Toenails and finger nails are made of a very hard protein called keratin. Horns, hooves, hair, and the EMP building in Seattle, are also made of this stuff, which is why the EMP looks like a huge pile of old, painted toenails. Finger and toe nails are not made out of calcium. Taking extra calcium helps bones, but not nails. Why do we have nails? They are basically tools with which to dig, tear, and pick at things. Unlike giant ant eaters, we cannot rip apart a termite mound, but we can manhandle a Lotto ticket. Nails help us manipulate fine objects.

Nail diseases are pretty common and fungal infections may be the most common, especially in older people, whose toenails grow slowly. This means that fungus can grow into the end faster than the nail can grow out. The fungus wins and turns the nails into little, mini EMP buildings without the music and coffee bar. It is a hard problem to cure and most people choose to keep their ugly toenails rather than treat. If you choose to treat, the only truly effective treatment is a twelve week course of an orally-taken anti-fungal medication which ends up in the nail itself. When the fungus tries to invade, it eats the medication and dies. You can find literature about lots of other “cures” including soaking your nails in urine. The great thing about urine is that it is cheap. Another common nail problem is separation, or “onycholysis.” In this condition, the end of the nail lifts off of the underlying nail bed. Frequent water exposure (under water knitting, snorkel poker) can cause this. Micro organisms love growing under a wet nail. They weaken the attachment of the nail to the nail bed. Long nails make the problem even worse because they increase the leverage on the nail. If this is happening to your toenails, check your shoe length. Bumping into the end of a short shoe can pull a nail off. Bozo the clown, who worked on his feet his entire career, never had this problem. Another common problem is infection of the nail edge. If you develop a red, painful area along the edge of the nail, you may have a “paronychia.” A crack in the skin can let bacteria into the skin next to the nail and start an infection. If you have had something like this for a long time, then it is called a “chronic paronychia,” and more likely to be a fungus. Yes, fungus again. Apparently we are something like old, rotting fir trees with fungi hanging off of us at every opportunity.

Nails can also help us diagnose other problems. Psoriasis and its associated arthritis often cause pitting marks in the nails. It’s not a problem for the nail, but it is a clue for the doctor. Have you noticed that white, half-moon-shape area at the base of your nails? It’s called the lunula and is a part of the nail matrix and where the nail is actually produced. Some people have a large, obvious lunula while in others it may not even be visible. I don’t know why this is, but I am very proud of my lunula. How big is your lunula? Color changes in the lunula can indicate a health problem. People with congestive heart failure (the number one cause of hospitalization in this country) can develop a reddish color to their lunula. Caution, looking at someone else’s lunula may be rude. You should probably ask first.