BOOK APPT: +65 9728 6734

Common nail diseases explained by a dermatologist

March 15, 2019
Nail Disease Treatment by Dermatologist

Nail abnormalities are often neglected. Patients tend to visit the dermatologist for skin-related concerns, such as acne or eczema. Yet, such diseases can be common and require diagnosis and management.

The nail (referring to the plate) is firmed rooted to the bed of our fingers or toes. They are made of modified keratin. It serves as a protective shield for our fingertips and toes. Nails on the fingers take approximately 5 to 6 months to grow out, while the toes require twice the duration. The slow growth rate and the difficulty of getting drugs to penetrate through the plates make it hard to treat the associated diseases.

Here, we share a few common diseases.

Nail Onychomycosis

Onychomycosis is a type of yeast or mould infection. The infection causes a discolouration (white, yellow or brown). Other characteristics include thickening, splitting, roughening of the nail.

Common factors that place individuals at greater risk include humidity, heat, trauma and diabetes. Basketball players may be more predisposed due to the direct trauma of having their toes stepped on by other competitors.

Onychomycosis may also be a symptom of the following conditions: psoriasis, eczema, trauma or ageing.

Treatment for onychomycosis: Topical antifungal agents are less ineffective, due to its inability for deeper penetration into the bed of the toe or finger. Instead, oral terbinafine or itraconazole is often prescribed.

Does my nail have a bacterial infection?

When your nails suffer from bacterial infection, it is termed as paronychia. Paronychia can be acute or chronic. In acute paronychia, it is generally painful with pus present, caused by the bacteria Staphylococcus aureus. Repetitive minor trauma, picking and tearing can cause a tear in skin of the finger bed, allowing bacteria to invade.

In chronic paronychia, individuals in wet working conditions or cold environment are at greater risk. Compared to acute paronychia, chronic paronychia is generally less painful.

How to treat acute paronychia: Antibiotics and drainage of any pus if present.

How to treat chronic paronychia: Topical imidazoles are often prescribed. The patient should also avoid wet conditions, e.g. to use cotton-lined gloves when exposed to wet work. Manicuring or finger sucking should be avoided. Apply emollient creams regularly.

Ingrown toenail

Ingrowns at the toes can be hard, swollen and painful. Trimming your nails too short, especially on the sides of your big toes, can cause an ingrown. Trimming the corners may encourage the plates to grow inwards, digging into your skin. Your skin then breaks due to the pressure, triggering an infection. Tight shoe wear or trauma can also cause ingrowns.

If excessive inflammation and swelling are present, patients are advised to visit a dermatologist for proper treatment. Oral antibiotics may be prescribed, and the dermatologist will assess if there is a need for surgical removal.

To prevent ingrowns, wear proper-fitting shoes that have adequate room for the toes. Wear socks too. Cut straight across instead of rounding the corners.


Tumours on nails can be benign or malignant. Warts are the most common type of benign tumour affecting them.

Dermatological diseases that can affect nail conditions

Psoriasis: Patients who suffer from psoriasis may notice that their nails are scaly or pitted, with debris collected under them. In severe cases, the plate crumples, along with thickening of the finger or toe bed.

Generally, the condition should improve with effective psoriasis management. There are no nail-specific treatments for patients with psoriasis.

Eczema: While eczema does not typically cause nail changes, certain patients may suffer from brittle nails. The plate may also be rippled and deformed, due to the body’s inflammatory process. Horizontal ridges can be seen across the nail, with thickening and sometimes discolouration.


Nail abnormalities can benefit from the application of moisturizers, especially for patients suffering from eczema. Use a dermatologist-formulated emollient such as Multi-CERAM™ Moisturizer, with phyto-ceramides for skin barrier repair and multi-ceramides for skin lipid restoration.

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.
Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email Alternatively, you may fill up our contact form here.

Top Nail Fungus Tips & Treatment by Singapore Dermatologist

January 10, 2017

By Dr. Teo Wan Lin, Consultant Dermatologist at TWL Specialist Skin & Laser Centre

Nail Fungus Treatment by Singapore Dermatologist

Do I have nail fungus?    

Nail fungus presents as discolored, thickened, cracked or broken parts of the nail. It can affect one or many nails, fingernails and toenails are equally susceptible. People who are constantly exposed to wet work, like washing, as well as people with diabetes or chronic illnesses are more prone to getting fungus. There are other causes of abnormal nails such as psoriasis, eczema, trauma and nutritional deficiencies which must be diagnosed and evaluated by a qualified dermatologist.

Will manicures and pedicures help?

Manicures and pedicures do not help nail fungus, on the contrary they could be the cause of introducing bacterial and fungus infections if instruments and containers used are not properly sterilised. In addition, many buffing and practices of “cleaning out” and shaping nails are not necessary for nail health and may instead cause damage to the nail cuticle, which is a natural protector against nail infections. For beautiful healthy nails, good health and nutrition is essential, any abnormal looking nails should be evaluated and treated by a dermatologist. Several treatments are available depending on the underlying cause.

What to do?

If you have such symptoms promptly seek the care of a dermatologist who will evaluate the cause of the nail abnormalities and treat it appropriately, so as to get the best chance of recovery to a healthy nails!

Can my nail be normal again?

Nails grow at a much slower pace than hair. Fingernails grow at a rate of about 3mm per month, taking about 4-6 months to fully regrow a lost fingernail, and about 1 year for toenails. This is also the case for abnormal nails caused by disease. Hence, it is of utmost importance to get early correct diagnosis and treatment by a dermatologist to have a best chance of recovery.

The longer the nail remains abnormal without any specialist treatment, the harder it is for it to gain complete recovery even with medical treatment.

What treatments are available?

Depending on the diagnosis, various treatments in the form of creams, lotions, oral medications and laser therapies. Fungal infections when confirmed with laboratory tests usually require treatment with oral antifungal medications. As adjunct treatment, it is also critical restore healthy skin barrier function around the nail folds. A ceramide-based moisturiser such as the Multi-CERAM, is often prescribed to repair skin barrier function around the nail folds ravaged by the fungus.

© 2017 Dr Teo Wan Lin. All rights reserved.


Meet with Dr. Teo Wan Lin, accredited dermatologist at TWL Specialist Skin & Laser Centre for a thorough consultation and a full skin examination. 

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email Alternatively, you may fill up our contact form here.

2022 © Copyright - TWL Specialist Skin & Laser Centre