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Hair & Nail Disorders

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

Dealing with hair and nail disorders can be frustrating, especially when they begin to affect your confidence and well-being. Whether it is thinning hair, brittle nails, or unexpected changes in your scalp, or nail health, these conditions can leave you feeling concerned, and self-conscious.

The good news is that many of these disorders are more common than you might think, and with the right treatment, you can reclaim healthier hair, and nails. In fact, by understanding the root causes, and identifying the early symptoms can make all the difference in getting the relief you need.

hair nail disorders Singapore.
Hair and nail disorders can indicate underlying health issues, affecting strength, growth, and overall appearance.

What are hair and nail disorders?

Hair and nail disorders encompass a wide range of conditions that affect the scalp, hair follicles, and nails. These issues can lead to a variety of symptoms like hair loss, nail deformities, itching, and infections.

In Singapore, where the climate is humid, and warm all-year-round, these conditions are quite prevalent, impacting people of all ages. Beyond the climate, factors such as genetics, lifestyle, environmental stressors, and diet can contribute to the development of these disorders.

Types of hair and nail disorders

Not all hair, and nail disorders are the same, as they vary in terms of causes, characteristics, symptoms, and treatments. Some of the more common conditions include, but are not limited to:

Hair Disorders

  • Androgenetic alopecia — androgenetic alopecia, or more commonly known as male or female pattern baldness, is characterised by gradual hair thinning, particularly at the crown, and hairline.
  • Alopecia areata — alopecia areata is an autoimmune condition where patches of hair fall out suddenly, leaving round, smooth bald spots on the scalp, or other parts of the body.
  • Telogen effluvium — telogen effluvium is a temporary hair shedding caused by stress, illness, or hormonal changes, resulting in hair thinning across the scalp.
  • Scalp infection — scalp infection, either due to bacterial or fungal infections such as tinea capitis, can cause itching, scaling, and hair loss.
  • Seborrheic dermatitis — seborrheic dermatitis is a chronic scalp condition marked by red, scaly patches, and persistent dandruff, often exacerbated by stress, or weather changes.
  • Lichen planus — lichen planus is an autoimmune condition that affects both the scalp, and skin, leading to hair loss, itching, and scalp inflammation.
ingrown toenail treatment singapore
Ingrown toenails occur when the nail grows into the surrounding skin, causing pain, swelling, and potential infection if left untreated.

Nail Disorders

  • Ingrown toenails — ingrown toenails occur when the edges of the nail grow into the surrounding skin, often due to improper nail trimming, tight footwear, or trauma.
  • Onychoschizia — onychoschizia, or better known as brittle nail syndrome, is a condition that leads to nail splitting, or peeling.
  • Onychogryphosis — meanwhile, onychogryphosis is described as thickened, curved nails that resemble a ram’s horn, often caused by trauma, or pressure.
  • Onychomycosis (fungal infections) — onychomycosis is a fungal infection that causes thickened, discoloured, and brittle nails.
  • Onycholysis — onycholysis is the separation of the nail from the nail bed, often due to trauma, or infections.
  • Psoriasis of the nails — psoriasis of the nails is a condition where psoriasis affects the fingernails, or toenails, causing changes such as pitting, discolouration, thickening, or lifting of the nail plate.
androgenetic alopecia Singapore.
Androgenetic alopecia is a common hair condition that causes gradual hair thinning, often due to genetics or a family history of the condition.

What causes hair and nail disorders?

The causes of hair and nail disorders vary depending on the type. However, there are several factors that can trigger, or even worsen hair and nail disorders. This includes:

  • Autoimmune disorders — conditions such as alopecia areata, and lichen planus are triggered by the immune system attacking hair follicles, or nail beds.
  • Environmental factors — constant exposure to moisture, chemicals, and pollutants can lead to weakened nails, and scalp issues.
  • Genetic predisposition — family history plays a significant role in conditions like androgenetic alopecia, and certain nail disorders.
  • Hormonal changes — hormonal fluctuations, especially during pregnancy, menopause, or thyroid diseases, can affect hair health.
  • Stress, and diet — poor nutrition, and high levels of stress can result in hair thinning, brittle nails, and scalp inflammation.

What are the symptoms of hair and nail disorders?

Each hair and nail disorder carries different symptoms, with the potentiality of overlapping. As such, you should seek medical attention if you begin to experience any of the following symptoms:

Hair Disorders

Androgenetic alopecia

  • Gradual hair thinning, usually starting at the temples, and crown in men (receding hairline).
  • Widening part, or thinning at the top of the scalp in women.
  • Hair becomes finer, softer, and shorter over time.

Alopecia areata

  • Sudden, round patches of hair loss on the scalp, beard, or other parts of the body.
  • Smooth, hairless skin in the affected areas.
  • Tingling, itching, or burning sensation before hair falls out.
  • Can affect the eyebrows, eyelashes, or facial hair.

Telogen effluvium

  • Diffuse thinning or shedding hair all over the scalp.
  • Increased hair fall, especially while washing or combing.
  • Hair appears less dense, and may appear lifeless.
  • Often triggered by stress, illness, or hormonal changes.

Scalp infections

  • Scaly patches on the scalp, often appearing red, and itchy.
  • Hair may break off close to the scalp, leaving bald spots.
  • Pus-filled sores, or crusty lesions.
  • Swollen lymph nodes in severe cases.

Seborrheic dermatitis

  • Persistent dandruff with white, or yellow flakes.
  • Red, greasy patches of skin, particularly along the hairline.
  • Itchy scalps that may feel irritated, or sore.
  • Hair loss in areas with severe inflammation.

Lichen planus

  • Itchy, reddish-purple bumps on the scalp.
  • Patches of hair loss with scarring.
  • Scales, or crusts, may form on the affected areas.
  • May cause permanent hair loss if left untreated.
Seborrheic dermatitis causes symptoms such as redness, and severe itchiness, leading to hair loss in areas with high inflammation.

Nail Disorders

Ingrown toenails

  • Pain, redness, and swelling along the nail edge.
  • Tenderness around the nail fold.
  • Pus, or infection.
  • Throbbing sensation, especially when walking, or wearing tight shoes.
  • Can either be acute, or chronic.

Onychoschizia

  • Brittle, thin, and uneven nail edges.
  • Nails that peel, split, or break easily.
  • Nails may appear dull, or rough.
  • Often associated with frequent wetting, and drying of hands.

Onychogryphosis

  • Thickened, overgrown, and curved nails, often resembling a ram’s horn.
  • Nails are difficult to trim, and may cause discomfort.
  • Yellow, or brown discolouration.
  • Typically affecting the big toes.

Onychomycosis

  • Foul odour from the affected nails.
  • Yellow, white, or brown discolouration of the nails.
  • Nails become thickened, brittle, or crumbly.
  • Separation of the nail from the nail bed.

 

Onycholysis

  • Nails detach, or lift from the nail bed, usually starting from the tip.
  • Discolouration in the detach area, typically white, yellow, or green.
  • Pain, or discomfort, particularly when pressure is applied.
  • Triggered by trauma, infections, or exposure to irritants.

Psoriasis on the nails

  • Pitting, or small dents on the nail surface.
  • Thickening, or crumbling of the nail plate.
  • Discolouration, with the nails appearing yellow, brown, or white.
  • Nails may lift, or separate from the nail bed.
  • Pain, or tenderness in severe cases.
Brittle nails is a common symptom for a variety of nail disorders. ALT-text: what is brittle nails
Brittle nails is a common symptom for a variety of nail disorders.

How are hair and nail disorders diagnosed in Singapore?

Diagnosing hair and nail disorders is essential to providing targeted treatment, and preventing further complications. These conditions can often be assessed during a visit to a dermatologist, who will use a combination of clinical evaluations, and diagnostic tests to determine the root cause.

Prior to any tests, our dermatologists at Livingstone Dermatology will discuss your symptoms, medical history, family history, and lifestyle factors, including stress levels, diet, and exposure to chemicals.

Based on the initial assessment, the following diagnostic procedures may be performed to diagnose hair disorders:

  • Scalp biopsy — a scalp biopsy entails a small sample of scalp tissue being taken, and examined under a microscope to identify inflammation, infections, or autoimmune disorders like alopecia areata, or lichen planus.
  • Trichoscopy — a trichoscopy refers to a non-invasive test using a dermatoscope to examine the hair, and scalp closely. It allows our dermatologist to assess hair shaft abnormalities, scalp conditions, and patterns of hair loss, such as those seen in androgenetic alopecia, or telogen effluvium.
  • Pull test — a pull test is a diagnostic test, whereby the dermatologist gently tugs on a small section of hair to see how many strands come out. A positive pull indicates active hair shedding, which may suggest telogen effluvium, or an underlying scalp disorder.
  • Fungal culture — in the event our dermatologist suspects fungal infections, a sample of the hair, or scalp debris is collected, and cultured to identify the specific fungus responsible for the infection.
  • Blood tests — a blood test is often conducted to check for hormonal imbalances, nutritional deficiencies, or autoimmune markers. These can provide insights into conditions like androgenetic alopecia, or telogen effluvium triggered by internal factors.
fungal infection Singapore
A fungal culture can help dermatologist determine if certain hair disorders are caused by fungal infection.

Meanwhile, our dermatologist may perform one of the following diagnostic procedures to diagnose nail disorders:

  • Nail clipping for microscopy, and culture — a nail clipping for microscopy, and culture refers to a small portion of the affected nail being clipped, and examined under a microscope. It is then cultured to detect fungal infections, such as onychomycosis.
  • Nail biopsy — in cases of severe nail deformities, or suspected malignancies, a biopsy may be performed. A sample of nail tissue is taken to look for conditions like lichen planus, psoriasis, or melanoma.
  • Digital dermoscopy — a digital dermoscope uses a specialised microscope to examine nail plate abnormalities, pigmentation, and subungual lesions, helping to diagnose conditions like onycholysis or paronychia.
  • Patch test — For patients with suspected contact dermatitis around the nails, a patch test can identify potential allergens. This is particularly useful if nail changes are due to exposure to chemicals, cosmetics, or nail products.
  • Blood tests — a blood test may be ordered to evaluate for systemic conditions like thyroid disorders, anaemia, or autoimmune diseases, which can contribute to nail abnormalities like brittle nails or onychoschisia.
Our dermatologist may collect samples under the nails to be tested for fungal infection.

How are newborn hair and nail disorders treated in Singapore?

We understand that hair, and nail disorders can significantly affect one’s self-esteem, and quality of life. While prevention is ideal, it may not always be possible to avoid these conditions entirely.

However, a range of effective treatment options are available to help manage symptoms, and promote healing. For hair disorders, this includes:

Topical Treatments

  • Minoxidil — minoxidil is often used to stimulate hair growth in androgenetic alopecia. It is applied directly to the scalp, helping prolong the hair follicle’s growth phase.
  • Medicated shampoos — medicated shampoos, which are shampoos containing ketoconazole, zinc pyrithione, or selenium sulfide, can reduce inflammation, and flaking, especially for patients with seborrheic dermatitis.

Oral Medications

  • Finasteride — finasteride is commonly prescribed for men with androgenetic alopecia, helping to slow hair loss, and promote regrowth by reducing dihydrotestosterone (DHT) levels.
  • Corticosteroids — corticosteroids are often administered orally, or injected as it helps with managing autoimmune-related hair loss like alopecia areata, reducing inflammation that damages hair follicles.

Therapy

  • Immunotherapy — immunotherapy is often recommended for severe cases of alopecia areata as it helps stimulate hair regrowth by triggering an immune response on the scalp.
  • Phototherapy — phototherapy, or light therapy, is effective for treating scalp conditions such as lichen planus as it helps in reducing inflammation, while promoting healing.

Supplements

  • Nutritional supplements — our dermatologists may also recommend consuming nutritional supplements that contain biotin, zinc, and iron to support hair growth, and improve hair strength, especially for those with deficiencies contributing to telogen effluvium.

When it comes to treating nail disorders, our dermatologist may opt to proceed with one of the following treatment procedures:

Topical Treatments

  • Antifungal creams — antifungal creams are usually prescribed to treat nail disorders caused by fungal infections, such as onychomycosis. These creams contain ingredients such as ciclopirox, or amorolfine to help clear the infection.
  • Topical steroids — topical steroids are used to reduce inflammation, and help the nail reattach to the nail beds.

Oral Medications

  • Antifungal medications — in severe fungal infection cases, our dermatologist may prescribe oral antifungal medications to help clear the infection.
  • Antibiotics — oral antibiotics usually given in the event the nail disorders are caused by a bacterial infection, accompanied by pus formation.

Nail Procedures

  • Nail surgery — nail surgery is often the course of treatment to remove the affected nails, while facilitating a smooth recovery.
  • Therapeutic procedures — depending on the type of nail disorder, cryotherapy or laser therapy may be recommended to help improve the condition.

Lifestyle Changes

  • Nail care — nail care such as keeping nails trimmed regularly, and avoiding prolonged exposure to water can prevent nail disorders from exacerbating, while allowing it to heal smoothly.
  • Protective gloves — by wearing protective gloves while performing tasks involving chemicals can help maintain nail health.
  • Applying moisturiser — applying urea-based moisturisers can help reduce symptoms of brittle nails. In fact, taking biotin supplements can help strengthen brittle nails, thereby reducing the likelihood of splitting, and breakage.
nail disorders Singapore
By keeping your nails trimmed, and practicing good hygiene, it will help reduce the likelihood of developing nail disorders, especially those that are caused by bacterial, or fungal infections.

The state of our hair and nails can reflect our overall health, and understanding the root cause of your symptoms is the first step to effectively treating hair and nail conditions. With the right treatment approach, these symptoms can be managed effectively.

At Livingstone Dermatology, we offer tailored solutions to restore your hair and nail health. If you have been experiencing concerning symptoms, reach out to us for a thorough consultation and personalised treatment plan tailored to your needs.

Frequently Asked Questions

Can hair loss be prevented?

Although hair loss is a natural part of ageing, there are some preventive measures that you can take to prevent, or minimise the hair loss. These steps include:

  • Maintaining a healthy diet.
  • Managing your stress level.
  • Minimising exposure to environmental damages, such as UV rays, and harsh weather.
  • Practicing proper hair care.
  • Undergoing routine medical check-ups, especially if you have a genetic condition that leads to hair loss.
  • Quitting smoking, and reducing alcohol intake.

Yes, certain hair loss can be reversed, especially if treatment begins early. In fact, topical treatments such as minoxidil, oral treatments such as finasteride, and therapies like platelet-rich-plasma (PRP) can stimulate hair regrowth.
However, it is important to understand that the success rate varies depending on the cause, and severity of hair loss.

Temporary hair loss, such as telogen effluvium, often follows a stressful event, or illness, and typically resolves on its own within a few months. In contrast, androgenetic alopecia, and certain autoimmune conditions may lead to more permanent hair loss if not treated early.

While some natural remedies like rosemary oil, aloe vera, or coconut oil may improve scalp health, they are usually not as effective as medically-proven treatments like minoxidil, or finasteride.

If you have been experiencing hair loss, with a family history of hair conditions, then it is best to consult a dermatologist for personalised advice.

It may take approximately between 3 to 6 months to notice significant improvements. However, it is important to note that when it comes to undergoing hair loss treatments, consistency is the key to seeing results.

Yes, brittle nails can function as a health indicator as it usually indicates a deficiency in nutrients like biotin, or iron. They may also be a sign of an underlying condition such as hypothyroidism. However, they can also result from regular exposure to water, harsh chemicals, or ageing.

While mild fungal infections can sometimes be treated with over-the-counter antifungal creams, or medicated nail lacquers, persistent infections typically require prescription oral antifungals for more effective results.

If you have a nail disorder, it is best to consult with a dermatologist before getting manicures, or pedicures done. In the event your dermatologist says it is permissible to have these treatments done, it is important to ensure the salon uses sterilised tools, and practices proper hygiene to avoid exacerbating the condition, or introducing new infections.

One of the best ways to help make your nails stronger is by keeping them moisturised, trimming them regularly, and avoiding using them as tools. Additionally, it is best to protect them from harsh chemicals by wearing protective gloves.

While using a nail hardener may be beneficial for some individuals, it is encouraged to speak with your dermatologist if it is recommended to use a nail hardener if you are diagnosed with a nail disorder.

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