Friday 26 May 2017

Overcoming brittle nails and 'honeymoon cystitis'

Nail care
Nail care

Advice from our GP on treating fungal nail infections and advice on how to avoid a urinary tract infection after sex.

Question: My daughter has very mild psoriasis and also seems to have brittle nails. I read online that there is a connection. Is there anything that she can do to strengthen them? Are there any products that she can paint on or even dietary guidelines? She drinks lots of milk and eats nuts daily but nothing seems to work. Can you help us?

Dr Nina replies: Two of the most common causes of brittle nails are prolonged exposure to water or overuse of nail polish. The first may be an occupational hazard. If you wash your hands regularly for work, you should apply hand cream frequently throughout the day. Breaking the nail polish habit and allowing nails to heal and grow naturally may help improve the second.

Fungal infections are the most common cause of nail infections. These are more common in toenails but may occur in any. Fungal infections may cause thickening, crumbling and splitting of the nails.

Up to 10pc of dermatology complaints may be related to nail health. It takes about three to six months for a full new nail to grow. Nails do become more brittle with age and so most nail complaints are more common in older people.

An under or overactive thyroid may cause nails to become brittle and crack. Psoriasis may cause brittle crumbling nails. It may also cause the nails to appear yellow. Brittle nails may also be associated with other inflammatory arthritis. If your nail changes are associated with generalised pain in your joints or other physical symptoms, it should be discussed with your doctor.

In anaemia the nail may become spoon shaped and seem thinner or more brittle. Transverse lines across the nail can be a sign of recent ill health or injury, and may occur during chemotherapy. Whitening of the nails may be due to malnutrition but can also occur in a number of diseases including diabetes, liver disease or kidney and heart failure. The appearance of small pits on the nail surface may suggest psoriasis, other inflammatory conditions or eczema.

Our fingernails grow about 3.5mm per month. Toenails from more slowly at about 1.6mm per month. Women's nails generally grow more slowly than men's. Nails grow faster in summer than in winter.

Symptoms of nail problems include thickening or thinning, and peeling or splitting of the nails. Changes in the nails colour, shape and surface can be significant. Other problems may include changes on the skin surrounding the nail or pain.

If your nails are unusually brittle and you can't identify a simple cause it is worth having a check up. Your doctor may decide to run some simple blood tests to rule out any malnutrition.

If you have brittle nails, basic nail care is very important. Nails should be cleaned gently with a soft brush. Cut the nail straight across. Wear protective gloves when washing dishes or using cleaning agents.

Moisturise your hands regularly. Using a nail hardener may help protect nails. There are some suggestions that taking a biotin supplement can help improve nails. However biotin is readily available in a wide variety of foods and so it is unlikely that those who eat well would be deficient and require supplements.

Lastly, don't be tempted to use regular polish to cover unsightly nails. The chemical and techniques used to remove these may just exacerbate the problem. If psoriasis is a cause, steroid creams and ointments applied on the nails and nail bed may help reduce inflammation.

Why do I get a kidney infection after sex?

Urinary tract infections (UTIs) are the second most common type of infection in the body. They occur more commonly in women. This is due to the fact that the urethra is much shorter than in men and is also located near to the anal area. This facilitates the passage of bacteria into the body. Sex creates friction and facilitates the transfer of bacteria in the genital area. Thus UTIs in sexually active women are common. They used to be referred to as “honeymoon cystitis”. Most women will have some bacteria in their urine post-intercourse, but this usually clears itself within 24 hours.

If you have a UTI you may feel the urge to urinate more frequently, but only pass a small amount. There may be pain or stinging passing urine and urine may appear cloudy, foul-smelling or blood-tinged. Other symptoms include back pain, fever, nausea or pressure or pain in the abdomen. If a UTI is confirmed an antibiotic will be prescribed.

For those with recurrent infections a low dose of antibiotic taken at night may be prescribed for several months. Another remedy may include taking a single dose of antibiotic after sexual intercourse or taking a short course of antibiotics as soon as symptoms appear. In most cases simple preventive measures can be helpful.

Cranberry juice or vitamin C make the urine more acidic and so make it harder for bacteria to grow. Drink plenty of water. This helps keep the urinary tract flushed through and makes it more difficult for bacteria to grow. Pass urine when the urge occurs and avoid resisting the urge to go. Passing urine after intercourse will help flush out any bacteria that may have entered the body. Wipe from front to back to prevent the transfer of bacteria from the anal area.

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