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Dr. Andrew Rynne

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Have a tiny hole in nail. Symptoms of median nail dystrophy?

Answered by
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Dr. Sudarshan


Practicing since :2005

Answered : 1391 Questions

I believe I may have median nail dystrophy. I trapped my fore finger about two years ago. About a year ago I noticed a tiny hole at the base of my nail. Now it is a XXXXXXX ridge all along my nail, with some sort of scab at the base, that sometimes bleeds, but it is not painful.

Are there any cures for this?
Tue, 18 Dec 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 29 minutes later

Thanks for writing in.

Median nail dystrophy or longitudinal splitting or canal formation in the midline of the nail. The split, which often resembles a fir tree, occurs at the cuticle and proceeds outward as the nail grows .

As in your case trauma may be a cause for the dystrophy.

Treatment can be avoidance of trauma.Topical treatment with steroid drops daily or protopic ointment(o.1%) daily can help after 3-6 months of treatment.

Before starting treatment confirmation of diagnosis is must.Habit tic deformity or traumatic dystrophy closely mimics the median nail dystrophy.
If you can upload the photos of the nails it would be of great help in predicting the condition.
Photos can be uploaded by UPLOAD YOUR REPORTS SECTION.

Hope this helps.
I will be available for follow up.

MD Dermatology.
Above answer was peer-reviewed by
Follow-up: Have a tiny hole in nail. Symptoms of median nail dystrophy? 19 hours later
Dear Dr Sud

I have already attached a photo of my nail yesterday, it is showing on the my screen as though it is attached to the query. Hopefully you can find it.

Thank you for your help and look forwrd to hearing from you once you have had a look at the picture.

Kind regards,
Answered by Dr. Sudarshan 4 hours later
Hi again XXXXXXX

I was able to view the photo.It does not look like median nail dystrophy.
It is more of traumatic dystrophy .
You should take biotin supplement for atleast 3 months .Biotin is essential for nail growth.Also you should apply betamethasone drops over the proximal nail fold.

If the nail matrix is damaged nail growth may not be normal even after treatment.
If it is intact your nail can grow back at 3 months.
The time for growth of finger nail is 3 months.So 3 month treatment would be needed.

Hope this helps.

Above answer was peer-reviewed by

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