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"What is wrong with my nail?"
A few years back I had a severe nail injury, and my thumbnail has never grown back properly. It isn't well attached to the nail bed, and it's discolored and looks unhealthy. What should I do?
There are a couple of possibilities here. Sometimes, with a severe nail injury, there is damage to the area under the cuticle and nail fold where the new nail tissue is formed. If the damage is significant here, or if there is significant residual scarring, the nail will not grow back normally. Unfortunately, if this is the case, there is very little that can be done to rectify the problem. Other times, damage to the nail allows the nail to separate from the nail bed. This creates a space under the nail where fungus and other organisms can settle in and cause an infection. Fungal infections of the nail in particular are very chronic and result in thickening, distortion, yellowing, and sometimes also odor of the nail. Your primary care doctor should be able to tell the difference between these two possibilities quickly with a physical examination. If there is any doubt, they make take some scrapings from under the nail and look at them under a microscope or send them to a laboratory to look for fungus. If fungal infection is confirmed, then this can be treated with a several months long course of oral antifungal medications.
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