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By H. C. Dung, Curtis P. Clogston, Joeming W Dunn

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Onycholysis is the most common condition predating a nail fungal infection. Fungal infections of the nail, medically known as tinea unguinum, are extremely common with advancing age. It is estimated that 80% of persons age 80 or older will develop a nail fungal infection. The infection becomes more common with advancing age as the immune system’s ability to protect against a fungal invader is diminished. The same fungus that causes infection of the feet also causes nail fungus, as mentioned previously during our discussion of foot diseases.

Certainly, this is not an alternative that would be considered by many! Skin Care Needs The skin care needs of the scalp are to remove excess skin scale, loosen shedding hair, and maintain the biofilm of sweat, sebum, and organisms in balance. Many might suggest that the scalp should be moisturized to smooth down the skin scale and allow barrier repair to occur. While this is generally the case in other body areas, this logic does not pertain to the scalp. Skin scale provides a home for the fungal and bacterial organisms and allows sweat and sebum to accumulate on the scalp.

Usually these structures are moisturized at the same time the hands are moisturized, but there are some key differences to consider. The outer stratum corneum layer of the skin of the hands is replaced every two weeks, but the nails are nonliving, thus, any dehydration damage inflicted is permanent. Remoisturizing the nails can be minimally enhanced with urea and lactic acid, which increase the water binding sites on the nail keratin, but their effect is temporary until the next hand washing. Also, too much urea and lactic acid can over soften the nail plate, making it more susceptible to fracture.

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