Nail problems and nail health explained

How nails grow and stay healthy

Nails are made of a tough protein called keratin and grow slowly from the base, under the skin. Fingernails grow faster than toenails, and it can take several months for a fingernail, and up to a year or more for a toenail, to grow out completely. This slow growth is why nail treatments often take a long time to show results. Healthy nails are usually smooth and a fairly even colour, though harmless ridges and small white marks are common and not a cause for concern. General health, diet, age, and how you look after your hands and feet all affect your nails. Keeping nails clean and dry, trimming them regularly, and avoiding damage all help keep them in good condition. Many nail changes are simply part of getting older and do not need treatment.

Fungal nail infections

Fungal nail infections are common, especially in toenails, and often follow athlete's foot spreading to the nail. The nail may become thickened, discoloured (often white, yellow, or brown), brittle, or crumbly, and it can lift from the nail bed. They are usually not painful at first but can become uncomfortable and unsightly, and they can spread to other nails. They are more likely if your feet get hot and sweaty, if you have certain conditions such as diabetes, or if the nail has been damaged. A pharmacist can advise on treatments for milder cases, and a GP may arrange tests or treatment for more stubborn or severe infections; treatment can take many months because the nail grows slowly. Keeping feet clean and dry, wearing well-fitting shoes, and not sharing towels or nail tools help prevent and limit spread.

Ingrown toenails and injuries

An ingrown toenail happens when the edge of the nail, usually on the big toe, grows into the surrounding skin, causing pain, redness, and swelling, and sometimes infection. It is often linked to cutting nails too short or into a curve, wearing tight shoes, or injury. For mild cases, soaking the foot in warm water, keeping the area clean, wearing comfortable footwear, and gently easing the skin away can help. Cutting toenails straight across, rather than rounded, helps prevent them. If the toe becomes very painful, or shows signs of infection such as spreading redness, swelling, warmth, or pus, see a GP or a foot specialist (podiatrist), who can treat it, sometimes with a minor procedure. Nail injuries, such as bruising under the nail after trapping a finger, are common and usually heal on their own as the nail grows out.

Colour and texture changes

Nails can change colour and texture for many reasons, most of them harmless. Brittle, splitting nails are common, particularly with age or frequent contact with water and chemicals, and moisturising and wearing gloves for wet or cleaning tasks can help. White spots or lines usually follow minor knocks and grow out. Ridges running along the nail are generally a normal part of ageing. Some changes, though, deserve attention: nails that become spoon-shaped or very pale can sometimes relate to iron deficiency, while pitting or lifting may be linked to skin conditions such as psoriasis. Yellow, thickened nails often reflect fungal infection. A new dark streak or mark under a nail, especially one that is changing, should always be checked by a GP, as rarely it can be a sign of something serious that needs assessment.

When to see a professional

Most nail problems can be managed at home or with advice from a pharmacist, but some need professional help. See a GP or podiatrist if a nail problem is painful, not improving, or getting worse, if a toenail is ingrown and infected, or if you have diabetes or poor circulation and develop any foot or nail problem, as these need extra care. A pharmacist can advise on fungal nail treatments and general nail care. See a GP promptly for a new or changing dark mark or streak under a nail, a nail that separates from its bed without obvious injury, or nail changes alongside other symptoms such as widespread skin changes. If you find looking after your feet difficult, a podiatrist can help with routine nail care, which is especially important for older people and those with long-term conditions.