Nail disorders
Nail problems, properly diagnosed.
Nails are more than cosmetic — they reflect your overall health. Changes in nail colour, texture, shape or growth pattern can signal skin conditions, systemic disease or infection. Dr Claudia Moloabi assesses nail disorders with the same diagnostic rigour applied to every condition at Omnia Dermatology.
Understanding nail disorders
What your nails are telling you.
The nails are extensions of the skin, and many dermatological and systemic conditions leave visible signs there. Psoriasis frequently involves the nails — causing pitting, lifting, thickening or discolouration. Eczema, lichen planus and alopecia areata also have well-recognised nail manifestations.
Beyond skin conditions, nail changes can reflect thyroid disease, iron deficiency, liver or kidney disease, or medication effects. A sudden change in a single nail warrants careful examination — not because it is always serious, but because accurate diagnosis is the only way to know.
Nail disorders are frequently under-assessed. Patients are told their nails are simply cosmetic, or treated empirically with antifungals that don't address the actual cause. At Omnia Dermatology, nail examination includes dermoscopy of the nail plate and bed, and investigations are chosen to answer a specific clinical question.
Nail conditions we assess and treat
- Psoriatic nail disease
- Onycholysis (nail lifting from the bed)
- Melanonychia (dark streaks in the nail)
- Nail pitting, ridging and dystrophy
- Paronychia (inflammation around the nail fold)
- Brittle, thin or slow-growing nails
- Subungual lesions requiring assessment
- Nail changes associated with systemic disease
What we treat
Nail conditions we see regularly.
From cosmetically distressing to clinically significant — all nail concerns are assessed with equal care.
01
Psoriatic nail disease
Up to 50% of psoriasis patients develop nail involvement. Correct identification opens access to specific systemic and targeted treatments.
02
Melanonychia
A dark streak running along the nail may be benign — pigmentation from the nail matrix — or require further investigation. Specialist assessment with dermoscopy gives a clear answer.
03
Nail dystrophy
Deformed, thickened or discoloured nails with multiple possible causes — fungal infection, inflammatory skin disease, trauma or systemic illness. Diagnosis comes before treatment.
04
Paronychia & nail fold disorders
Painful, swollen nail folds caused by infection, irritant exposure or inflammatory skin disease — each requiring a different approach.
How we approach nail disorders
Examine first, treat second.
Nail disorders are frequently mistreated because they are misdiagnosed. The right diagnosis makes all the difference.
Clinical examination
All twenty nails are examined — not just the affected ones. Nail shape, colour, surface, bed, and surrounding skin all form part of the picture.
Nail dermoscopy
Dermoscopy of the nail reveals detail invisible to the naked eye, particularly for pigmented lesions and subungual disorders.
Targeted investigations
Nail clippings for mycology (fungal culture), blood work for systemic causes, or nail biopsy where a histological diagnosis is needed.
Diagnosis and treatment plan
Treatment matched to the actual diagnosis — not empirical antifungals. Options range from topical nail treatments to systemic therapy and, where indicated, nail procedures.
Review
Nail conditions respond slowly — review appointments track improvement over months and adjust treatment if needed.
Nail questions
Nail disorders, answered.
Have a question that isn't covered here? Contact the practice directly.
How do I know if my nail problem is fungal or something else?
You can't know for certain without testing. Nail fungus (onychomycosis) causes thickening, discolouration and brittleness — but so do psoriasis, lichen planus and nail trauma. Treating a non-fungal nail condition with antifungals won't work. A nail clipping for mycology culture, combined with a clinical examination, gives a definitive answer.
What is melanonychia and should I be worried?
Melanonychia is a longitudinal dark streak in the nail. It can be caused by nail matrix pigmentation — which is common and benign, particularly in darker skin tones — or in some cases by a subungual melanoma. Dermoscopy of the nail can usually distinguish between the two without a biopsy. Any new or changing dark nail streak should be assessed by a dermatologist.
My nails are constantly brittle and breaking — is this a deficiency?
Brittle nails (onychoschizia and onychorrhexis) can be caused by iron or biotin deficiency, thyroid disease, repeated wetting and drying of the hands, harsh nail products, or inflammatory skin conditions. A specialist assessment will check for underlying causes before recommending treatment — which may include blood work, nail fortification strategies and protective measures.
Can a nail condition require surgery?
Some nail conditions are best treated with a minor nail procedure — ingrown nails, nail biopsies, or removal of a damaged or infected nail. At Omnia Dermatology, nail surgery is performed in practice under local anaesthesia. See our dedicated nail surgery page for more information.