Category:Caring for Nail Dystrophy

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Regular nail care is essential for those with PC. Patients use a variety of methods and tools. Following is a list of various medications, products, tips and tools which help PCers care for their nails.



PC does not cause infections. However, it is possible for those with PC, to get a secondary fungal infection (such as a nail infection or athlete's foot, etc.). An infection is caused by germs from the outside, not from something internally. Children with fragile nails are more susceptible to infection because they don't have the same barriers, but the infection is not caused by PC. However, infections do happen because it is often easier for germs to get through PC skin and nails. Infections are more common in children than in adults because children are more exposed to germs (through putting their hands everywhere, not washing well, etc.).

An antifungal treatment will not improve the PC condition; however, it may work well to treat a secondary infection. Most of these drugs are not designed for long term use; they are designed only to treat an infection.

Preventing Infections

"Daikins Solution can be used; however, just as effective and less expensive is to put 1 capful of bleach (unscented, plain household bleach) into 1 gallon of water then soak. This kills yeast which causes fungus and virus; it is powerful. Use a fresh batch each time as it loses potency if stored. Rinse after using. Apply Vaseline while still wet.

Questions: What about vinegar instead of bleach? Answer: It kills yeast, but it stings

Question: What about peroxide? Answer: Not as effective, plus it causes tissue damage.

Question: What about witch hazel? Answer: Okay, but it has lots of alcohol and it dries the skin

Question: Instead of using Vaseline, what about A&D or Aquaphor. Answer: Okay, but more expensive and likely not really more effective"

Antimicrobial Bleach Bath

by Dr. Leonard Milstone, 2002

Aim for a 0.05% solution of hypochlorite. Laundry bleach contains 5% hypochlorite.

Use 1 ounce bleach in a gallon of water to give 0.04%. (2 tablespoons) Or put 30 ounces (about 4 cups) of bleach in the average 30 gallon tub. If you only fill the tub half full of water, use two cups of bleach.

If this concentration is irritating, it can be reduced to 0.01%.

Soaking should be for at least 30 minutes, 1-2 times per week.

K6a patient "Infected - red swollen, filled with pus. Nail pulsates and is extremely painful. Trim when feel the twinge of infected nail. With children, won't know until it's too late. Sometimes, can trim and avoid the swollen nail. Many times, must wait until nail "ripens". Then soak for long time in very warm water until nail is very soft. A gentle slice with a sharp razor blade may be enough to draw out the pus. Sometimes an especially thick nail will need help of large nail clippers, but pressure is involved with those, so if can get the pus through the nail with razor blade, the pain is less severe. Once pus comes out, soak again. We like the bubbly Hydrogen Peroxide. Then add an antibiotic ointment. If infection is too bad, will on occasion need a prescription antibiotic. Great relief when pus comes out. Sometimes it's not enough and on occasion, red lines have gone up the finger. In that case, an immediate trip to the doctor for an antibiotic is necessary."

K6a patient "If the nail area starts to get red, soak it in warm, salty water or warm solution of Epsom Salts as often as possible. Sometimes prolonged soaking soften nails so hole forms spontaneously - the best outcome. Soaking also relieves symptoms without needing antibiotics or lancing."

K6a patient "Swimming for us often results in nail infections."

K6a patient "We put Sally Hanson Hard as Nails (a clear polish) on nails after sanding them. We thinks it makes the nail more durable, and less prone to infection."

K6a patient "Infected nails; Very painful "our heart beats in our finger: and it's very hot." Wait for nail to mature (takes analgesic syrup to calm the pain.) Once the pus is assembled, bore with a needle and disinfect. Great relief when pus comes out."

K6a patient "Trim regularly using large nail clippers. Trim PC children's nails every few weeks using large nail clippers and razor blades. Soak nails in water first. Seems to ward off infectious nails. Can sometimes feel a twinge in nail to warn of oncoming infection. Trimming immediately can avoid the problem altogether. Never get infected nails as an adult, but young children still do."

K6a patient "I found out from one of my relatives that she was taken a strong medicine (very expensive as well) recommended by a dermatologist she met. She has been taking this medicine daily for the past 4-5 months I think and the interesting thing is that her thickened nails are healing pretty good. I went to see her and i saw that her thumbnail was almost leveled to the skin, according to her this same nail was really thick before she starting taking this medicine. The medicine's name is Seritral."

  • Comment 1 (PC Physician Panel member; Dermatologist) -- "Seritral is an oral anti-fungal agent and the excipient is just the inert material that holds the pill together. The name of the anti-fungal is itraconazole and it does work well as an antifungal, but patients using this medicine should be monitored for possible liver toxicities, especially if they receive it for a longer period of time or at a high dose. The antifungal will rid the feet of the fungus and if there was a fungal infection going on there, it may improve the condition by reducing the "trauma" to the feet, but will not get rid of the problem altogether because it doesn't change the genetic features of the skin. It is also remotely possible that there may be a second effect of the drug, in addition to the anti-fungal effects, that could help to improve the condition (but not cure it), but this has never been studied and so I would be very hesitant to draw that conclusion."


    Lamisil also comes in sprays
    Lamisil also comes in sprays

    Informal comments from physicians on the IPCRR Physician Panel:

    Dr. Peter Hull said "It is possible that the abnormal nails could become infected with fungi including non-dermatophytes. Lamisil would only work to get rid of dermatophyte fungi but the nail would remail abnormal if it was affected by PC."

    Dr. Philip Fleckman said "Terbinafine (Lamisil) is a good drug for dermatophyte infections (but not Candida or other yeast infections) of the skin. Dermatophytes are a group of fungi that live in the top part of the outer, barrier layer of the skin (the stratum corneum of the epidermis). Dermatophytes cause athelete's foot (tinea pedis), jock itch (tinea cruris), and most types of nail fungal infections (onychomycosis). Because the nails in PC are thicker than normal, they are often mistaken for nail fungal infection and treated with terbinafine. Unless the nails or feet are infected, I know of no reason why terbinafine would improve PC."

    K16 patient "Me on the other hand have it quite bad, well worst after the kids anyway. Now I am at the point where I don't even have PC in spots it is just raw skin and itches really bad. I also see that I am getting athletes foot or real bad itching on top of toes and between as well." Physician "It is possible she could have athlete's foot on top of her PC and if that is the case it should respond to to Lamisil which is a OTC medicine."

    ??? patient "I've been using Lamisil about 4 months & doctor asked me to stop taking it because it is not going to be get rid my problem."

    K16 patient "While chatting with my brother, he told me his new doctor has been giving him Lamisil for his feet (fungal infection) and cordisone shots!! He just doesn't get it about his own feet....and apparently this new doctor hasn't a clue about what PC is!"

    K6a patient "The doctor asked that we pick up an anti-fungal cream. She first thought lamisil, but changed to miconazole. At the store the only Miconazole was a 'vaginal' cream, but the pharmacist said okay to use on feet; they just didn't carry the 'foot care' package, but it would be the same. I started immediately to soak my feet with a capful of bleach and then applied the anti-fungal cream (Miconazole). I did that yesterday evening and today morning, and I would say it's already helping me a lot. Since the last 4 or 5 years my feet started to itches a lot, specially in the heels, and since I started with this medication it is not itching anymore. That's great!"

    Tea Tree Oil

    Tea tree oil is an extraction from the Melaleuca tree. Tea tree oil or melaleuca oil is a clear to very pale golden color essential oil with a fresh camphoraceous odour. It is taken from the leaves of the Melaleuca alternifolia which is native to the northeast coast of New South Wales, Australia. The oil has beneficial medical properties (including antiseptic and antifungal action), and is also believed to have beneficial cosmetic properties.


    Tea Tree Oil can be found [here], other places online, and in many health stores.

    K16 patient "We heard about tree oil from our son & his Australian friends. My husband decided to give it a try on his feet, especially when they swell up & get infected...and it does seem to work! They don't stay infected as long and it aids in the pain, but it does have a unique odor, in other words , stinky! ha ha but after a while you kind of grow to like the "smell". I guess the aborigines from Australia have used it for centuries, for every ailment and it has been only within the past century that "whitemen" discovered and now market it. A great product! I keep it handy."

    K6a patient "Tea Tree oil for nail infections. Used as both a prophylactic (prevents the infection) and as a treatment. Not a miracle cure, but seems to help somewhat."

    K6a patient "For nail infections I use Tea tree oil - An Australian natural oil known for its antibacterial properties. Soaked hands and feet in water with drops of the oil in water."

    K16 patient "Some type of fungus in my groin area - pink blotches with a chalky feel. They itch sometimes and I’ve been treating them with tea tree oil to reduce the itch and make them go away."

    K17 patient "I have tried a lot of things including Tea Tree Oil on my calluses. It did not work for me, but does seem to help when a toenail gets inflamed. My dermatologist recommended AmLactin (RX only I believe). There are several over the counter remedies I've tried as well. One that works fairly well for me (couple times a week at night) is Heel Rescue Superior Moisturizing Foot Cream. It comes in a 16 oz jar with a pump in the middle. It doesn't take a lot and as I said, I only use it a couple of times a week when I'm already sitting in the bed. A little goes a long way. I guess what works and doesn't work for one may or may not work for another."

    K6b patient "For skin, have lotion. Tea tree, aloe lotion."

    Trimming Tools

    PC patients use a variety of tools to trim and manage their nails. Many of these products are also used to manage keratoderma.

    Scalpels and knives


    Power Tools


    Urea is an emollient (skin softening agent) which helps to moisturize the skin and is used in topical dermatological products to promote rehydration of the skin. If covered by an occlusive dressing, 40% urea preparations may be used as keratolytic agents (for debridement of nails and removal of calluses.)

    Generic Name: Urea Cream, Gel, and Ointment 25%, 30%, 40%, and 50% Brand Name: Examples include Carmol 40 and Keralac

    K17 patient "For thick nails I use a Rx Urea 40% Gel. This comes with an applicator and looks like clear nail polish. I use it twice a day and it dries pretty quickly (less than 5 minutes). I have been using on my two thumb nails for only one week and have noticed one of them is considerably thinner. The other one (right) was thicker to begin with."

    Nail Care for Children with PC

    K6a patient "Nail care for children. Trim baby's nails when asleep or relaxed. Use the sharpest pair of nail clippers you can find, and don't take off too much at a time. Then file the nail smooth, in one direction only. Filing back and forth seems to make it sore. The more we messed with the nail, the more likely we were to have problems. Groom their nails about every 2 weeks. The nails are more noticeable when they're longer, but it's the balance between "short enough" and "not too often". Then apply a nail polish top coat or nail hardener."

    K6a patient "Trim regularly using large nail clippers. Trim PC children's nails every few weeks using large nail clippers and razor blades. Soak nails in water first. Seems to ward off infectious nails. Can sometimes feel a twinge in nail to warn of oncoming infection. Trimming immediately can avoid the problem altogether. Never get infected nails as an adult, but young children still do."

    K16 patient: "Wait until she is fast asleep - that is the only way I've been able to do my daughter's feet, and that is how my mother did mine. I have about 45 minutes to do it before her sleep gets lighter and it gets impossible, and the feet are dry by then, but at least she's still for a moment. Maybe you could try it, too. Hope you find a way that works!"

    Artificial Nails

    K17 patient "I have really bad nails though but manage to disguise them by filing them flat and putting false nails on."

    K17 patient "I always wear false fingernails. The big toe nails on both my feet are also false. You can still see the thickness from the side even with tips."

    ??? patient "My sister and I have been filing down our nails since we were pre teens. I have applied artificial nails on my own since I was about 18. We both have had acrylic nails put on professionally (when they first came out) but they didn't work out.... it took too long, was embarrassing and costed too much. So I just watched what the manicurist did and I knew I could do it myself. To make a long story short I am now 46 and I am still wearing artificial nails which I redo religiously once a week. My sister, who isn't as vain as I am, doesn't wear them anymore because they won't stay on with the type of nails she has.

    Even though mine don't look perfect, they do fool most people! Now that they have come out with artificial toenails I also apply a fake one on my big toes and it feels great to wear sandals! Of course there are a couple of down sides to wearing false nails but I think it's worth it and it has made me feel more secure throughout my life."

    ??? patient "I manage the condition by using a dremel tool and thinning them out and also by going to a nail salon to have gel tips put on them, it took awhile to find a good nail tech who has a good attitude and is very patient with my condition. I usually get gel nails and they last several weeks and then I have to remove them. Sometimes if I am too ruff with my nails or accidentally smash them while the artificial nails are on they will get an infection so that's another thing I have to manage, not getting nail infections. Infections are very painful and require me using the dremel tool to take off as much as the fake nail as possible and sticking a needle into the nail bed until the puss oozes out. It is a pain I have learned to deal with because when I was younger I would have a few nails at one time infected and they would throb to the point where I felt it feel better if I could just cut my fingers off. After the puss is released the nails kind of shed their own dead shell and a new nail grows. My feet are affected by PC as well and I have to dremel them too. If I don't get enough sleep the planters warts will hurt and I will have to dig at them. Not having enough sleep ruins my day because everything on my feet ache, the calluses and everything. In the past when I have painted my nails after making them shorter and filing them down, and have painted them it's as though the nail soaks in the nail polish and it starts to hurt and feel horrible. It is so hard to remove nail polish from PC nails because the nails soak it up like they are a sponge."

    Nail Removal

    NOTE: For those with PC, there isn't a success story about removing the nails. They grow back. The only people I know who report success with this are people who do not have a PC mutation. One PCer has had their toenails removed, but they have had to repeat it several times. There are other similar disorders where nail removal does work, but so far not for PC. So right now, nail removal is NOT recommended by any of the physicians on the PC physician panel.

    K16 patient "Had toe nails removed. The first surgery all the toenails grew back exactly the same. It has taken 4 attempts to permanently remove the nails, each time I had it done a few less nails would grow back. Now left with pain free toes and the nail bed has been replaced with regular old hard skin which is much easier to shave off. Still have 2 very stubborn nails left now (4th toe on each foot) which seem to refuse to stop growing. The removal of the toenails is not too bad with some strong pain relief immediately after the surgery. The pain seems to go within hours"

    K6a patient "Nails are removed so they are soft, kind of a callus layer. I use an emory board and file them smooth. Then to keep from splitting or from skin splitting I use a nail hardener. Then days later I use vaseline."

    K6a patient " Doctor shaved nail bed on big toes to see if it would make them grow flat. Made toe nails worse - quite lumpy. Painful operation."

    K6a Patient "Big toenails always swelling and falling off. Causing a lot of pain. I had both the big toes on my feet removed. The procedure was not that big a deal. I spent one night in the hospital with a bit of pain (mind you I was on a bunch of pain killers) but not much worse then when they would swell and fall off. For some reason none of my other toenails ever gave me trouble. Procedure didn't work - nails grew back. However, the two big toe nails don't swell as often. Don't know if it's a coincidence but since the procedure (at least 10 years ago) they have only fallen off 3 or 4 times."

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