Ask the Doctors: Nail inflammation, infection can occur after manicures

Q: Right after I got a manicure, the skin around two of my fingernails got red and really swollen. My roommate says it can happen when the manicurist cuts your cuticles. Is that true?

A: The focus on the fingernails is often as a decorative space. However, they play a crucial role in protecting and stabilizing the tips of the fingers. This allows them to become the versatile tools we rely on countless times throughout each day.

The nails themselves, which we use when we scratch an itch, pick up a tiny object or untie a bow, are also part of that tool kit. All of this makes the state of our nails an important part of general health.

You have described the symptoms of paronychia, which refers to inflammation and infection in the skin surrounding a fingernail or a toenail. It can occur when a pathogen, typically bacteria, finds a way past the barriers that protect the tissues around and beneath the nail.

One of these barriers is the cuticle, which is the band of tissue that arcs across the top of the nail. It shields the nail root, which is where nail growth begins. The folds of skin along the sides of the nail also offer protection. Along with the cuticle, they shield the complex and delicate tissues involved in nail growth.

The most common cause of paronychia is a staph infection caused by the bacterium Staphylococcus aureus. Strep bacteria and fungi can cause nail infections as well. The infection itself can occur when the protective barriers around your fingernails or toenails are breached.

It can be due to an injury, an ingrown toenail, from biting your nails or cuticles, from prolonged contact with water or other liquids, from contact with a corrosive substance and, yes, from an injury that occurs in the course of having your nails cut or filed, and the cuticles trimmed or pushed back during a manicure.

This type of infection is usually pretty straightforward. Diagnosis is with a visual exam, and treatment depends on the severity of the infection. Mild cases can be treated at home. This includes soaking the area several times a day in clean, warm water to help ease pain and swelling. Be sure to dry it thoroughly and use a topical antibiotic to address the infection.

You will want to see your health care provider if an abscess has formed; they may need to lance and drain it. As with any infection, the infected area must be kept clean and dry. When an infection fails to clear up, it is possible that oral antibiotics may be prescribed. When this is the case, be sure to take the entire course of antibiotics, even if the infection appears to be better.

To avoid paronychia, don't bite or chew your nails or cuticles, and avoid cutting your cuticles and nails too short. Wear waterproof gloves when working with water. Using hand lotion and rubbing it into your cuticles will help keep them soft and hydrated, which will keep them from cracking.

Q: My father is 76 and lives alone. Lately he's gotten worried about dementia. I saw on the news that the MIND diet can help with that. If that's true, I'm hoping we can use that to get him to cut down on junk food, which he loves. What else can help him stay sharp?

A: An expanding body of research suggests that diet and nutrition can play an important role in protecting cognitive health as we age. The Mediterranean diet - with its focus on fresh produce, grains, legumes, fish, lean animal proteins and healthful fats - is often linked to improved physical and mental health.

Now research around the MIND diet has put this nutritional approach back into the headlines. As with previous studies, research on the MIND diet found that a focus on fresh rather than processed foods was associated with improved cognition.

The concept of the MIND diet arises from a study published by researchers at Rush University in 2015. (For those who are curious, the full - and unwieldy - name of the diet is the "Mediterranean-Dietary Approach to Systolic Hypertension (DASH) diet intervention for neurodegenerative delay," which is shortened to MIND.)

In analyzing health data gathered from 960 older adults over the course of five years, the researchers found a correlation between the dietary approach of the Mediterranean diet (and similar diets) and a slower rate of decline in cognitive function. Using that data, they crafted the MIND diet.

Like its forebears, the MIND diet emphasizes fresh vegetables, fruits and leafy greens, beans, legumes, whole grains, nuts, healthful fats and lean proteins. It also limits red meat, cheeses, fried foods, sweets and processed foods.

But the MIND diet takes a slight detour. It specifies a minimum of six weekly servings of leafy greens, as well as two servings of fresh berries per week. These two food groups were found to be linked to improved cognitive outcomes in the study. It's also important to note that, in the studies with the most robust link between diet and cognitive health, the participants were longtime adherents to this type of eating. It's a yearslong lifestyle, not a short-term diet.

Additional factors can affect cognitive health. These include the use of tobacco products, alcohol and drugs; chronic inflammation; substance abuse; physical activity; social engagement; and age-related changes to the brain. Regular exercise is key to maintaining brain health. This includes physical exertion of moderate intensity, which results in an increase in heart rate.

Diet and exercise are important factors in lowering the risk of Type 2 diabetes and cardiovascular disease. Both of these have been shown to be risk factors for several types of dementia, including Alzheimer's disease and vascular dementia.

Regular contact with other people, both in casual and social settings, is also crucial to staying sharp. According to the Centers for Disease Control and Prevention, social isolation is associated with a 50% increase in the risk of developing dementia.

Talk to your dad about all of this. You can ease his anxiety and help him craft a more healthful lifestyle.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.