Nail Health Checkup Program

Appearance screening, etiological testing, and systemic related index screening. In addition, most of the so-called "nail microcirculation testing" and "nail nutrient screening" on the market have no clinical basis, so there is no need to do it randomly.

When I was an intern in the dermatology department a while ago, I met seven or eight patients a day who raised their fingers and asked, "Doctor, if the vertical lines on my nails mean that my liver is not in good condition?" One of them, a young girl who had just graduated, even went so far as to go so far as to go through a round of liver cancer screening by herself, which cost several thousand. In the end, she only had manicures for three months in a row, and the nail surface was polished too thin, revealing the texture of the nail bed itself.

In fact, when most people come for a check-up, the first step is a doctor's naked eye + dermoscopy preliminary screening, without having to draw blood. An experienced dermatologist can screen out typical onychomycosis, psoriatic nails, and periungual warts at a glance. If he is unsure, he can use a dermatoscope to magnify it dozens of times to see whether there is bleeding, uneven pigment distribution, or abnormal blood vessels under the nail. To be fair here, the "vertical nail stripes = liver disease" and "white spots = calcium deficiency" that are so popular on the Internet are not completely nonsense. It is true that some patients with severe liver disease will have white and layered nails, and infants and young children with calcium deficiency may also develop dots. White nails, but the opposite is not true at all - 90% of vertical nail lines are normal physiological aging, just like wrinkles on the face. Most of the white spots are caused by you chewing your nails a while ago or knocking on the corner of the table and bruising the nail matrix, and they will grow out on their own in two months.

If onychomycosis is suspected to be a fungal infection at the initial screening, etiology testing will be necessary. The habits of different hospitals in this area are quite different. Some grassroots hospitals are accustomed to doing fungal microscopy first. They scrape off some nail clippings, dissolve them with potassium hydroxide and look at them under a microscope. The results are available in 20 minutes and cost more than ten yuan. However, the false negative rate is not low. Sometimes the scraped area happens to be free of fungi, so it is easy to miss it. Some hospitals will directly perform fungal culture and put the scraped nail clippings into culture medium for two weeks. This can identify the specific fungus and can also determine drug sensitivity to facilitate subsequent medication. However, the waiting time is too long. Many people can’t wait and buy their own medication first. In the past two years, there have been more advanced fungal PCR tests, which can produce results in one or two days and are highly accurate. However, they are more expensive, costing more than 100 yuan, and are suitable for people who are in a hurry to get a diagnosis.

If your nails are deformed or discolored and are not caused by fungi or skin diseases, then you need to check for systemic problems. For example, I met a patient before, and his nails slowly turned into depressions like spoons. After a blood test, I found out that it was iron deficiency anemia. After taking iron supplements for three months, the nails grew back. Some people's nails suddenly become brittle and easy to delaminate, ruling out the problem of manicure. They may need to check their thyroid function. Many patients with hypothyroidism have this symptom. If a black band that is more than 3mm wide suddenly grows on the nail, and it is still widening rapidly, with uneven color, and the skin around the nail is also darkened, then you should be alert to the possibility of malignant transformation of the onychomycosis and perform a biopsy in time to check for melanoma. Do not be careless.

By the way, a reminder, many nail salons now have some kind of "nail health tester". They take a light and shine it twice and it will tell you that you are deficient in vitamin A and collagen, and they want you to buy their nutritional oils and nail care packages. They are all IQ taxes. The trace element content of nails cannot reflect the nutritional status of the whole body at all. If you really want to check whether you are deficient in vitamins, a blood draw is more accurate than anything else.

To be honest, nails are a "health barometer" hanging on your hand. Don't panic if there are small changes, but don't take it completely seriously. If you really need a check-up, go to the dermatology department of a regular hospital and it will be more effective than checking ten pieces of popular science online. I had a 2mm brown line on my nails two years ago. I was scared to death and went for a dermatoscopy. The doctor said that the pigmentation was caused by typing on the keyboard every day.