Isla Bennett
Dark nails can be alarming, and there are many possible causes, ranging from harmless to potentially fatal. The appearance of black lines or spots on the fingernail or toenail may be a symptom of an underlying condition. It is important to consult a dermatologist or healthcare provider to help identify the cause and start treatment. This article will explore the various causes of blackness under the fingernails and provide information on diagnosis and treatment options.
| Characteristics | Values |
|---|---|
| Condition | Melanonychia |
| Description | Brown or black lines in nails |
| Causes | Melanocytic activation, melanocytic proliferation, race, pregnancy, infections, inflammation, poor nutrition, trauma, cancer, too much iron, vitamin deficiencies, fungal infection, bacterial infection, chemotherapy, medication, melanoma, nail injury, nail biting, tight shoes, and more |
| Diagnosis | Dermatoscopy, biopsy, onychoscopy |
| Treatment | Tumor or cancerous area removal, antifungal medication, surgery |
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What You'll Learn
Melanonychia
Melanocytic activation occurs when melanocytes are activated to produce melanin, without an increase in the number of melanocytes. This can be caused by trauma, infection, inflammation, or certain medications. For example, chemotherapy is the medication most likely to cause melanonychia. Other causes include inflammatory skin diseases, fungal, bacterial, or viral infections, and friction from shoes or nail-biting.
Melanocytic proliferation is the result of an increased number of melanocyte cells in the nails, which can be cancerous or noncancerous. This type of melanonychia is more commonly seen in children and is associated with benign tumours or malignant tumours such as basal cell carcinoma. It can also be caused by race, with melanonychia naturally occurring in African American, Hispanic, Indian, Japanese, and other dark-skinned individuals.
The diagnosis of melanonychia involves a series of examinations by a healthcare professional, including a review of the patient's medical history and a dermatoscopic exam using a specific type of microscope. A nail biopsy may also be performed to examine the discoloured areas for any signs of malignancy.
While melanonychia can have many different causes, it is important to have a doctor examine any dark streaks in your nails as they can indicate nail melanoma, the most serious type of skin cancer. An early diagnosis of a malignant lesion is key to a favourable outcome.
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Trauma
Another form of nail trauma that can cause blackness is a condition called splinter haemorrhages. These are small areas of bleeding (haemorrhaging) that occur under the nails, often after an injury to the nail. They resemble thin, reddish-brown lines that run vertically in the direction of nail growth and can affect both the fingernails and toenails. Splinter haemorrhages occur when the small blood vessels under the nail bed burst due to damage. They can be a sign of an underlying health condition if they appear in more than one nail.
Additionally, certain habits can also cause trauma to the nail and lead to blackness. Biting, picking, or pulling out nails can result in black spots or lines under the nail. Wearing tight shoes or gloves can also damage the nails and cause them to appear dark. These habits can be avoided, and in the case of nail-biting, specific treatments can be sought to prevent the behaviour.
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Infection
Blackness under the fingernails can be caused by a condition known as melanonychia, which occurs when pigment cells called melanocytes deposit melanin, a brown-coloured pigment, into the nail. This condition can affect both the fingernails and toenails and can appear as brown or black stripes on the nails. While melanonychia can sometimes be harmless, it can also indicate potentially serious health issues, including various types of infections.
Fungal infections, in particular, are a well-known cause of melanonychia. These infections can invade the nail bed and lead to changes in nail colour, texture, and thickness. Common types of fungal infections that affect the nails include dermatophyte infections, yeast infections, and non-dermatophyte mould infections. Early diagnosis and treatment of fungal infections are crucial to prevent potential nail damage and spread to other nails or people.
Viral infections can also contribute to melanonychia. Certain viruses, such as the human papillomavirus (HPV), can infect the nail bed and cause changes in nail pigmentation. Moreover, viral infections that affect the skin, like herpes zoster, can lead to post-inflammatory hyperpigmentation, resulting in melanonychia.
It is important to note that infections are not the only cause of melanonychia. Other factors, such as trauma, nutritional deficiencies, medication, inflammatory skin diseases, and cancer, can also play a role in the development of melanonychia. Therefore, it is always advisable to consult a healthcare professional for a thorough evaluation and accurate diagnosis.
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Inflammation
Melanonychia is a condition that causes brown or black lines in your fingernails or toenails. It is caused by the activation of melanocytes, which are pigment cells that release a brown-coloured pigment called melanin. While melanonychia can occur naturally in people with darker skin tones, it can also be caused by inflammatory skin diseases that affect the nails. This includes lichen planus, an inflammatory skin condition that often results in an itchy rash. Up to 35% of people with lichen planus experience splinter haemorrhages, or small areas of bleeding under the nails, which can appear as thin, reddish-brown lines.
It is important to note that melanonychia can have many different causes, ranging from harmless to potentially fatal. Dark stripes on the nails can be a sign of increased melanin deposits, which can occur due to various factors such as trauma, nutritional deficiencies, or medication. In some cases, it may indicate the presence of benign or malignant tumours. Therefore, it is always advisable to consult a doctor or dermatologist to examine any dark streaks in your nails and determine the underlying cause.
While melanonychia itself may not be harmful, it is crucial to have a medical professional evaluate any changes in your nails. This is because nail changes, including discolouration, texture, or shape alterations, can sometimes be indicative of underlying health issues. Early detection and treatment are essential for maintaining overall health and well-being.
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Medication
The discolouration of nails can be caused by medication, particularly by chemotherapy, which is known to cause nails to grow slowly or stop growing altogether. Other medications that may cause discolouration include those used to treat HIV/AIDS and malaria.
It is important to note that discoloured nails can be a sign of an underlying health condition. Melanonychia, for example, is a condition where brown or black lines appear on the nails due to an increase in melanin production. This can be caused by various factors, including race, nutrition, and medication. While melanonychia can have harmless causes, it can also indicate a potentially fatal condition such as melanoma, the most serious type of skin cancer. Therefore, it is always advisable to consult a doctor or dermatologist if you notice any discolouration or other changes in your nails.
In addition to medication, there are several other factors that can contribute to nail discolouration. These include trauma or injury to the nail, vitamin deficiencies (such as a lack of vitamin B12, vitamin D, or protein), and certain infections. In some cases, discoloured nails can also be a sign of more serious underlying health conditions, such as cancer, endocrine disorders, or inflammatory skin diseases.
While changes in nail colour can be harmless, it is always recommended to seek medical advice to ensure proper diagnosis and treatment. A doctor or dermatologist will be able to examine your nails, consider your medical history, and perform any necessary tests to determine the underlying cause of the discolouration.
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Frequently asked questions
There are several possible causes for blackness under your fingernails. One cause could be melanonychia, which occurs when pigment cells deposit melanin into the nail, resulting in brown or black stripes. Other possible causes include trauma or injury to the nail, bacterial or fungal infections, and in some cases, nail cancer.
Melanonychia is a condition where melanin, the substance responsible for skin pigmentation, causes nail discolouration. It can affect one or more nails and can appear as dark bands or streaks, or involve the entire nail.
Yes, there are three main types of melanonychia: longitudinal melanonychia, diffuse or total melanonychia, and transverse melanonychia. Longitudinal melanonychia appears as a long band along the length of the nail, diffuse or total melanonychia involves the entire nail turning dark, and transverse melanonychia appears as a band across the nail.
Melanonychia can be caused by several factors, including race, pregnancy, fungal or bacterial infections, inflammation, and certain medications. It can also be related to nutritional deficiencies, such as a lack of protein, vitamin D, or vitamin B12.
It is important to consult a dermatologist or healthcare provider if you notice any changes in the colour, texture, or shape of your nails. They can help identify the cause and determine if further treatment is necessary.
