacteria from the mouth is transferred to the nail surface and skin on the fingertips.
  • Saliva being sticky in nature can also trap dust and microbes from the environment.

Due to the various effects of nail biting, an infection becomes likely for several different reasons depending on the site of the infection. We will look at some of the common localized infection caused by nail biting. However, nail biting can cause systemic infections. This means that many areas in the body are infected simultaneously. It is well known that nail biters are also more prone to contracting common human infections like the flu and cold.

Fingertip Infections

Nail biting can lead to infections of the skin lying around the nail. This is known as paronychia. It is mainly caused by bacteria or fungi. During the course of biting the nails, the teeth may injure the skin unintentionally. However, many biters also tend to bite at the surrounding skin or pick at it with their fingers.  The injury compromises the integrity of the skin and bacteria or fungi can the invade the tissue. Since the hands and especially the fingers are in contact with various surfaces and substances during the course of the day, the area is easily infected.

Even the normal skin flora, the bacteria that naturally live on the skin, will quickly infect the exposed area. Bacteria from the mouth may also be highly pathogenic. This means it can cause serious infections yet it is able to reside in the mouth without causing a problem in most instances. The reason that these bacteria may not be a problem in the mouth is that it is kept in check by other species of bacteria also residing in the mouth as well as saliva. However, once these bacteria make contact with the broken skin, it can quickly infect the exposed tissue of the fingertips.

Skin and Eye Infections

Even if you do not have skin diseases, it is only natural to scratch your body several times in a day. Often it is just gentle scratching and the itch, if present, is quickly relieved. Sometimes it is just a habit or a sign of nervousness. But when scratching with the fingertips that have jagged nails, even slight pressure can cause tiny tears in the skin. These tears may not be visible. It may not even pain or bleed. But it may be sufficient to create an entry point for bacteria and fungi to infect your skin. It may result in serious infections like impetigo which can then extend into deeper tissues causing cellulitis.

The eyes are just as prone to injury to the jagged bitten nails. We rub our eyes and even gently scratch our eyelids several times in a day often without realizing it. The skin on the eyelids are thin and the tissue of the eyes are very delicate. Injury and infection may lead to conditions like blepharitis, conjunctivitis and keratitis. The risk is much greater in contact lens wearers who have to make close contact with the eye to insert and remove the lenses. Sometimes the bitten fingernails may contaminate the contact lens and even cause it to tear which then injures the eye and implants the microbes from the fingers.

Mouth and Gut Infections

Countless microbes enter the gut through the mouth. These microbes may be in the food that we eat and fluids that we drink. It may be on the utensils that we use and on our hands when we feed ourselves. However, it is usually in small amounts and most dangerous microbes are not present if we practice proper hygiene and consume foods or drinks from reputable sources. Most of us wash our hands prior to eating. But nail biters do not practice this level of hygiene when they partake in their habit. Therefore the chances of introducing microbes from the environment that are not likely to enter the mouth under normal circumstances is high in nail biters.

The microbes can infect the mouth but the mouth has several mechanisms to prevent this from occurring. An infection can also arise in the gut once these microbes travel further down. Although the stomach acid is able to kill even large amounts of different microorganisms, some can survive the highly corrosive environment. In this ways microorganisms from the environment, either in the air or settled on objects (fomites), can enter the mouth and cause infections of the gut. A simple handshake, pressing a button or touching a doorknob and then biting the nails afterwards can introduce these microbes into the body.

Ways To Avoid Infections from Nail Biting

The best way to avoid infections is to stop biting the nails. However, it is often easier said than done. Here are some tips to reduce the chances of an infection if you are a nail biter.

  • Apply bitter-tasting nail polish on your fingers. Although nail biting is a compulsion that needs to be treated with behavioral therapy, the nail polish will at least minimize your nail biting.
  • File your nails regularly if you are a nail biter. Keep it smooth but remember that this does not make up for a habit that needs to be stopped.
  • Trim your nails before you can bite it. Although your biting is trimming it as well, some nail biters do not bite their nails on a daily basis.
  • Wash your hands thoroughly before and after you bite. Just as much as nail biting became a habit, you may be able to develop a routine of good hygiene that can also become a habit.
  • Carry a hand sanitizer so that you can at least disinfect the fingers regularly if you unconsciously bite your nails.
  • Think about where your hand has been before you bite. Does it have fecal particles that you picked up from a contaminated object? How many thousands or even millions of microbes are on your fingertips? If you regularly think about these issue, it may discourage you from nail biting.

Paronychia (for Parents) – Primary Children’s Hospital

What Is Paronychia?

Paronychia (pahr-uh-NIK-ee-uh) is an infection of the skin around a fingernail or toenail. The infected area can become swollen, red, and painful, and a pus-filled blister (abscess) may form.

Most of the time, paronychia is not serious and can be treated at home. In rare cases, the infection can spread to the rest of the finger or toe and lead to a deeper infection that may need a doctor’s help.

Kids usually don’t get paronychia in a toe (unless they have an ingrown toenail). But fingernail paronychia is one of the most common hand infections.

What Causes Paronychia?

Paronychia usually happens when the skin around the nail is irritated or injured. When skin gets damaged like this, germs can get in and cause an infection. These germs can be:

  • bacteria, causing bacterial paronychia
  • fungi, causing fungal paronychia

Things that can injure the skin around a nail include:

  • biting or pulling off a hangnail
  • frequent sucking on a finger
  • clipping a nail too short or trimming the cuticle
  • getting manicures
  • having hands in water a lot (as from a job washing dishes)
  • having an ingrown toenail

Kids with diabetes also have a higher chance of getting paronychia infections.

What Are the Signs & Symptoms of Paronychia?

If your child has paronychia, it’s usually easy to recognize. Look for:

  • an area of red, swollen skin around a nail that’s painful, warm, and tender to the touch
  • a pus-filled blister

Bacterial paronychia:

  • usually appears very suddenly

Fungal paronychia:

  • can take longer to notice and causes less obvious symptoms
  • can be a chronic condition (last for a long time)

Chronic paronychia can cause changes in the affected nail. It might turn a different color or look as though it is detached or abnormally shaped.

In rare cases, if the paronychia is especially severe and goes untreated, the infection can spread beyond the area of the nail.

How Is Paronychia Diagnosed?

Usually, a doctor or nurse practitioner can diagnose paronychia by looking at the infected area. In some cases, they may take a pus sample to be checked in a laboratory to see what type of bacteria or fungus caused the infection.

How Is Paronychia Treated?

Treating paronychia depends on how severe the infection is and whether it has started to spread. Often, soaking the infected nail in warm water for 20 minutes a few times a day will help it heal on its own in a few days.

If there’s an abscess, a doctor might need to drain it. In rare cases, part of the nail may have to be removed. The doctor also might prescribe antibiotics to treat the infection.

Usually, after an abscess is drained, the affected finger or toe heals quickly with no long-term problems.

For fungal paronychia, the doctor may prescribe antifungal creams, lotions, or oral (taken by mouth) medicines.

Can Paronychia Be Prevented?

Have kids follow these tips to lower their risk of paronychia:

  • Don’t bite or pick nails.
  • Trim fingernails and toenails with clippers or manicure scissors, and smooth the edges with an emery board or nail file. The best time to do this is after a bath or shower, when nails are softer. They shouldn’t cut their nails too short.
  • Don’t push cuticles back or trim them and don’t use cuticle remover. Damaging cuticles can let bacteria get into the skin and cause an infection.
  • Wear rubber gloves if there’s a chance their hands might be in contact with harsh detergents or chemicals.
  • If your child has diabetes, make sure it is well-controlled.

As much as possible, have kids try to avoid injuring their nails and the skin around them. Nails grow very slowly, so any damage to them can last a long time and increase the risk of paronychia.

When Should I Call the Doctor?

Call your doctor if:

  • Your child has paronychia that doesn’t get better with treatment.
  • The infection seems to be spreading.

Reviewed by: Elana Pearl Ben-Joseph, MD

Date reviewed: August 2019

Paronychia Treatment In Dallas | The Hand And Wrist Institute

What is a Paronychia?

Paronychia is an infection of the folds of skin surrounding the fingernail. There are two types of paronychia: acute and chronic. While paronychial infections are typically mild in severity, they can be complicated by abscess formation, felon, or osteomyelitis of the finger. It is important to seek treatment for a paronychia early before complications develop. Diabetics and people who are immunocompromised are prone to more serious presentations of paronychia.


What causes a Paronychia?

Paronychia is caused by the invasion of a microorganism under the skin of the nail folds. Acute paronychia are typically bacterial in nature, while chronic paronychia are usually fungal infections, onychomycosis. Traumatic injury to the nail folds results in a break in the integrity of the skin, allowing entry of microorganisms. Some common sources of nail fold trauma include manicures, hangnails, and fingernail biting. Moisture can also compound paronychia by providing an ideal environment for bacteria and fungi to thrive. Children who suck their fingers may experience paronychia for this reason. Likewise occupations and hobbies which expose hands repeatedly to moisture may result in paronychia. Dishwashers, nurses, and swimmers are a few examples.

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What are the symptoms of a Paronychia?

Acute paronychia presents with pain and swelling on a lateral nail fold. If an abscess is present, the area may be fluctuant, and a purulent discharge may be seen. Chronic paronychia presents with recurrent bouts of swelling of the nail folds. The proximal nail fold is typically involved. The symptoms are not as dramatic as seen with acute paronychia. Discomfort is present, and the affected area may have a spongy, boggy feel to it. Discharge is usually minimal, if present at all.


How is a Paronychia diagnosed?

Paronychia is a common infection and is usually diagnosed clinically based on a history of trauma to the nail fold and the symptoms described above. If drainage is present, it may be useful to perform a culture for bacteria and a KOH prep to identify any fungal elements to guide antimicrobial treatment. If herpetic whitlow is suspected, a viral culture would be useful to confirm the diagnosis. Imaging studies are generally not needed unless there is suspicion of a foreign body, fracture, or spread of infection to the bone.


How is a Paronychia treated?

Non-surgical

Minor paronychia, with redness, tenderness, and no fluctuant areas indicating abscess, can be treated with soaks. Epsom’s salts or Burrow’s solution soaks for approximately fifteen minutes three to four times a day may be all that is needed for the condition to heal. Soaks are useful in both acute and chronic paronychia.

If the paronychia involves more extensive redness without abscess, or if the patient is diabetic or immunocompromised, oral antibiotics oral antifungals will be needed in addition to the soaks.

Surgical

If an abscess is present, incision and drainage will be necessary. After the purulent material is removed, the wound will be irrigated and packed with gauze to allow healing to occur on its own. Sometimes removal of a portion of the fingernail may be needed.


How can Dr. Knight help you with Paronychia?

While not fatal (or even really painful), Paronychia can be an annoying ailment at best, and the fact of the matter is that no infection should go untreated, as it could possibly develop into other conditions that are far less benign. Should the infection spread into the bone, there could be very serious consequences, so it is best to treat quickly and fiercely to avoid this. Dr. Knight is well versed in treating these injuries, and will keep a simple infection from developing into something much more serious.

See Dr. Knight, one of the best hand surgeons in Dallas and see if he can help you live a more pain free life. Come to our Southlake hand and wrist center or Dallas Fort-Worth friendly office location.


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Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.

Finger Infections & Swollen Fingers: 6 Possible Causes

Finger Infection Overview

Injury or infection to a finger or fingers is a common problem. Infection can range from mild to potentially serious. Often, these infections start out small and are relatively easy to treat. Failure to properly treat these infections can result in permanent disability or loss of the finger.

Early recognition and proper treatment of the following main finger infections will help prevent most of the serious outcomes.

  • Paronychia: A paronychia is an infection of the finger that involves the tissue at the edges of the fingernail. This infection is usually superficial and localized to the soft tissue and skin around the fingernail. This is the most common bacterial infection seen in the hand.
  • Felon: A felon is an infection of the fingertip. This infection is located in the fingertip pad and soft tissue associated with it.
  • Herpetic whitlow: A herpetic whitlow is an infection of the fingertip area caused by a virus. This is the most common viral infection of the hand. This infection is often misdiagnosed as a paronychia or felon.
  • Cellulitis: This is a superficial infection of the skin and underlying tissue. It is usually on the surface and does not involve deeper structures of the hand or finger.
  • Infectious flexor tenosynovitis: This infection involves the tendon sheaths responsible for flexing or closing the hand. This is also a type of deep space infection.
  • Deep space infection: This is an infection of one or several deep structures of the hand or fingers, including the tendons, blood vessels, and muscles. Infection may involve one or more of these structures. A collar button abscess is such an infection when it is located in the web space of the fingers.

Finger Infection Causes

Bacteria cause most of these finger infections. The exception to this is the herpetic whitlow, which is caused by a virus. How the infection starts and is found in a particular location is what makes each specific type of infection unique. Usually some form of trauma is the initial event. This may be a cut, animal bite, or puncture wound.

  • Paronychia: The offending bacteria are usually staphylococcal and streptococcal organisms. Rarely, a fungus causes this infection, which usually begins as a hangnail. Often a person will attempt to bite off the piece of nail that is at the corner. This results in an open wound that allows the bacteria found on the skin and the bacteria found in the mouth to infect the wound. The infection can then spread to the surrounding tissue next to the nail and cuticle.
  • Felon: This bacterial infection of the finger pad, caused by the same organisms that cause paronychia, is usually the result of a puncture wound. The wound allows the introduction of bacteria deep into the fingertip pad. Because the fingertip has multiple compartments, the infection is contained in this area.
  • Herpetic whitlow: The offending viral organism is the herpes simplex virus type I or II. This is the same virus that causes oral or genital herpes infections. People in certain occupations are more at risk for this infection. These include dentists, hygienists, physicians, nurses, or any other person who may have contact with saliva or body fluids that contain the virus. People with oral or genital herpes may also infect their own fingers.
  • Cellulitis: The most common causes of this bacterial infection are staphylococcal and streptococcal organisms. This infection is usually the result of an open wound that allows the bacteria to infect the local skin and tissue. The infection can also spread to the hand and fingers by blood carrying the organisms.
  • Infectious flexor tenosynovitis: This bacterial infection is usually the result of penetrating trauma that introduces bacteria into the deep structures and tendon sheaths, which allows the spread along the tendon and associated sheath.
  • Deep space infection: This bacterial infection is usually the result of a puncture wound or deep cut that introduces the bacteria to the deep tissue. The collar button abscess is associated with the web space between the fingers. The deep structures of the hand create many potential compartments for an infection to invade.

Finger Infection Symptoms

Each of the main finger infections has specific signs and symptoms that make identification unique and can sometimes cause confusion if not properly evaluated.

  • Paronychia: The area next to the fingernail will appear red and swollen. A visible collection of pus may be seen under the skin and nail. This fluid may be actually leaking out of the wound. The area will be tender and painful to the touch. The drainage from the area is usually a cloudy white-yellow color.
  • Felon: The fingertip is swollen and painful. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch.
  • Herpetic whitlow: The fingertip area will be red and tender. A burning or itching sensation may be present in the area. There may be mild swelling, but not as extensive as in the felon. There may be a single or many open wounds in the area affected. These open wounds often occur in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy. You may also have a low-grade fever and have swollen and tender lymph nodes in the area.
  • Cellulitis: The area will be red and warm to the touch. The area may be slightly swollen and tender. This is usually a superficial infection, so the deep structures should not be involved. The motion of the fingers and hand should not be difficult or painful. If painful or difficult, this may indicate a deep space infection of some type.
  • Infectious flexor tenosynovitis: Four major signs often are found with this condition. First is tenderness over the flexor or palm side of the finger. This pain is found over the tendons in the finger. Second is uniform swelling of the finger. Third is pain on extending or straightening of the finger. Fourth, the finger will be held in a slightly flexed or partially bent position. These signs are called Kanavel cardinal signs. All 4 signs may not be present at first or all at once.
  • Deep space infections: The deep space infection that arises in the web space of the fingers is also called a collar button abscess. The space between the fingers will be painful and swollen. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin.

When to Seek Medical Care

The key to preventing disability and possible loss of the finger is early and appropriate treatment. If any signs and symptoms are present, you should contact your doctor at once.

If you have signs or symptoms of a felon, cellulitis, infectious flexor tenosynovitis, or deep space infection, you should seek emergency care at once.

Exams and Tests

The correct diagnosis will start with a detailed history and physical exam. People who have a localized infection will be treated differently than someone with a severe infection. Coexisting problems such as diabetes or blood vessel disorders of the arms and legs will complicate the infection and may change the degree of treatment.  

  • Important information that your doctor will need to know will include the following:
    • How did the injury or infection start?
    • When did this first occur or begin?
    • Where did it occur? Home? Work? In water? In dirt? From an animal or human bite?
    • Is it possible that a foreign body is in the wound?
    • What have you done to care for this before seeing your doctor?
    • When was your last tetanus shot?
    • Any previous injuries to the area?
    • Any other medical problems that you may have not mentioned?
  • Specific information may help pinpoint the type of finger infection:
    • Paronychia: A history of nail biting may aid the diagnosis.
    • Felon: A history of a puncture wound or cut will aid the diagnosis. This would include a plant thorn. The doctor may obtain an x-ray to look for involvement of the bone or possible foreign body.
    • Herpetic whitlow: A history of contact with body fluids that may contain the herpes virus will aid the diagnosis. The diagnosis can often be made from the history and the appearance of the lesions. The presence of a clear fluid from the wounds may indicate a viral infection rather than a bacterial infection. A sample of the fluid may be analyzed by a Tzank smear, which will identify certain cells, indicating a viral cause.
    • Cellulitis: The doctor will need to consider other causes that may look similar such as gout, various rashes, insect sting, burns, or blood clot before the final diagnosis is made. An X-ray may be obtained to look for a foreign body or gas formation that would indicate a type of serious cellulitis.
    • Infectious flexor tenosynovitis: A history of a puncture wound or cut will aid the diagnosis. The presence of the 4 Kanavel cardinal signs is a strong diagnostic aid. A recent sexually transmitted disease may indicate a type of gonorrhea-related infection, which may resemble infectious flexor tenosynovitis.
    • Deep space infections: A history of puncture wound or other wound may aid the diagnosis. The finding of swelling between the fingers with a slow spreading of the involved fingers will help identify a collar button abscess.

Finger Infection Treatment – Self-Care at Home

Because finger infections have the potential to become severe, home care is limited. A very minor paronychia may be managed at home if you have no other complicating medical illness, such as diabetes. All of the other infections require urgent evaluation and treatment by a doctor. Because delay in treatment may result in disability or loss of the finger, you should not hesitate to obtain medical care.

A small, simple paronychia may respond to frequent warm water soaks and elevation of the hand. However, if no improvement is noticed in 1–2 days, you should see your doctor at once.

Medical Treatment

The mainstay of treatment for finger infections is antibiotics and proper wound care. This can range from a simple incision and drainage of the wound to an extensive surgical exploration of the wound to remove as much infected material as possible.

Some of the infections can be treated in a doctor’s office or clinic, but several will require inpatient treatment and IV antibiotics. Because the organisms that cause these infections are similar, many of the same types of antibiotics may be used.

  • Paronychia: Often the wound may be treated with wound care alone. If a collection of pus is present, it will need to be drained. This may be done in several different ways. Commonly a scalpel is used to make a simple incision over the collection of pus to allow drainage. Or the scalpel may be inserted along the edge of the nail to allow drainage. If the infection is large, a part of the nail may be removed. If this procedure is required, the doctor will inject a local anesthetic at the base of the finger that will provide for a pain-free procedure. Most often, you will be placed on an oral antibiotic. You will then be instructed how to take care of the wound at home. (See paronychia.)
  • Felon: Often, incision and drainage is required because the infection develops within the multiple compartments of the fingertip pad. Usually an incision will be made on one or both sides of the fingertip. The doctor will then insert an instrument into the wound and break up the compartments to aid in the drainage. Sometimes, a piece of rubber tubing or gauze will be placed into the wound to aid the initial drainage. The wound may also be flushed out with a sterile solution to remove as much debris as possible. These infections will require antibiotics. The wound will then require specific home care as prescribed by your doctor.
  • Herpetic whitlow: Antiviral drugs such as acyclovir (Zovirax) may shorten the duration of illness. Pain medication is often needed. The wound must be properly protected to prevent a secondary bacterial infection and to prevent you from infecting other sites on your body or other people. Incision and drainage is not proper and, if done, may actually delay healing.
  • Cellulitis: This infection is superficial, and oral antibiotics are usually sufficient. If the area is extensive or your immune system is weakened, then you may be treated in the hospital with IV antibiotics.
  • Infectious flexor tenosynovitis: This is a surgical emergency and will require rapid treatment, hospital admission, and early treatment with IV antibiotics. Usually, the area will need to be surgically opened and all debris and infected material removed. Because of the intricate nature of the fingers and hands, a hand surgeon will usually perform this procedure. After surgery, several days of IV antibiotics will be required followed by a course of oral antibiotics.
  • Deep space infections: Much like flexor infectious tenosynovitis, this can require emergency care. If the infection is mild, then only oral antibiotics may be needed. If more severe, a hand surgeon should evaluate the wound and IV antibiotics begun. Often these wounds will require incision and drainage followed by a course of antibiotics.

Next Steps – Follow-up

You need to understand the doctor’s instructions completely and ask any questions you have in order to thoroughly understand your care at home.

  • If you have been prescribed antibiotics for a finger infection, you must follow the directions and take them for the prescribed time period.
  • Often, your doctor will instruct you to keep your hand elevated to prevent swelling. This is important and needs to be done both during the day and night. By placing pillows next to you while sleeping, your hand can remain elevated.
  • Wound care will often need to be continued at home. This may include daily warm water soaks, dressing changes, and application of antibiotic ointment. The different types of wound care are extensive. Your doctor should explain in detail.
  • The finger or hand may be placed in a splint. This provides both immobilization and protection. It will be important to follow the instructions regarding the care of the splint. You will need to protect and properly care for the splint. You should closely monitor the finger or hand to watch for complications such as swelling or infection under the splint.
  • Often, you will be asked to return to the doctor’s office in 24-48 hours. This may be necessary to remove packing or change a dressing. It is very important that you have close follow-up care to monitor the progress or identify any further problems.

Prevention

Common sense safety practices will help prevent many of the finger wounds that become a problem. Simple things such as wearing protective work gloves may prevent injury. Wearing latex or vinyl gloves is mandatory if possible exposure to bodily fluids is expected. Avoid chewing on your nails, and wash your hands as needed. Seek early medical attention as soon as you think an infection is present.

Outlook

If the infections are treated early and properly, the prognosis for full recovery is good. However, if treatment is delayed, or if the infection is severe, the prognosis is not as good.

  • With the infections that involve deep structures such as infectious flexor tenosynovitis, even with the best care, the outcome may be less than desirable. Loss of function, loss of sensation, disfigurement, or even loss of the finger is possible.
  • Your doctor will need to evaluate each case individually and present the likely outcome based on the findings.

For More Information

See the following for related finger injuries:

Multimedia

Media file 1: Flexor tendon sheaths and radial and ulnar bursae. Image courtesy of Randle L Likes, DO.
 

Media type: Illustration

Media file 2: A herpetic whitlow. Image courtesy of Glen Vaughn, MD.

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Media file 3: A moderate paronychia. Swelling and redness around the edge of the nail is caused by a large pus collection under the skin. Image courtesy of Christina L Kukula, DO.

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Media file 4: Drainage of pus from a paronychia. Image courtesy of Glen Vaughn, MD.

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Media file 5: A paronychia can progress to a felon if left untreated. Image courtesy of A paronychia can progress to a felon if left untreated. Image courtesy of Glen Vaughn, MD.

Media type: Photo

Media file 6: Anatomy of the fingernail. Top – The normal fingernail. Bottom – Nail bed laceration with subungual hematoma.

Media type: Image
 

Synonyms and Keywords

paronychia, hangnail, onychia lateralis, onychia periungualis, felon, whitlow, herpetic whitlow, cellulitis, infectious flexor tenosynovitis, pyogenic flexor tenosynovitis, flexor tendosynovitis, tendosynovitis, deep space infections, collar button abscess, finger injury, finger infection, onychomycosis

Nail Problems and Injuries | Michigan Medicine

Topic Overview

Minor fingernail and toenail problems are common. At one time or another, almost everyone has caught a nail on something, causing it to rip, or has smashed a finger in a door, leaving blood under the nail. These kinds of injuries can be quite painful but are usually not serious. You can often relieve pain and prevent infection of minor nail problems at home.

Normally, fingernails grow about one-tenth of a millimeter each day. Toenails grow at about one-half or one-third the rate of the fingernails. Aging and diseases that decrease blood flow to the hands and feet may slow nail growth.

Common nail changes include:

  • Splitting, peeling, or brittle nails. These are common problems that develop when your hands are frequently exposed to water, strong soaps, and other chemicals. You may be able to prevent some of these problems if you use lotion and avoid repeatedly putting your hands in water.
  • Color changes.

    • Little white marks (leukonychia) often appear after minor injuries. They may last for weeks or months and usually go away on their own.
    • It is common for a nail to turn black after an injury. The black or purple-black color is caused by blood under the nail and will go away as the injury heals.
    • Black, brown, or purple discoloration under a nail that has not been injured may be caused by melanoma.
  • Changes in the shape or texture of nails, which may occur for a variety of reasons. Some nail changes, such as the formation of ridges, are normal with aging. Thick, brittle, or dark nails are more common in older adults who have poor circulation.
  • Ingrown nails, which are often caused by improper trimming, tight shoes, or heredity. Your nails may grow into the surrounding skin, causing pain, swelling, and infection. In rare cases, an abscess may develop under a nail (subungual abscess).
  • Separation from the nail bed. Once your nail separates from its nail bed, for whatever reason, it will not reattach. Nails grow back slowly. It takes about 6 months for fingernails and up to 18 months for toenails to grow back attached to the nail bed.
  • Infection and allergic reactions. These are common problems caused by artificial nails.
  • Fungal nail infections, which can vary in appearance depending on the type of fungus infecting the nail or the location of the infection. It is not unusual for fungal nail infections to follow athlete’s foot infections. For more information, see the topic Fungal Nail Infections.

Nail problems can also be caused by:

  • An injury to a nail.
  • Hangnails, which may lead to a minor infection next to your nails (paronychia), causing the skin around the nails to become swollen and tender.
  • Nail-biting, which can lead to fingertips that are red and sore and cuticles that bleed. Nail-biting also increases the chance of bacterial infections around your nail beds and in your mouth.
  • Side effects of medicines, such as chemotherapy and antimalarial medicines.
  • Diseases of the skin, such as psoriasis and eczema.
  • Skin growths, such as warts, cysts, and moles.
  • Other diseases such as Addison’s disease, peripheral arterial disease, and HIV infection.

Check Your Symptoms

Do you have a problem with your nails?

This means a problem that affects the nails only and not any other part of the limb (no other parts of the finger or hand or of the toe or foot).

How old are you?

Less than 12 years

Less than 12 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Did you injure a nail?

This could include tearing a nail, separating a nail from the nail bed, or hitting the nail hard enough that blood collects under it.

Do you have pain under or around the nail?

How bad is the pain

on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

Do you have diabetes, a

weakened immune system

, or peripheral arterial disease?

Yes

Diabetes, immune problems, or peripheral arterial disease

No

Diabetes, immune problems, or peripheral arterial disease

Is there an object under the nail that you cannot remove?

Do you think you may have a fever?

Are there red streaks leading away from the area or pus draining from it?

Do you have an ingrown nail?

Ingrown means that the nail has grown into the skin instead of over it.

Have you had nail problems for more than 2 weeks?

Yes

Nail problems for more than 2 weeks

No

Nail problems for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Home Treatment

Home treatment can help relieve pain, prevent infection, and promote healing. To relieve pain from an injury to the nail, try the following:

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever pain:

Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Signs of infection develop.
  • Symptoms become more severe or frequent despite home treatment.

Prevention

To prevent common nail problems:

  • Apply hand cream frequently throughout the day. Be sure to massage the cream into the nail and cuticle.
  • Wear gloves when you are working in your garden or when the weather turns cold.
  • Wear cotton-lined rubber gloves or disposable plastic gloves to protect your hands from overexposure to water, detergents, and other chemicals.
  • Trim your fingernails weekly, after bathing, when they are softer.
    • Do not trim nails too short.
    • Use an emery board and sharp manicure scissors or clippers to trim your fingernails. Nails that are smooth and well-cared for are less likely to become damaged.
  • Trim toenails monthly, after bathing.
    • Cut them straight across and leave the nails a little longer at the corners so that the sharp ends don’t cut into your skin.
    • If you have a chronic disease, such as diabetes, peripheral arterial disease, or a disease that causes problems with your immune system, discuss with your doctor the best way to trim your toenails before trimming them yourself.
  • Be especially careful when trimming your baby’s nails.
  • Avoid trimming your cuticles. Even a minor cut alongside your nail can cause infection.
  • Do not bite or pick at your nails.

To prevent a fungal nail infection:

  • Keep your feet clean and dry. Dry feet are less likely to become infected. Apply powder to your feet when needed.
  • Wear clean, dry socks. Change your socks once a day or more frequently if they become wet.
  • Wear roomy shoes that allow air to circulate around your feet.
  • Wear shower sandals or shower shoes when you use public pools, spas, and showers.

To prevent problems with artificial nails:

  • Test for a reaction to the artificial nail by having just one nail applied. Wait several days to see whether redness, itching, pain, or rash around or under the nail or separation of the nail from the nail bed develops.
  • Do not apply an artificial nail if the nail or the skin around the nail looks irritated or infected.
  • If an artificial nail does separate from the nail bed, dip your fingertip into rubbing alcohol for 15 seconds before reattaching the artificial nail. This will clean the space between the nails.
  • Do not wear artificial nails for longer than 3 months at a time. Give your natural nails a month to rest before reapplying artificial nails.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • When did your nail problem begin?
  • Was there an injury?
  • Have you had a nail problem like this in the past? If so, how was it treated?
  • Did you try any home treatment? If so, what? Did it help?
  • Has anything improved your nail problem or made it worse?
  • Are you taking any medicines?
  • Do you have any health risks?

Credits

Current as of:
February 26, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine

Current as of: February 26, 2020

Author:
Healthwise Staff

Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine

What Causes Hangnails and How to Treat Them

Rolf BrudererGetty Images

It can seem ridiculous that a little piece of skin near your nail can hurt like hell and annoy you all day. But as anyone who’s had a hangnail can attest, they’re all that and more. They’re painful, nasty looking, and they get even worse if you’re tempted to get rid of them right now by whatever means you have on hand—which is usually your fingers or your teeth. Don’t do it!

Most hangnails seem to pop out of nowhere. “Most people don’t notice a hangnail until after it has fully developed and they feel roughness around the nail or pain from inflammation,” says Benjamin J. Jacobs, M.D., hand surgeon at Rebound Orthopedics and Neurosurgery in Portland, Oregon.

And when you do notice them, you usually want to get of and treat them right now. Which is fine if you have the right tools—and your other fingers and your teeth are not the right tools. To know how to treat hangnails right and prevent them next time, it helps to know exactly what hangnails actually are.

Of course, hangnails aren’t part of your nail at all—they’re actually made of skin cells that form small, tag-like projections near the nail, says Dawn Davis, M. D., dermatologist at the Mayo Clinic. They occur when the skin separates from the surface, but still remains anchored at the base.

People with dry skin seem to get them more frequently, says Dr. Jacobs. Dry skin can trigger skin separation (and since you’re more likely to have dry skin in the winter, that explains the preponderance of hangnails you get in that season, too).

The reason they hurt so badly comes down to their location. “There are many nerve endings and blood vessels in this area,” says Dr. Davis. In addition, hangnails usually come with inflammation, and that swelling can press on and irritate all those nerve endings.

How to treat hangnails

Avoid the temptation to rip the little suckers off. Not only will yanking off inflamed tissue hurt, but you’re also leaving your fingers prone to infection.

“When you pull them off, you typically tear some of the normal surface skin that keeps out bacteria,” says Dr. Jacobs. “When you pull off a hangnail, you can develop an infection of the surrounding skin.”

Biting them off introduces germs into both your fingers and your mouth. So strike that option, too.

Instead, if you do notice a hangnail, follow these steps to take care of it.

Ideally, you’ll want to soften the skin before you start treating it, so wash your hands or take a warm shower. Sanitize a fingernail clipper or nail scissors with rubbing alcohol, and then cut the hangnail off close to the normal skin level, says Dr. Jacobs.

Then apply a lotion to protect skin from drying out even more and creating more hangnails. Look for a lotion with low alcohol and water content—these ingredients will dry out the skin more, he says.

If your hangnail is already pretty painful and red, it’s likely already inflamed. An inflamed hangnail isn’t necessarily an infected hangnail—yet—but you’ll need to keep an eye on it during treatment.

Treat inflamed hangnails with ice and over-the-counter pain medication to help with the symptoms, says Dr. Jacobs. An antibiotic ointment in addition to that can help prevent an infection from developing.

But if it’s already inflamed and infected? More severe pain and redness over a larger area can indicate infection. Another telltale sign: Drainage, or pus.

If you have concern that there may be an infection, you should seek medical attention—some skin infections in the fingers can get nasty and be persistent and you may even need oral antibiotics for them.

How to prevent hangnails

What you can do to protect your hands from hangnails is pretty basic—which means it’s super doable.

  • Keep your skin hydrated. That means use hand lotion on a regular basis, especially after showering and after washing your hands.
  • Wear gloves when you’re outside and it’s cold, and also when you’re washing dishes. Cold can be drying, but so can hot water and soap.

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    90,000 Why can’t you scratch mosquito bites? Can mosquitoes in Russia carry dangerous diseases? By infectious disease specialist

    Scratching mosquito bites is not worth it, despite the fact that it is very pleasant. Then reckoning always comes – the bites swell even more, itch more and heal longer. Where does the itch come from, what will help to cope with it and what dangerous diseases mosquitoes can carry in Russia – says Yulia Korzhenkova, an infectious disease specialist at the Ilyinsky Hospital .

    Better not to be bitten: simple rules

    The best thing about dealing with mosquitoes is to avoid them.They are most active from evening to dawn. Most of the mosquito flocks are near water bodies, swamps, in shady parks and forests. If an evening walk in these places cannot be avoided, clothes should cover the skin as much as possible. You should definitely use repellents. There is a great choice of them, but the main thing that you should pay attention to when buying is whether it is possible to use the product on the body or only on clothes. Both options are acceptable and effective, but it is important not to apply the one for clothes to the skin – this can cause irritation.

    It is worth using fumigators indoors with the window open, especially if you notice that mosquitoes have become frequent guests in your bedroom due to the open windows.

    Why does a mosquito bite itch?

    Only female mosquitoes bite and suck blood. Males feed on flower nectar. Itching that a person feels after a bite is a reaction to saliva. The mosquito injects it before a meal to prevent blood clotting. It acts as an allergen and causes an allergic reaction – itching, swelling of the bite site.

    Can bites be scratched? This is a relief, right?

    It is definitely impossible to scratch. Scratching most often leads to infection. Normally, conditionally pathogenic flora is present on the skin of every person – bacteria that can cause disease only under certain conditions. More bacteria under the fingernails.

    Combing a bite, a person injures the skin and brings pathogens from under the nails to the place of injury. This causes inflammation of the bite site: it can turn red, swell, and start to fester.This means that treatment will be required, and the wound will take longer to heal than if it is not scratched at all.

    How to smear mosquito bites so that they do not itch?

    Pressing down on the bite with your finger or the back of your nail will also help relieve the urge to scratch. But you should not press with the sharp part of the nail – this is tantamount to combing.

    To relieve itching, you can use “Calamine” – a lotion with calamine (zinc carbonate plus iron oxide) and zinc oxide. It is a white solution – when it dries, it forms a crust and relieves itching topically.It is actively used in pediatrics and helps in most cases. It is reapplied several times throughout the day, but it is important to rinse off these white crusts once a day to monitor the condition of the bite and check for infection. The drug is not absorbed and has no systemic effect on the body

    If the action of “Kalamin” is not enough, then apply a cream with 1% hydrocortisone content (for example, “Lokoid”), this is a hormonal drug.

    Does sprinkling alcohol and applying soda really help?

    Alcohol is unlikely to relieve itching, but it disinfects – this is the prevention of secondary infection when combing.Some people use perfume for these purposes, sometimes it may even seem that it is more effective than just wiping the bite with alcohol. This is because spraying a cool perfume has a local cooling effect and can thus relieve itching.

    To relieve itching, you can use cold (apply ice or something cool to the bite), as well as soda – it is mixed with water until mushy and applied to the bites. Drying, the composition forms a crust, similar to “Kalamin”.

    Do mosquitoes carry disease? How can you get infected from a mosquito?

    The first association with diseases and mosquitoes is malaria. But in Russia it has not been registered for a long time. It is believed that scientists defeated the disease in the USSR by the early 1960s. 94% of the world’s malaria cases now occur in Africa.

    Mosquitoes can also transmit Dengue fever, chikungunya, yellow fever and Zika viruses. Most often, these are female mosquitoes of the species Aedes aegypti and, to a lesser extent, Ae.albopictus. In Russia, these types of mosquitoes do not live – only in the tropics.

    On the territory of Russia, mosquitoes can carry bacterial infections (tularemia) and parasitic diseases (dirofilariasis). But this is extremely rare: according to rough estimates, there are a maximum of 2-5% of infected mosquitoes on the territory of the country.

    Mosquito bite allergy: how to recognize and what to do

    As a rule, mosquito bites do not cause serious consequences. Only if there is an allergy called Skeeter’s syndrome, a strong local reaction will appear after the bite: an itchy rash, painful redness, swelling and induration up to 2-10 cm in diameter.All this can be accompanied by fever (fever).

    In case of such a reaction, it is recommended to take an antihistamine, and in case of fever – non-steroidal anti-inflammatory drugs (for example, based on ibuprofen). In severe cases, you need to call an ambulance.

    Unless a person has Skeeter’s syndrome, a severe allergic reaction is unlikely to occur: generalized urticaria and anaphylaxis are very rare.

    Source: sports.ru

    Kozheed beetle bites in the apartment. Photo

    No matter how carefully we maintain cleanliness and hygiene in our home, it happens that despite all the efforts we make, we have to deal with domestic pests. Most often, the threat comes from the world of insects, the assortment of inconspicuous small creatures that can be found in secluded places of the house is very wide – these are cockroaches, and bugs, and flies, and ants. The most unpleasant thing in this situation is that it is becoming increasingly difficult to find a reliable and safe way to destroy the invaders of the territory.Of course, when we are dealing with the invasion of small aggressors, we are most afraid of bites, the infection that can occur after a bite. In this article, we will consider how relevant this fear is, when skin beetles appear in the house, what skin bites look like, how to deal with an insect.

    Kozheed beetle: specificity of the species, lifestyle

    One of the smallest and at the same time common pests in the house are kozheed beetles. The average body length of insects is from 1.3 to 12 mm, the shape is oval or almost round, the integuments of the shell are covered with small hairs.The dark brown or black color of the carapace allows insects to remain undetected on dark surfaces, in hidden places under furniture.

    Kozheed beetle

    Covered with many long hairs, the larvae have a spindle-shaped body, sometimes an especially large tuft of hair forms a kind of brush-tail.

    The development of a new generation of insects begins in May after mating of the beetles. In the same month, females lay eggs, taking care of their future offspring, they lay them in places where the larva will find a sufficient amount of food that it needs for growth and development.Interestingly, adults feed mainly on plant sap, but the larva, which must survive 5-6 molts before becoming an adult, needs a different diet – dry matter of plant or animal origin. Woolen carpets (a special type of carpet skin-eater stands out), zoological and plant collections that are poorly looked after, as well as dry food reserves can become excellent food for the larvae.

    Is the skin-eating beetle dangerous for humans

    The appearance of any insect in a living room is dangerous, the skin-eating beetle is no exception to the rule.If this amazing insect has occasionally caught your eye, you urgently need to check the state of all things that may be of interest to the kozheed from a gastronomic point of view.

    Most often, eggs are laid in rarely ventilated areas – storerooms, closets, sheds, not attics, in basements. Looking for a place rich in food for her offspring, which will provide him with a quick and comfortable development into an adult bug, a female skinhead can look into an apartment.In apartment conditions, kozheedy can live in carpets, dry food supplies, dried herbs, less often in clothes made from natural fabrics.

    The main danger that comes from the skinhead for humans is the discomfort that causes the presence of any insect; damage to expensive things; spread of infections. The problem of beetle bites is somewhat controversial, on which we will dwell in more detail.

    Do the beetles themselves bite the larvae of the skin beetles

    In 2-3 weeks after laying the eggs, the larvae appear from them.The hairy little caterpillars have a long journey from larva to adult. Most species of kozheeda undergo a one-year generation, however, there are those that take two years to grow into an adult insect. During this entire period, the insect must actively and intensively feed. Kozheedy do not belong to blood-sucking parasites, however, like any other insect, they can bite.

    People are afraid of kozheedov because they fear that they might bite.In fact, it is difficult to unequivocally answer the question of whether these insects bite people, since different sources provide different information. From the point of view of encyclopedic sources, a kozheed bite is a myth, the only danger that comes from a beetle is economic harm, the loss of valuable things from wool and silk.

    Meanwhile, on the Web you can find a photo of a skin bite. In the photographs, the bite of a kozheed beetle (see kozheed beetles bites in the photo) looks about the same as the bite of any other insect – it is a local reddening of the skin and a bite mark.Most likely, if kozheedy bite people, then in extremely rare cases. Twelve millimeter kozheeda larva and bites are incompatible. It can be assumed that people associate them into one, therefore, immediately after they find marks on their bodies that resemble bites, they notice skin beetles or their larvae in the room. An attack on humans is not characteristic of either larvae or adult insects of this species. But the appearance of spots and redness can be explained by an allergic reaction to the presence of beetles in the living room, so in any case, it is necessary to fight with unexpected guests.

    How to deal with skin beetles

    Thorough cleaning of the room is a sure remedy for skin beetles. It is better, of course, if you find the kozheed at the egg stage at home, then your things will not be damaged. Females lay eggs in small batches, each egg has an elongated oval shape. In order to destroy eggs, rinse things thoroughly in soapy water, it is better to soak them in it for a while.

    For the destruction of larvae and beetles, you can use boric acid powder, which is harmless to humans.Alternatively, mothballs can be placed in the contaminated areas. If none of the recommended methods worked, use chemicals, but be careful when choosing and using them.

    In the future, remember about the prevention of skin diseases: do not make a dump of vegetables and food waste at home, do not forget to take care of your plant, entomological and zoological ones

    Tick-borne borreliosis (Lyme disease) – symptoms and consequences of borreliosis

    What is tick-borne borreliosis?

    Tick-borne borreliosis (Lyme disease) is an infectious disease characterized by a wide range of symptoms, the most famous of which is erythema annular migrans.The main cause of Lyme disease is the ingestion of Borrelia bacteria. This type of bacteria is carried mainly by ticks, in which they multiply and are excreted along with feces, however, this type of infection can also be present in some types of lice – human, pubic ..

    The mechanism of human borreliosis infection occurs through a tick bite. When a tick is bitten or crushed with hands, when its contents, often in conjunction with borrelia, fall under the skin, an allergic-inflammatory reaction develops in this place, characterized by erythema, gradually migrating to neighboring parts of the body, and later, the person shows signs of intoxication organism.

    The incubation period of tick-borne borreliosis is from 1 to 30 days, most often 7-14 days. During this period, only redness can be seen on the human skin, which increases over time and begins to resemble a “target” in the pattern, however, after 10 days, the bite site turns pale, while the “rings” remain clearly pronounced. As the erythema increases and spreads, and in size it can reach 3-70 cm, itching, swelling, and sometimes soreness of the affected skin area appear at the site of the bite.This redness with rings is called erythema annulus, and due to the fact that it can move to other areas of the skin, it is called erythema annular migrans.

    At the same time, bacteria begin to spread through the circulatory and lymphatic systems throughout the body, often provoking the appearance of reddening of the skin in other parts of the body.

    A few days later, at the end of the incubation period for the reproduction of Borrelia, the victim begins to feel signs of intoxication (poisoning).Common symptoms at this stage of Lyme disease are general malaise and weakness, mild headaches, nausea, and muscle and bone pain. The body temperature rises to 38 ° C, sometimes chills are present. Further, after about a week, the body temperature drops to 37 ° C and accompanies the victim for several more days. The bite site begins to lose sensitivity and shrinks.

    Additionally, the patient may have a skin rash, conjunctivitis, arthralgia, sore throat, cough, testicular edema.

    The insidiousness of Lyme disease is that its first signs, described above, may disappear after a few days or weeks, even without treatment, but the infection remains, and an unsuspecting person becomes a carrier of the infection, which, having passed into a chronic form, gradually harms the body.

    If a person has a weakened immune system or any developmental abnormalities, genetic predisposition, as well as in the absence of the necessary treatment, the symptoms of borrelia lesions can be quite unpredictable, affecting the nervous and cardiovascular systems, the musculoskeletal system, the lining of the brain , leading a person to disability, and even death.

    Important! The immune response to infection with borrelias is late, therefore, in order to prevent chronic Lyme disease, it is necessary to consult a doctor not only at the first signs of borreliosis, but also immediately after a tick bite.

    Prevention of tick-borne borreliosis

    implies compliance with safety rules to prevent tick bites. There are currently no other preventive measures to prevent the onset and development of Lyme disease, including vaccination.

    Thus, in order to prevent a tick bite, it is necessary: ​​

    • When hiking in the forest, dress so that the tick cannot get on your skin – high boots, long trousers tucked into socks, a long-sleeved shirt tucked into trousers, it is good if with tight cuffs, gloves and a hat;
    • Treat clothes with insect repellent agents – so-called repellents;
    • Treat open areas of the body well with repellents;
    • If you have a dog in the house, after a walk, be sure to examine it for ticks, i.e.because they can get off the animal and crawl onto a person.

    If the tick does get on the skin and sticks, it must be removed.

    You need to unscrew the tick gradually, not pressing hard on it, so that its inner contents do not get under the skin, because it is this content that contains borrelia – the causative agents of borreliosis.

    When you have captured the tick by its head, gradually unscrew it like a screw. After the bite site, treat with a disinfectant.

    After removing the tick, consult a doctor.

    Also remember, when removing a tick, for example from an animal, do not crush it with your nails, so that the contents of the tick do not get on the skin. If there is an open wound on the skin (cut, etc.), the infection can easily get there and infect the body.

    Oh wound: dangerous fashion is gaining popularity among young people | Articles

    Light cuts and burns are in vogue in Europe. Mainly among young people. Adolescents inflict injuries on themselves, completely voluntarily and on their own initiative.Doctors say that “the process is as addictive as drugs.” What is the reason for this phenomenon and what to do about it – in the material of Izvestia.

    Blood soothes

    “The first time it was by accident – I felt itching at the site of the mosquito bite. Scratching was a natural reaction. I drove with my nails for a long time – the itching did not calm down. Increased pressure – blood appeared. I looked at her as if spellbound. There was a feeling that I had touched naked nerves and felt a thrill, ”- Hema Rodriguez (surname changed at her request.- Approx. Ed.) talks about the experienced feelings, more often looking at his forearm than in the eyes of the interlocutor.

    Her arm is striped with transverse scars from hand to elbow. Smooth – traces of knife cuts. Curved – from the contact of other objects that can break through the skin.

    Photo: Depositphotos

    “I remember the feeling, I wanted more. You know, it so happens that someone, in a fit of anger and a desire to hammer the physical pain in his heart, hits the wall with his fist.Or she bites her lip. Or he decides to slash his hand. No matter what: a knife, scissors, a nail, a piece of a plastic fountain pen, a zipper on a jacket … If only there was blood. It is soothing. Gradually you realize that you need it, you cannot do without it. It is addictive. Probably like a drug (I haven’t tried it – I don’t know). And cheap – no money at all. And it removes problems. ”

    Hema claims that she treated everything from vomiting to depression with such bloodletting. And he shows the edge of his palm, along which the tattoo runs: “Each scar builds my throne.”What a throne – there is no answer.

    Acute hype

    According to a study published in the British scientific journal Journal of Child Psychology and Psychiatry, 27.6% of European adolescents aged 15-16 years of their own free will damage their bodies without suicidal intentions at least once in a lifetime. 20% do it from time to time, and almost 8% do it on an ongoing basis.

    Over the past 30 years, the number of such cases recorded annually has increased 10 times.Experts warn of a trend that is more than alarming, although the media try not to talk about it.

    The phenomenon spreads like a pandemic and yet remains almost invisible to prying eyes, since most often they cut, beat and burn hands and in those places where they are usually hidden by the sleeves of a shirt.

    A team of Spanish scientists led by psychologist Daniel Vega, studying this problem, claims that 32.7% of people in the age group of the country’s population from 18 to 32 years old are prone to self-torture in this way.

    “There has been a paradigm shift in recent years. Self-injury that does not lead to suicide has historically been understood as a rare occurrence associated with some kind of serious mental disorder. Today we already know that this is not even a rarity at all. And it doesn’t only appear in people with mental disorders, ”explains Vega. – From the analysis of their behavior, we know that for the first time to hurt themselves for the sake of getting some unusual sensations – you can call them a high, here it’s probably not a more accurate term – they try at the age of 12 to 16 years.63% of people who have done it once continue to repeat the manic experience for at least a year. Historically, it was believed that this was characteristic almost exclusively of women, but now young men are also addicted to the “self-tapping”, although to a slightly lesser extent. ”

    Photo: Depositphotos

    “This is an effective and quick way to reduce the discomfort caused by anger, sadness and anxiety, and in no clinic can we offer them something as powerful,” adds a colleague from the psychiatric department of Hospital de la Santa Creu i Sant Pau Juan Carlos Pascual.- Strictly speaking, this phenomenon cannot be called new. The craze for this must be recognized as new. Before, we still talked about isolated cases. ”

    As it turns out, girls are more likely to use methods that include monitoring blood. Typically by inflicting cuts or scrapes on yourself. Whereas boys prefer to deliberately hit something or burn their skin with fire.

    Instant “arrival”

    Over the past 4–5 years, the problem has risen to its full extent, and it is fueled by works of popular culture – mainly film and television.This year, satellite and cable HBO premiered a television series based on Jillian Flynn’s book Sharp Objects (original version).

    The main character, played by Hollywood star Amy Adams, received multiple injuries all over her body. The camera focuses the viewer’s attention on the scars. The characters tell about the origin of almost each of them separately.

    Shot from the TV series “Sharp Objects”, starring Amy Adams

    Photo: Blumhouse Productions

    Prior to this, in 2014, the British pianist James Rhodes, who now lives in Spain, spoke in the book Instrumental with some special ecstasy about the sexual pleasure he experienced while using drugs, attempting suicide and “carving on the body” with a razor blade:

    “Self-harm not only promotes your self-affirmation – it allows you to express your disgust with the world around you.It teaches you how to control pain and allows you to enjoy the ritual, causing the body to produce more and more endorphins. This ghoulish, brutal abuse of oneself is like an unusual sexual adventure. You slashed your arm or leg – the effect came instantly, you feel an incredible surge of energy, elation. You were like an electric shock. Wherever there is a “coming” from heroin or cocaine – everything is much cooler here. ”

    “In the language of psychiatrists, this is called emotional regulation,” says Pascual, mentioned above.- The action may seem impulsive; the desire to cut yourself – arising suddenly. In fact, the person is planning it. In advance. Negative emotions accumulate in it – rage, sadness, anxiety, whatever. Relieving this tension with a sharpened blade is a way to reduce internal discomfort. Effectively and quickly. ”

    In pursuit of pain

    According to statistics from the Spanish edition of El Mundo, from 70 to 97% of people engaged in self-injury are prone to “carving on the body” – legs, arms, abdomen.From 21 to 44% – fight. From 15 to 35% – fired. And, despite such a tendency to self-harm, none of them even in their thoughts keeps killing themselves with this. They would rather peel potatoes in the kitchen with a knife than open their veins. But the risk of suicide by such actions, objectively speaking, increases.

    A textbook example is a girl observed in the psychiatry department of the São Pau Hospital, who introduced herself as Anna.

    Anna made her debut in self-injury when she was only 14 years old.The reason was overweight and bulimia, the fight against which turned into anorexia and nervous breakdowns due to the ineffectiveness of the treatment of these diseases. Today she is 16, and she is still not removed from the register: a couple of weeks ago, she once again cut her hands.

    When she was a fat woman, she was constantly teased at school. Good-natured at first. Gradually, this intensified, negative emotions began to prevail over positive ones – teasing turned into bullying. She undertook to lose weight on her own, after reading tips on the Internet.Among the most radical methods were recommendations for bloodletting and self-injury.

    Photo: Global Look Press / Jürgen Wiesler

    “At home they started hiding all objects that could cut myself: knives, forks and even pencil sharpeners, which I learned to disassemble better and more professionally than a watchmaker spins walkers,” Anna shares her “professional” skills. – Then I learned to create sharp objects from everything that came to hand.I could break off a piece from the cell phone frame. Or break the found glasses. Or “accidentally” drop the plate. If I walked past tables set out on the street by some restaurant, I could easily pretend that I urgently needed to tie my shoelaces. She would sit down near the table where there were wine glasses or glasses, and left with one of them. Sharp debris has always been with me. ”

    Slow growing up

    In the UK, self harm (self harm is an English term, as is often the case, took root in Russian, just changing the Latin spelling to Cyrillic) is one of the problems that psychiatrists trumpet at all angles about.Over the past three years, according to the results of a study conducted by specialists from the University of Manchester, the number of cases of harm caused by teenagers (ages 11 to 19) to their own bodies has increased by 68%.

    “Naturally, we are talking about cases that have been publicized,” notes May Balman, the Independent correspondent familiar with the topic. – But the trend is clear. As, however, and the reasons for its appearance and development. ”

    In Germany, according to the newspaper Die Welt, 35% of adolescents have tried to hurt themselves with a cutting object at least once.Curious is the dynamics of the change in addiction to self-harm depending on age: among 11-16-year-olds 34% tried it, between the ages of 16 and 18 – 29%, from 18 to 20 – 17%, from 20 to 24 – 13%, older 24 – 7%.

    Photo: Depositphotos

    The reasons, according to experts commenting on these indicators at the request of the publication, are the same as in other European countries: self-pity, internal disorder, a desire to attract attention and get away from their problems.There is also talk of teenagers getting pleasure from injuries, but Germans are still more inclined to believe that “the thrill of pain is more often flaunting in front of others and a desire to hide the true reasons listed earlier. As they grow older, “the wind in my head dies down”, young people get comfortable in life and grow smarter in the end. ”

    According to the journalist The Independent (with whom psychologists and psychiatrists are in solidarity for the most part), the social disorder resulting from infantilism is to blame for everything.

    “Teenagers (girls – in particular, they are the majority of the“ self-tapping screws ”) want to shift the solution of their problems of lack of communication and unhappy love to others, to demand that they show concern, pity, condescension and participation. They are not accustomed to looking for solutions on their own – they cannot do without the iron hand of their parents. We need a reorientation of a teenager – to playing sports (this is preferable), to reading books (although today, in the era of the Internet, this is unlikely – on the Internet they would rather run into films and literature, replete with bloody scenes than actual masterpieces of art) “, – I am convinced Balman.

    And she’s probably right. Sport requires overcoming, stress and even self-sacrifice. “Let my muscles ache from exertion rather than skin from cuts,” some of the interviewed teenagers who “got off the knife” already admit to their psychologists that they have found a way to heal.

    In Russia, the phenomenon of selfharma is also present. Although it is not as common as in the West (it is believed that 4% of the population have at least once tried to hurt themselves deliberately), but, as they say, here you just need to start.

    Google statistics show that only in European countries over the past year, requests to search for pages where “self-torturers” communicate, were made 42 million times. An analysis of the content of these network “clubs of interest” shows that no preventive activities are carried out with those who apply there, just the opposite, it works to expand contacts.

    “It is strange that the demonstration of naked breasts in social networks is imposed by a bunch of prohibitions by the supporters of morality, and free access to the pages pushing the visitor to self-mutilation,” complains Spanish psychologist Daniel Vega, stressing that a similar situation has developed not only in the Iberian Peninsula but also all over the world.

    READ ALSO

    Cosmetic aspects of nail products and services – Articles

    Source: Cosmetic Dermatology 2012; 25: 357-363.

    Cosmetic Dermatology 2012; 25: 357-363.

    From the University of Alabama School of Medicine at Birmingham. The authors do not disclose the existence of any conflicts of interest in relation to the materials of this article.

    Nail cosmetics is a multi-billion dollar industry that includes a variety of nail products and services such as manicures, pedicures, tips, nail extensions, nail hardening, nail art, and other products that promote the appearance of nails. with a smooth glossy surface.In 2004, Americans spent $ 6.8 billion on nail care products. Nail salons alone in 2005, according to the US Census Bureau, earned $ 1.7 billion. The tools and methods that are used to decorate the nails, especially the nail plate, offer radical solutions to the problem of general nail dystrophy, as they protect the nails from further damage, and also improve the self-esteem of patients. However, the use of nail cosmetics can lead to serious complications such as allergic contact dermatitis, irritant contact dermatitis, paronychia, onycholysis, onychomycosis and brittle nails.In this review, we evaluate various nail products, their effectiveness in people using these products, and highlight their potential benefits and negative effects.

    Nail polish remover

    Most nail polish removers contain harsh chemicals such as acetone, ethyl acetate, butyl acetate, or methyl ethyl ketone. Acetone nail polish removers tend to dry out nails, which can lead to brittle nails.Nail polish remover, due to irritation of the skin of the nail fold, can also contribute to the development of paronychia (Fig. 1). These effects can be minimized by limiting the use of nail polish removers to less than once a week and by using formulations that contain less aggressive solvents such as ethyl acetate. Until now, no serious clinical studies have been carried out on the effect on the body of nail polish removers that do not contain acetone; isolated cases of life-threatening toxic effects have been described in case of accidental ingestion of nail polish remover containing 7-butyrolactone [6].

    Figure 1 . Paronychia and onychochisis with signs of splitting of the nail plate and inflammation of the nail folds.

    Cuticle removers

    Eponychium, also known as cuticle, is often considered unattractive and removing it allows you to evenly apply nail polish and attach artificial nails; However, it is important to note that overly aggressive action on the cuticle can lead to the development of inflammatory diseases such as paronychia or onychomycosis (Figures 1 and 2).The cuticle fills the area between the proximal nail fold and the nail plate. When the continuity of this connection is disrupted, the area under the nail fold becomes prone to penetration of irritants, allergens, bacteria, fungi and other external harmful agents [7]. Cuticle removers contain harsh compounds such as sodium and potassium hydroxides, which, if used frequently and incorrectly, can irritate the nail plate.Excessive manipulations in the cuticle area can damage the nail matrix and lead to transverse leukonychia [8]. It is best to completely avoid manipulating the cuticle area. However, to reduce trauma to the nail roll, many nail specialists use special orange tree sticks rather than metal ones to gently push the cuticle closer to the proximal nail roll [9].

    Figure 2 . Onychomycosis with distal onycholysis.

    Nail trimming (trimming and deburring)

    When nails are trimmed in an oval shape to form an arch, they are more prone to developing ingrown nails and chips. Therefore, nails should be trimmed in a straighter line, with minimal arcing. Shaping the nail in one direction with a nail file, rather than with a clipper or scissors, reduces shear forces. Softening nails by soaking them in water prior to cutting also helps to minimize cracking that can occur during clipping [9].The use of a blunt-edged blade minimizes the risk of injury to the surrounding soft tissue [10].

    Means for strengthening nails and nail care

    Nail hardeners provide temporary relief from brittle nails. This pathology affects about 20% of the US population. These agents either mechanically protect the nail plate or chemically alter the structure of the nails using stitching keratin [11, 12]. Nail hardeners are commonly used as a base coat to help limit contact of the nail plate with detergents and solutions, thereby reducing evaporation and water loss in the nails [13].They are also included in creams (for example, aluminum chloride, tannin, tazarotene 0.1%), which can be directly applied to the nails [14].

    Most nail strengthening products come in modified form in nail varnishes containing various concentrations of solvents and resins with the addition of nylon, silk, acrylic, minerals, or proteins to increase the adhesion of the products on the nail plate. Nail hardeners that contain formaldehyde can indeed negatively alter the structure of nail keratin due to increased cross-linking, leading to increased nail density with prolonged use, resulting in decreased nail plate flexibility despite increased nail strength.This paradoxically leads to brittle nails. It has been shown that in high concentrations formaldehyde can cause changes in nail color from blue to red, as well as the cause of onycholysis (Figure 3), paronychia (Figure 1), subungual hyperkeratosis, ectopic contact dermatitis (Figure 4), and in some cases lead to the development of ventral pterygium (fusion of the subungual tissue with the free edge of the nail plate) with the onset of severe pain [11-15]. In some formulations, the formaldehyde content was reduced to between 1% and 2%, but still continued to show negative effects such as contact dermatitis and onycholysis [16].

    Dimethylurea is a nail hardening factor and also a factor that chemically alters keratin, albeit to a lesser extent than formaldehyde, and is used as a base coat. Dimethylurea does not penetrate as deeply as formaldehyde, which reduces the risk of nail brittleness and the risk of sensitization [15]. Other formaldehyde-free and nail strengthening products include Teflon, silk, nylon, acrylic resins, keratin and vitamins [17].

    Means for moisturizing the nail plate

    The ability of the nail to maintain a constant level of hydrates is lower than in the skin due to the constant rate of water transport through the nail plate [18].Frequent hand washing causes the nails to contract and expand, resulting in fractures between the comeocytes of the nail plate [19]. Means that help moisturize the nail plate are divided into sealants that prevent moisture evaporation, which perform an occlusive function, and moisturizers that perform the function of retaining moisture. As a rule, white cotton gloves are used as a sealant [1]. Mineral oils or lubricants (lubricants) are used as moisturizers, which prolong the hydration state and can increase flexibility in sealing the upper surface of the nail plate, thereby delaying water evaporation [20].

    However, a study by Stern et al. [18] showed no significant difference between the water content of brittle nails compared to normal healthy nails, which contradicts the current notion that brittle nails contain less water and therefore, you should prescribe funds to help moisturize the nail plate. This study challenges the current practice of prescribing moisturizers to treat brittle nails, showing that there is no relationship between water content in the nail plate and brittle nails [18].

    Figure 3 . Distal onycholysis with separation of the distal nail plate from the nail bed.

    Figure 4 . Dermatitis around the eyes as a secondary side process when using nail polish.

    Nail polish

    Applying nail polish is the final step in any manicure or pedicure and is a popular nail decorating tool. Nail polish provides mechanical strength and can act as a waterproof agent to minimize evaporation in the nails and improve nail plate moisture.It also protects the nail to a certain extent from the damaging effects of detergents.

    Varnish is a mixture of film-forming agents, thermoplastic resin, plasticizer, filler, pigment and solvent. Thermoplastic resin is a toluene sulfonamide formaldehyde resin, which is a common allergen in most cases of nail dermatitis. It is estimated that 1% to 3% of the US population has a clinically unrecognized allergy to nail polish [21], which can manifest itself as nail dystrophy, onycholysis, paronychia, and dermatitis on skin contact or elsewhere [22].If an allergic reaction to nail polish manifests as ectopic dermatitis, the face (Figure 4), ears, neck and lower eyelid are usually affected [8]. Contact dermatitis in the periungual region can predispose to the development of onychomycosis and paronychia. In the case of allergic contact dermatitis, an application skin test should be performed (table). Hypoallergenic nail polish contains phthalic polyester resin instead of toluene sulfonamide formaldehyde resin, which can still lead to the development of ectopic dermatitis.30

    Prolonged use of nail polish can sometimes lead to discoloration of the nail, as well as the development of keratin granulations (Figure 5), which are defined as white scaly spots on the nail plate [1]. After applying pigmented nail polish for more than 7 days, especially deep reds and browns [10], patients may develop yellow keratin staining in the distal nail plate, which usually disappears within 2 weeks without treatment [31].Dyes that cause yellow nail staining include D & C red [6, 7, 34] and FD & C Yellow [5] aluminum varnish [32]. Granulation in the area of ​​the nail plate usually occurs when nail varnish is reapplied without removing the old varnish layer [1].

    Nail extension

    Artificial nails made of plastic that have been shaped in advance are glued to regular nails and offer a temporary cosmetic solution in cases of slowly growing nails or nail plate degeneration.Ethyl cyanoacrylate is a common allergen found in most adhesives used and can cause periungual dermatitis. Some patients develop erythematous pruritic papules in the paronychia area several hours after the artificial nail is applied [33]. To prevent allergic contact dermatitis, it is recommended to wear artificial nails for less than 48 hours after the artificial nail is applied [34].

    In addition to allergic contact dermatitis, artificial nails can cause onycholysis, paronychia, and onychomycosis [35].A unique side effect of acrylate exposure is the development of paresthesia in the distal fingertips. Splitting and dry nails develop after the removal of artificial nails due to the loss of natural oils (Figure 1) [36].

    Recommended allergens for application tests

    Nail enamel [8, 23]

    Enamel removers

    [4, 14]

    Cuticle removers [8-24]

    Means for nail extension

    [8-23.26]

    Artificial nails [8-27,29]

    Benzalkonium chloride

    Rosin

    Drometrizol

    Formaldehyde

    Glycerphthalate resins

    Guanine powder

    Nickel

    Nitrocellulose

    Several nail polishes (water-soluble ingredients)

    Formaldehyde resins of toluene sulfonamide

    Acetone

    Butyl acetate

    Ethyl acetate

    Methyl ethyl ketone

    Potassium hydroxide

    Propylene glycol

    Trisodium phosphate

    Trolamine

    2-hydroxyethyl acrylate

    Liquid acrylic monomers (ethyl methacrylate or isobutyl methacrylate)

    Benzophenone

    Butyloxytoluene (gel nails)

    Ethyl acrylate

    Ethyl cyanoacrylate

    Ethylene glycol dimethacrylate

    Powder of polymethyl methacrylate or ethyl methacrylate with benzoyl peroxide

    Triethylene glycol diacrylate

    Cyanoacrylate glue

    Methyl-ethyl-hydroquinone

    Other adhesives

    P-tert butyl phenolic resins

    Tricresil ethyl phthalate

    Figure 5 .Degranulation of keratin in the nail plate.

    Nail extension

    For nail extension, a highly sensitizing liquid monomer (ethyl methacrylate) and a powdered polymer (polymethyl methacrylate) cured with benzoyl peroxide are used, which then hardens directly on the nail. An initial methacrylic acid primer (a strong skin irritant) is applied to the nail to improve the adhesion of the acrylate mixture to the nail plate [8].

    Allergic reactions to acrylic monomers during nail extension can initially manifest as itching and progress to painful paronychia, paresthesia, nail dystrophy, and in some cases onycholysis. True nail loss is rare [37]. Distant ectopic dermatitis can be found on the face and eyelids [8]. The physician should consider the possibility of performing an application skin test in patients after nail extension with chronic degeneration of the nail plates or in the event of a new periungual pathology (table).

    Acrylic monomers can also cause an irritating reaction, which leads to a thickening of the nail bed with the possible development of onycholysis. An irritant reaction to methacrylic acid can manifest itself as a burning sensation on contact with the cuticle or the nail bed in the case of a thin nail plate [8].

    Fungal and bacterial colonization are the most common lesions in nails after nail extension due to their increased water content [38]. With prolonged use of extended nails, there is a risk of an increased susceptibility to infection, since acrylic loosens the nail along the edges, and the nail folds become more susceptible to infection.To prevent the development of paronychia, it is important to change the attached acrylic derivatives every 3 weeks [9]. To prevent onycholysis, it is important to keep the acrylic joints short and thin to maintain flexibility and reduce stress on the nail [3].

    UV treated gel nails

    Gel nails treated with ultraviolet rays to solidify are used as an alternative to blending acrylic monomers with polymer powder and shaping embossed nails.Primer and catalyst are not required for attachment or shaping [1]. Gel in semi-liquid form is similar to nail polish, after application it is exposed to UV light, as a result of which the gel hardens. The odorlessness and ease of use make this service a popular choice in nail salons. It is important to note, however, that a large amount of gel applied during hardening can shrink in volume up to 20%, producing torque on the nail bed, which leads to heaving and formation of cracks in the area of ​​the nail plate [8].A hypoallergenic nail gel, which does not contain methacrylic acid, can also lead to contact sensitization, because it still contains another acrylate functional gel, a monomer [35]. Gel that remains uncured in the liquid phase can spread to other areas of the skin and cause distant contact dermatitis. Other adverse nail reactions that have been reported include paresthesias, subungual and paronychial eczema and, in some cases, virtually complete disappearance of the nails [8].MacFarlane and Alonso [40] reported 2 cases in which exposure to UV lamps in nail salons may have led to the development of squamous cell carcinoma in the fingers, so this potential relationship should be taken into account.

    Nail wrap

    The nail wrapping is carried out in the area of ​​the free edges to optimally lengthen the nails and repair cracked, broken or weakened nails. This procedure must be repeated frequently to maintain healthy nails.Fibrous substances such as flax, fiberglass or silk are laid in layers, between which there are transparent nail polish and a sensitizing adhesive such as methacrylate [8]. It is important to take precautions to avoid contact with the adhesive, as this can lead to contact dermatitis in the skin surrounding the nail, with the potential for dermatitis around the eye and dorsal hand [27].

    Improvement of sanitary conditions of salons

    The nail salon professionals are responsible for sterilizing the nail salon.Sterilization of instruments after servicing each client is important, as contaminated equipment can contribute to the uncontrolled transmission of infections such as paronychia, onychomycosis and viral warts [41]. The porous nail files used to remove calluses during pedicure cannot be sterilized and this may be associated with an increased risk of plantar wart virus transmission to other clients. It is best if customers bring their own tools or the salon uses disposable tools.Although each state in the United States has its own guidelines and regulations for sterilizing salon manicure instruments, most experts recommend using disinfectants available from various hospitals and registered with the EPA [1].

    In addition to factors predisposing to onychomycosis, nail baths can be a breeding ground for mycobacteria, leading to furunculosis and subsequent scarring. In a large series of observations in northern California, carried out in 2002, Mycobacteriumfortuitum was found among the cultures of microorganisms isolated from foot bath filters in beauty salons, which were taken by patients with furunculosis after a pedicure [41].Patients with small insect-like lesions developed boils and then hyperpigmented scars. In the case of clinical signs and a high likelihood of such a disease, empirical treatment is recommended. It is also important to ensure that foot bath filters are changed frequently as a preventive measure [42].

    Vigilance regarding nail salon licensing procedures is critical to patient safety.Safety instructions for manicure include provisions that foot baths must be kept clean and reusable instruments must be autoclaved. Also, during a pedicure, manipulations on the cuticle of the nail are minimized. Patient safety precautions include the following: do not shave less than 24 hours before pedicure and bring personal nail care tools from home [39].

    Cosmetics for nails

    There are many organic substances, such as vitamins, amino acids, minerals, that are sold under the nail care label, although the effectiveness of most of these substances has not yet been determined.It is well known that a lack of certain substances can lead to nail degeneration. Deficiency of vitamin A causes dystrophic changes in the nails of the type of eggshell [43], iron deficiency leads to the occurrence of koilonychia and brittle nails [44]. With zinc deficiency, nails become brittle, grayish, and other anomalies of the nail plate develop [45]. In such cases, elimination of the deficiency of the corresponding vitamin / trace element can lead to the elimination of nail dystrophy.

    Overuse of supplements in patients without signs of vitamin and trace element deficiency in the nails can lead to a number of negative consequences.Selenium overdose can lead to nail loss, although microdose supplements strengthen nails in selenium-deficient patients [46,47]. Likewise, an overdose of vitamin A can lead to severe nail destruction [45]. It is interesting to note that the use of iron supplements, even without an apparent iron deficiency in the body, can reduce nail brittleness over a long period of time [7].

    It has been proven that the use of biotin increases the thickness of the nail by 25% by increasing the amount of synthesized cytokeratins.In addition, the use of biotin has been shown to enhance nail growth and reduce lamellar cleavage of the nail plate [48]. Taking 2.5 mg of biotin daily for at least 6 months has been shown to improve nail health [49]. Biotin is used in the treatment of brittle nail syndrome with few side effects such as gastrointestinal upset. An improvement in the quality of nails was noted after 2-3 months of daily administration of the drug [7].

    A daily intake of 10 mg of choline-stabilized orthosilicic acid, a bioavailable form of silicon, also reduces the fragility of the nail plate by promoting enhanced collagen synthesis and formation [50]. It has also demonstrated some benefit in patients with psoriatic nail lesions [45, 51, 52].

    High doses of vitamin E (600–1200 IU) help manage yellow nail syndrome [53]. A combination of vitamin C, primrose oil, and pyridoxine has been suggested for the treatment of brittle nails, but improved nail health has not been proven [54].It was assumed that drugs containing the amino acid cystine can improve the condition of nails and their growth due to their positive effect on the cells of hyponychia (subungual bed), but these benefits have not been confirmed [7].

    Conclusion

    Nail cosmetics play an important role in maintaining and improving nail aesthetics, and the use of these cosmetics is widespread in society. Despite the benefits in use, many nail care products and their ingredients can lead to allergic, infectious and idiopathic nail conditions.It is very important for clinicians to be aware of the potential side effects of cosmetic nail care products.

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    18. Stern DK, Diamantis S, Smith E, et al. Water content and other aspects of brittle versus normal fingernails. J Am Acad Dermatol. 2007; 57: 31-36.

    19. van de Kerkhof PC, Pasch MC, Scher RK, et al.Brittle nail syndrome: a pathogenesis-based approach with a proposed grading system. J Am Acad Dermatol. 2005; 53: 644-651.

    20. lorizzo M, Pazzaglia M, M Piraccini B, et al. Brittle nails. J Cosmet Dermatol. 2004; 3: 138-144.

    21. Fuchs T, Gutgesell C. Is contact allergy to toluene sulphonamide-formaldehyde resin common? BrJ Dermatol. 1996; 135: 1013-1014.

    22. Militello G. Contact and primary irritant dermatitis of the nail unit diagnosis and treatment.Dermatol Ther. 2007; 20: 47-53.

    22. Militello G. Contact and primary irritant dermatitis of the nail unit diagnosis and treatment. Dermatol Ther. 2007; 20: 47-53.

    23. Hausen BM, Milbrodt M, Koenig WA. The allergens of nail polish. (I), allergenic constituents of common nail polish and toluenesulfonamide-formaldehyde resin (TS-F-R). Contact Dermatitis. 1995; 33: 157-164.

    24. Engasser PG. Nail cosmetics. In: Scher RK, Daniel CR, eds. Nails: Therapy, Diagnosis, Surgery.2nd ed. Philadelphia, PA: Saunders; 1997: 276-281.

    25. Koppula SV, Storrs FJ. Screening allergens for acrylate dermatitis associated with artificial nails. Am J Contact Dermat. 1995; 6: 75-77.

    26. Guin JD. Eyelid dermatitis from benzophenone used in nail enhancement. Contact Dermatitis. 2000; 43: 308-309.

    27. Pigatto PD, Giacchetti A, Altomare GF Unusual sensitization to cyanoacrylate ester. Contact Dermatitis. 1986; 14:193.

    28.Shelley ED, Shelley WB. Chronic dermatitis simulating small-plaque parapsoriasis due to cyanoacrylate adhesive used on fingernails. JAMA. 1984; 252: 2455-2456.

    29. Burrows D, Rycroft RJ. Contact dermatitis from PTBP resin and tri-cresyl ethyl phthalate in a plastic nail adhesive. Contact Deimatitis. 1981; 7: 336-337.

    30. Kanerva L, Lauerma A, Jolanki R, et al. Methyl acrylate: a new sensitizer in nail lacquer. Contact Dermatitis. 1995; 33: 203-204.

    31.Brauer E, Baran R. Cosmetics: the care and adornment of the nail. In: Baran R, Dawber RPR, de Berker DAR, et al, eds. Baran and Dawber s Diseases oj the Nails and Their Management. 3rd ed. Oxford: Blackwell Science Ltd; 358-369.

    32. Samman PD. Nail disorders caused by external influences. J Soc Cosmet Chem. 1977; 28: 351-356.

    33. Freeman S, Lee MS, Gudmundsen K. Adverse contact reactions to sculptured acrylic nails: 4 case reports and a literature review.Contact Dermatitis. 1995; 33: 381-385.

    34. Guin JD, Baas K, Nelson-Adesokan P Contact sensitization to cyanoacrylate adhesive as a cause of severe onychodystrophy. Int J Dermatol. 1998; 37: 31-36.

    35. Hemmer W, Focke M, Wantke F, et al. Allergic contact dermatitis to artificial fingernails prepared from UV light-cured acrylates. J Am Acad Dermatol. 1996; 35: 377-380.

    36. Jeanes A, Green J. Nail art: a review of current infection control issues.J Hosp Infect. 2001; 49: 139-142.

    37. Mowad CM, Ferringer T. Allergic contact dermatitis from acrylates in artificial nails. Dermatitis. 2004; 15: 51-53.

    38. Shemer A, Trau FI, Davidovici B, et al. Onycomycosis due to artificial nails. J EurAcad Dermatol Venereol. 2008; 22: 998-1000.

    39. Chang RM, Hare AQ, Rich R Treating cosmetically induced nail problems. Dermatol Ther. 2007; 20: 54-59.

    40. MacFarlane DF, Alonso CA. Occurrence of nonmelanoma skin cancers on the hands after UV nail light exposure.Arch Dermatol. 2009; 145: 447-449.

    41. Sekula SA, Havel J, Otillar LJ. Nail salons can be risky business. Arch Dermatol. 2002; 138: 414-415.

    42. Winthrop KL, Abrams M, Yakrus M, et al. An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon. N Engl J Med. 2002; 346: 1366-1371.

    43. Bereston ES. Examination of the nails as a diagnostic aid. ] Insur Med. 1950; 6: 38-41.

    44. Djaldetti M, Fishman R Hart J.The iron content of finger-nails in iron deficient patients. Clin Sci (London). 1987; 72: 669-672.

    45. Scheinfeld N, Dahdah MJ, Scher R. Vitamins and minerals: their role in nail health and disease. J Dmgs Dermatol. 2007; 6: 782-787.

    46. ​​Vinton NE, Dahlstrom KA, Strobel CT, et al. Macrocytosis and pseudoalbinism: manifestations of selenium deficiency. J Pediatr. 1987; 111: 711-717.

    47. Reid ME, Stratton MS, Lillico AJ, et al. A report of high-dose selenium supplementation: response and toxicities.J Trace Elem Med Biol. 2004; 18: 69-74.

    48. Runne U, Orfanos CE. The human nail: structure, growth and pathological changes. Curr Probl Dermatol. 1981; 9: 102-149.

    49. Colombo VE, Gerber F, Bronhofer M, et al. Treatment of brittle fingernails and onychoschizia with biotin: scanning electron microscopy. J Am Acad Dermatol. 1990; 23: 1127-1132.

    50. Barel A, Calomme M, Timchenko A, et al. Effect of oral intake of choline-stabilized orthosilicic acid on the skin, nails, and hair in women with photodamaged skin (published online ahead of print October 26, 2005].Arch Dermatol Res. 2005; 297: 147-153.

    51. Lassus A. Colloidal silicic acid for the treatment of psoriatic skin lesions, arthropathy and onychopathy, a pilot study. J Int Med Res. 1997; 25: 206-209.

    52. Hochman LG, Scher RK, Meyerson MS. Brittle nails: response to daily biotin supplementation. Cutis. 1993; 51: 303-305.

    53. Ayres S Jr, Mihan R. Yellow nail syndrome: response to vitamin E. Arch Dermatol. 1973; 108: 267-268.

    54.Campbell AJ, McEwan GC. Treatment of brittle nails and dry eyes. BrJ Dermatol. 1981; 105: 113.

    90,000 🧬 Pathology of nail plates

    Nadezhda Nabatnikova, dermatovenerologist, cosmetologist, podologist at GMS Clinic tells in detail about possible pathologies of the nail plates.

    In the life of a modern woman, there are often situations when one cannot do without showing marigolds – be it a selfie on the steering wheel or the punishment of a guilty life partner.Therefore, every modern woman knows that the nails should be in order: both on the hands and on the feet – you never know how the situation will turn out. But, in addition to purely aesthetic and protective functions, nails are a very important indicator of health – having a complex anatomical structure, the nail plates react to changes in the state of the body and can be a kind of indicators of various diseases. Often the only symptom. It is important to closely monitor the condition of your nails and you should know what changes in the nail plate can serve as an alarming signal.

    What are the nail changes and what can they mean?

    To make it easier for you to have a constructive dialogue with your doctor, let’s look at the most common changes in the nail plates and the factors that can cause them:

    • Flaky, brittle nails.
      Most often they are an indicator of aggressive effects on the nails: injuries (pinching, impact, tight shoes). Manicure or pedicure with coarse abrasive files or an incorrectly selected cutter.The use of aggressive chemicals to remove the aesthetic coating or base coat. Contact with aggressive household chemicals. Lack of calcium. chronic hypothermia of the hands and feet. One of the signs of fungal infection of the nails.
    • Transverse grooves and tubercles.
      Small grooves often indicate gastrointestinal problems. Large – most often the result of slowing down the growth of nails or cessation of oxygen access to them after nail extension or gel application.
    • Spots on the nails.
      White – signal a violation of the process of formation of the nail plate: the structural elements of the nail are replaced by air layers. This usually occurs as a result of injury (pinching, bump, tight shoes, nail biting, etc.) or due to a lack of vitamins A and C.
      Black – these are post-traumatic hematomas – blows, pinching, prolonged stress on the foot, etc. Also one of the symptoms of endocarditis.
    • Longitudinal stripes.
      They are single and multiple. The most common cause is a lack of B vitamins and dehydration. Note that dehydration can signal thyroid problems. Or simply a consequence of the evaporation of water from the nail plates with frequent use of lamps to dry the varnish. Or both.
    • Yellowish nails.
      Often betrays lovers of red lacquer. It happens when using a low-quality nail polish remover or painting nails without using a base.More serious reasons are hepatitis or toxic liver damage. Often this phenomenon is observed in smokers, as a result of the deposition of tar and combustion products. Yellow spots of the “oil” type are a sign of fungal infection of the toenails.
    • Pale nails.
      Usually, the result of anemia is found in pregnant women, strict vegetarians, with impaired absorption of iron.
    • Linear pigmentation in various shades of brown.
      There may be melanonychia – the deposition of melanin in the nail plate, and maybe the initial stage of subungual melanoma.You must immediately consult a doctor.

    Factors that can also lead to a change in the nail plates, which you should definitely inform your doctor about:

    • acute infection, accompanied by rashes on the hands and 2-3 weeks after it. The use of antibiotics, antiviral drugs;
    • history of psoriasis in you or a close relative;
    • diet or diet change;
    • eruptions on the body or patches of baldness on the head;
    • Chronic hand diseases – eczema or dyshidrosis.

    How to help your nails maintain their beauty and health?

    Basic rules:

    1. Gentle mechanical and chemical treatment for manicure and pedicure
    2. Good nutrition
    3. Treatment of chronic diseases
    4. Caring for hands in the presence of occupational injurious factors
    5. Correct comfort shoes
    6. Timely diagnosis and treatment of pathology of the nail plates

    Dermatovenereologist
    Dermatologist

    90,000 miscellaneous / pictures, gifs, funny comics, interesting articles on the topic.

    “It is said that God created nails to scratch insect bites. Why did he create the fucking insects then? There would be no need to create nails. Do you understand? This is confusing.
    Some say: “I believe in the harmony of nature.” Big fish feeds on small ones. Every organ in your body is constantly fighting invading bacteria. Do you call this “harmony”? Planets explode, meteorites collide and collapse. What is the intent here? What’s the point of flooding? Drown people? In other words, if you want to find design, you must search everywhere.View the whole picture. People project their own views of nature. ”

    “When the priest said to me:“ Rain is needed for the plants to grow, ”I asked:“ Why then rain over the sea? ”. I really wanted to find out. I was not an atheist. He made me stretch out my arms and beat me. It was then that I began to doubt his sanity.
    Then he said: “The ways of the Lord are inscrutable. And I fell for it.

    And then I asked: “Why did the flood take the lives of the children, they didn’t know anything in life?” He replied: “Because the ways of the Lord are inscrutable. We may not know this, but everything has a purpose.” And he told me a few stories to prove it. He said that he once met a man who was blinded by cataracts. The blind man said that after he became blind, he realized many things that he had not appreciated before. And the priest concluded: “He became blind in order to realize how wonderful it is to have sight, and also how wonderful it is to have feelings.Therefore, everything has a purpose. “And it paralyzed my ability to invent something new.

    That was a good point. But then, over time, I did not notice that the blind are somehow especially cleverer than the rest. Yes, that blind that he was talking about was like that. But I also met people with negative experiences that made them worse. See what I mean?

    It is very difficult to be objective. There were still contradictions inside me when I started asking myself these questions. I decided, “Okay, it’s better if I go to church once a month.Until I give up completely. ”After I thought:“ God would know that I was wrong.