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Ask Dr. S. Attili Your Own Question
Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 5175
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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Receding Nails. Hi there, several of my fingernails are

Customer Question

Receding Nails.

Hi there, several of my fingernails are receding. Over the past two years I've tried anti-fungal nail creams (the clippings proved negative) gentle creams/handwash and multi-vitamin tablets, but without any joy. I've had bloodtests and I do not have any signs of psoriasis. I went to see a dermatologist but she said it wasn't clear what was wrong and to use a skin colour nail varnish! Until two years ago, my nails grew quickly & were healthy and strong. Now 9 out of 10 of my fingernails is receding. Any advice? It's really upsetting - I'm not sure what else to do. Thank you

Thank you
Submitted: 5 years ago.
Category: Dermatology
Expert:  Dr. S. Attili replied 5 years ago.
Hi. I will do my best to advise. However, please note that this does not substitute an in-person consultation with a doctor.

Are you able to upload pictures of our nails? How many times were nail clippings taken overall? Are our toe nails affected? Do you have any hobbies like playing music? Do you take medications for anything else?
Customer: replied 5 years ago.
Hi there, I will upload some pictures now. I've probably had 3 nail clippings done over 2 years. My toe nails are clear. I've never had any kind of fungal nail infection. I don't play any music, I do a fair bit of typing, but that's with the pads of my fingers. I was on the Yasmin pill, but have just come off it and and am now on Spironolatone.
Expert:  Dr. S. Attili replied 5 years ago.
Thanks. Given the appearance, there are three possibilities

1. Fungal infection- unlikely because they did not respond to treatment and clippings were negative

2. Trauma from typing- but shouldn't affect non-typing fingers

3. Psoriasis- most likely despite the absence of psoriasis elsewhere.

In this situation i would usually recommend empirical treatment with a psoriasis gel called dovobet. Have you tried this before?

Customer: replied 5 years ago.
Hi there,

Thanks. I've not tried Dovobet before. Is it safe to use long-term? How long would you recommend using it for?

If not Dovobet, would you recommend taking anything else?

I have quite bad circulation - my hands can get quite cold so I wondered if that might have something to do with it.

Thank you

Expert:  Dr. S. Attili replied 5 years ago.
I wouldn't suggest using dovobet once a day for more than 3 months, unless it is working, in which case it is safe to continue for upto 1 year.

Yes bad circulation can also certainly cause this. I did not realise that you had bad circulation. But it is still worth giving dovobet a shot in case this is psoriasis, as if the problem is being caused by the bad circulation, you cannot really do anything, apart from taking drugs like aspirin and pentoxifyline. You should probably speak to your doctor and consider these medications anyway, as this would help.