Can Nail Issues from Hair Pulling Be Treated with Care or Surgery?

Nail problems

Hello doctor, I have a habit of plucking my beard with my hands, and now the lunar crescents on my left and right index and middle fingers are uneven (one side is higher than the other, with the side facing the thumb being higher).
Additionally, there is dead skin growing around them.
Can this be repaired through maintenance or surgery? Thank you for your response, doctor.

J, 10~19 year old female. Ask Date: 2022/02/24

Dr. Wu Yuxin reply Dermatology

If you're feeling unwell, do you want to seek medical attention directly?

Reply Date: 2022/02/24

More Info

Nail issues resulting from habits such as hair pulling can indeed be concerning, and your situation with the unevenness of the lunula (the crescent-shaped white area at the base of the nail) and the presence of dead skin around your fingers is not uncommon. Let’s explore the potential treatments and care options available for your condition.

Firstly, it’s important to understand that the lunula can vary in size and visibility from person to person, and it can be affected by various factors, including trauma, health conditions, and habits like pulling hair or nails. In your case, the unevenness may be a result of repeated trauma to the nail matrix, which is the tissue under the base of the nail that produces new nail cells. When this area is damaged, it can lead to irregular nail growth, resulting in the appearance you described.

Care Options
1. Nail Care Routine: Establishing a proper nail care routine can help improve the health of your nails. This includes:
- Moisturizing: Regularly apply a good quality moisturizer to your nails and cuticles to prevent dryness and promote healing.

- Gentle Filing: Use a fine-grit nail file to smooth out any rough edges without causing further trauma to the nail.

- Avoiding Trauma: Try to avoid any activities that may further stress the nails, including pulling or biting.

2. Nutritional Support: Ensure you are getting adequate nutrients that support nail health, such as biotin, zinc, and protein. A balanced diet rich in vitamins and minerals can promote healthier nail growth.

3. Behavioral Modification: If hair pulling is a habit, consider seeking support to address this behavior. Cognitive-behavioral therapy (CBT) or habit-reversal training can be effective in reducing such habits.

Medical Treatments
If your nail issues do not improve with home care, or if you experience pain or infection, it may be time to consult a dermatologist or a healthcare professional specializing in nail disorders. They may recommend:
1. Topical Treatments: If there is any inflammation or infection, topical corticosteroids or antifungal treatments may be prescribed.

2. Surgical Options: In cases where the nail matrix is severely damaged, surgical intervention may be necessary. This could involve procedures to correct the nail shape or to remove any damaged tissue. However, surgery is typically considered a last resort after conservative treatments have been exhausted.

3. Follow-Up Care: Regular follow-ups with a healthcare provider can help monitor the condition of your nails and ensure that any underlying issues are addressed.

Conclusion
In summary, while nail issues resulting from hair pulling can often be managed with proper care and attention, more severe cases may require medical intervention. It’s essential to take a holistic approach that includes both physical care for your nails and addressing the underlying habits contributing to the issue. If you find that self-care measures are not yielding results, do not hesitate to seek professional advice for further evaluation and treatment options. Remember, the health of your nails is a reflection of your overall well-being, and taking proactive steps can lead to improvement over time.

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