Lifting NailsLike flaky, weak nails, this condition occurs almost exclusively in women. Here the end of the nail plate lifts off its bed, leading to a secondary infection with Candida. Accidentally banging the nail on a hard object will cause the nail to either break or lift off its bed, especially if the nails are long and hard. Again, repeated wetting and drying of the nails can cause them to separate from the nail beds.Lifting of the nails can be prevented by keeping your nails moderately short, wearing cotton gloves inside rubber or vinyl gloves for all wet work and making sure your nails are properly dried (by using a hair dryer) when they get wet.Once the nails have lifted, secondary infection usually occurs, which requires treatment with anti-fungal lotions such as Canestan or Dakarin. Oral antibiotics are of no use.
Ridged NailsAs people get older, their nails become more ridged, in a similar way to wrinkles appearing on the skin. There is no specific treatment for this condition.
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SKIN DISORDERS IN ADULTS: LIFTING AND RIDGED NAILS
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Acupuncture is a tradition in Chinese medicine now available from licensed acupuncturists in the United States. According to acupuncturists, HIV infection is a condition caused by the blockage of the flow of the life force, called chi. In addition, HIV infection might also be interpreted as a deficiency in a masculine, active quality called yang, as well as a deficiency in a feminine, passive quality called yin. Treatment is the insertion of needles at any of the 365 points along twelve body lines, which is said to permit the flow of chi. The needles are left in place for twenty to thirty minutes; treatment may continue to several days to several months. Acupuncture is poorly understood according to the criteria of traditional medicine, although it clearly has profound biologic effects: it can, in fact, be used in place of general anesthesia for some major operations. The usefulness of acupuncture as a treatment for HIV infection has not been tested with a clinical trial, so the benefits are not established. There are essentially no risks.*192\191\2*
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“I always look at other peoples’ noses—mostly their pores—comparing myself to them to reassure myself,” Bill said. “I see other people have pores and they’re doing okay, so I should. But I can’t reassure myself. I just get more down on myself.” Another man compared himself with others and thought, “Why can’t I have regular skin like that? Why can’t I have normal skin?” “I compare to reassure myself by seeing someone else with the same problems,” he said, “but I never see anyone else with the same problems.”Comparing is the most common BDD behavior of all. More than ninety percent of people with BDD do this. They frequently and silently compare their “ugly” body part with the same body part on others, thinking such things as “Do I look okay compared to her?” They seem to have built-in radar for the body part of concern, quickly focusing on it. As Mike described it, “I zero in on other peoples’ ears and compare them to mine.”One woman frequently compared herself to other women and also contrasted young people with old people to see if they had lines on their face. “I know every line and wrinkle on every person’s face,” she said. She usually felt that she looked worse than other people, which triggered panic attacks. “I say to myself, ‘I wish I could have that baby-smooth skin.’ I think how lucky any older woman is who has no wrinkles.” Another woman, who thought her breasts were too small, compared her breasts with those of every woman she saw. She said, “I panic when I see cleavage!” BDD sufferers generally don’t feel much better when they compare. In fact, they often feel worse. Aaron, who worried about his slightly receding hairline, told me, “I check out everyone’s hair. And everyone looks better than me, even bald guys. At least other bald guys have a little hair left that looks good. Mine looks terrible—thin and stringy. I’m the one guy who can’t lose his hair and keep any of his looks.” He then added, “It’s okay if other people are bald. They can look handsome, but I don’t because I have a long face.”Aaron experienced the typical no-win situation. People with BDD generally think that other people look better than they do, which reinforces their feelings of defectiveness. A handsome young man told me, “I constantly stare at other people’s noses and compare their’s to mine—I’m an expert on noses. I think how bad I look and how good they look. I’m envious of good-looking people.” “Do you ever see anyone who looks as bad as you think you do?” I asked him. “Occasionally I see people who look as bad as me, and I feel sorry for them,” he replied. “I don’t want people to feel sorry for me.”*105\204\8*