Skin appearing to extend further under the nails is a common observation that can sometimes cause discomfort or aesthetic concerns. This article provides information on what this occurrence represents and general approaches for its care.
Understanding Skin Growing Under Nails
The skin located just beneath the free edge of the nail is known as the hyponychium. This structure serves as a protective seal, forming a barrier that helps prevent bacteria and other substances from entering the nail unit. It contains numerous nerve endings, acting as an alert system if its protective seal is compromised. The hyponychium, along with the eponychium (cuticle area), are considered guardian seals of the nail unit.
When it seems like skin is “growing” under the nail, it is typically not a new growth but rather an extension or thickening of this existing hyponychium tissue. One specific condition is Pterygium inversum unguis (PIU), characterized by the adherence of the distal nail bed to the underside of the nail plate. This condition can be present from birth or acquired later in life. In PIU, the hyponychium extends further up the nail plate than is typical, sometimes causing discomfort or functional issues.
Causes and When to Be Concerned
Various factors can contribute to the hyponychium becoming more prominent or extending further along the nail bed. Trauma to the nail, such as aggressive cleaning under the nails or injury, can lead to its thickening or extension. Excessive dryness around the nails can also play a role in this phenomenon. In some cases, conditions like psoriasis can cause skin cells to grow too quickly under the nail, resulting in a thick, discolored, or chalky appearance.
Pterygium inversum unguis (PIU) can sometimes be genetic or idiopathic, meaning it has no clear cause. However, the acquired form of PIU is often associated with autoimmune conditions, such as lupus or scleroderma, or can be triggered by external factors like frequent gel manicures or nail biting. Fungal nail infections can also lead to thickened skin tissue beneath the nail. While often a benign issue, certain indicators suggest seeking medical advice, including pain, inflammation, discoloration, rapid growth, or signs of infection like pus or excessive swelling.
Safe Home Care and Practices to Avoid
For mild cases of extended hyponychium that do not cause significant issues, gentle home care can be beneficial. Maintaining good nail hygiene by regularly cleaning the nail area and keeping it free from debris is important. Applying moisturizers to the hands and cuticles can help keep the skin supple and prevent dryness. Trimming nails regularly can also contribute to overall nail health.
It is important to avoid certain practices that can worsen the condition or lead to injury. Do not cut or tear the skin under the nail, and avoid using sharp objects to scrape beneath the nail plate. These actions can damage the protective seal of the hyponychium, making the nail unit more susceptible to infections. Additionally, refrain from applying harsh chemicals to this sensitive area, as they can cause irritation or further damage.
Professional Treatment and Prevention
When home care is not sufficient or if there are signs of concern, a healthcare professional can provide further assessment. They can diagnose underlying conditions that might be contributing to the skin thickening, such as psoriasis or fungal infections. Depending on the cause, treatment might include prescribed topical medications. If an infection is suspected, antibiotics or antifungal medications may be necessary.
Long-term prevention largely involves reinforcing safe nail care habits. Consistent moisturizing of the hands and nails helps maintain skin health and flexibility. Avoiding trauma to the nails, such as from aggressive cleaning or biting, helps preserve the integrity of the hyponychium. Wearing protective gloves for activities that involve prolonged water exposure or harsh chemicals can also safeguard nail health.