
Changes in the colour of your fingernails can be harmless, but they can also indicate an underlying disease or health condition. If you have brown fingernails, you may have a condition called melanonychia, which occurs when pigment cells called melanocytes deposit melanin, a brown-coloured pigment, into the nail. Melanonychia can be caused by several factors, including skin cancer, infection, injury, vitamin B12 or vitamin D deficiency, and fungal infections. It is important to consult a doctor or dermatologist if you notice any changes in the colour of your fingernails, as an accurate diagnosis is vital to determine the underlying cause and rule out any serious conditions.
| Characteristics | Values |
|---|---|
| Condition | Melanonychia |
| Description | Black or brown lines in the nails |
| Causes | Melanin deposits, skin cancer, infection, injury, nail cancer, trauma, health conditions, vitamin B12 deficiency, vitamin D deficiency, protein deficiency, iron overload, fungal infections, bacterial infections, medication, chemotherapy drugs |
| Risk Factors | Racial differences, pregnancy, weakened immune system, environmental exposure to bacteria, viruses, or fungi, friction or trauma to the nail plate |
| Treatment | Surgery, medication adjustment, biopsy, balanced diet, reduced exposure to harsh chemicals |
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What You'll Learn
- Melanonychia: a condition caused by increased melanin deposits in the nail plate
- Skin cancer: brown nails can be a symptom of melanoma, the most serious form of skin cancer
- Iron deficiency: thin, spoon-shaped nails can indicate a lack of iron in the body
- Fungal infections: these can cause nail discolouration, usually accompanied by yellowing and thickening of the nail
- Vitamin B12, vitamin D, and protein deficiencies: these can all cause dark lines to appear on nails

Melanonychia: a condition caused by increased melanin deposits in the nail plate
Melanonychia refers to the Greek word "Melas", meaning black or brown, and "onyx", meaning nail. It is characterised by brown or black discolouration of the nail plate and is a common cause of nail plate pigmentation. It can affect one or multiple nails, both finger and toenails. Melanonychia can have many different causes, ranging from harmless to potentially fatal. It is therefore important to seek medical advice if you notice any dark streaks in your nails.
Melanonychia occurs when the pigment melanin is deposited into the growing nail. Melanin is produced by melanocytes, which typically lie dormant in the nail matrix. When melanocytes are activated, melanin is deposited into the nail plate, resulting in a pigmented band. This is known as longitudinal melanonychia. The deposition of melanin in the nail plate can occur through two processes: melanocytic activation and melanocytic proliferation.
Melanocytic activation refers to an increase in the production and deposition of melanin into the nail cells (onychocytes), without an increase in the number of melanocytes. Causes of melanocytic activation include trauma, infection, inflammation, and certain medications. For example, chemotherapy is the medication most likely to cause melanonychia. Other potential causes include inflammatory skin diseases, fungal, bacterial, and viral infections, and nutritional deficiencies, particularly a lack of protein, vitamin D, or vitamin B12.
Melanocytic proliferation, on the other hand, is a result of an increased number of melanocyte cells in the nails. This growth of melanocyte cells can be cancerous or noncancerous. Benign causes of melanocytic proliferation include nevi (moles) and lentigo (flat, pigmented areas of skin). Melanoma of the nail bed is the most serious possible cause of melanonychia. It is important to note that a dark vertical line on the nail can indicate nail melanoma, and early diagnosis is key to a favourable outcome.
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Skin cancer: brown nails can be a symptom of melanoma, the most serious form of skin cancer
Brown nails can be caused by melanonychia, which occurs when pigment cells called melanocytes deposit melanin, the brown-coloured pigment, into the nail. This can be caused by several factors, including skin cancer, infection, or injury.
Skin cancer can develop under and around the fingernails and toenails, and it is known as subungual melanoma when it occurs under the nails. Subungual melanoma is a rare but serious type of skin cancer that usually appears as a dark brown or black streak on the nail, running from the bottom to the top. It can also cause colour changes in or around the nail, with the nail bed becoming darker, which could be a sign of advanced melanoma.
The brown or black band can appear on any nail but is most common on the thumb or big toe of the dominant hand or foot. The streak may start small but can grow over time, potentially covering the entire nail and extending to the cuticle. The discolouration can be irregular and vary in shade, from dark brown to black.
Subungual melanoma is an aggressive form of melanoma that is not linked to sun exposure. It is most likely to develop in the big toe, thumb, or index finger and tends to occur in older individuals and people with skin of colour. A personal or family history of melanoma or previous nail trauma may also increase the risk.
While the early signs of subungual melanoma can be easy to miss, early detection and prompt treatment yield the best outcomes. Therefore, it is important to regularly check your nails for any changes and consult a dermatologist if you notice any concerning symptoms.
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Iron deficiency: thin, spoon-shaped nails can indicate a lack of iron in the body
Brown nails can be caused by melanonychia, which occurs when pigment cells called melanocytes deposit melanin, the brown-coloured pigment, into the nail. This can be caused by skin cancer, infection, injury, vitamin B12, vitamin D, or protein deficiencies, or other health conditions.
However, brown nails can also be a sign of iron deficiency, which is characterised by thin, spoon-shaped nails. This condition is known as koilonychia, derived from the Greek words "koilos", meaning "hollow", and "onikh", meaning "nail". People with koilonychia have nails that are thin, brittle, concave, and indented like a spoon, with the central portion of the nail depressed and the lateral aspects elevated.
Iron deficiency anaemia is the most common cause of koilonychia, and it can be due to several factors, including an inability to absorb iron, a diet low in iron, celiac disease, cancer, or intestinal bleeding. Certain populations are at a higher risk of developing iron deficiency and koilonychia, including those living at high altitudes, vegetarians, and people with malnutrition or eating disorders. Additionally, manual labour and walking barefoot have been linked to a higher prevalence of spoon nails.
If you suspect you have iron deficiency or koilonychia, it is important to consult a healthcare professional. They will be able to perform a physical examination, review your medical history, and conduct blood tests to determine the underlying cause of your symptoms. Treatment options may include dietary changes, such as increasing your intake of iron-rich foods or taking iron supplements, and addressing any underlying conditions.
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Fungal infections: these can cause nail discolouration, usually accompanied by yellowing and thickening of the nail
Brown nails can be caused by fungal infections. This discolouration is usually accompanied by yellowing and thickening of the nail. This phenomenon is called "melanonychia", which occurs when there is an increased number of melanocytes in the nail, leading to deposits of melanin—the brown-coloured pigment. These deposits are typically grouped together, and as the nail grows, a stripe of brown or black appears.
Fungal infections can produce melanin that becomes incorporated into the nail plate, causing melanonychia. This type of infection is more common in males and often affects the toenails. Environments that expose individuals to fungi, such as prolonged or repeated contact with water or wet substances, can increase the risk of developing fungal melanonychia.
It is important to note that melanonychia can sometimes be malignant or cancerous, so an accurate diagnosis is crucial. A doctor will typically diagnose melanonychia by taking a medical history, examining the nails, and determining the number of affected digits. They will also observe the pattern and colour of the melanonychia, and further tests may be required for a definitive diagnosis.
If you suspect a fungal infection, it is advisable to consult a healthcare professional. They can provide a proper diagnosis and recommend appropriate treatment options.
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Vitamin B12, vitamin D, and protein deficiencies: these can all cause dark lines to appear on nails
Melanonychia, characterised by black or brown lines on the nails, can be caused by vitamin B12, vitamin D, and protein deficiencies. Nails are made up of a protein called keratin, which requires nutrients to produce. A well-balanced diet with essential nutrients, including vitamins and minerals, is necessary for nail health.
Vitamin B12 plays a crucial role in maintaining nail health by regulating homocysteine levels in the blood and supporting heart health. It also aids in iron absorption and red blood cell production, which is essential for oxygen transportation to the nail cells. A deficiency in vitamin B12 can lead to dry, brittle nails that are more prone to splitting, cracking, and peeling. In some cases, it may even cause discolouration, resulting in bluish or grey-brown pigmentation on the nails.
Vitamin D is also vital for nail health. A deficiency in vitamin D can impact the overall health and appearance of the nails, potentially leading to dark lines or other discolouration. Ensuring adequate vitamin D intake is crucial for maintaining strong and healthy nails.
Protein deficiency can also contribute to nail health issues. Nails are primarily composed of keratin, a protein. Therefore, a lack of sufficient protein in the diet can affect nail growth and strength, leading to brittle nails that are more susceptible to breakage. Including protein-rich foods such as lean meats, poultry, fish, beans, lentils, and dairy is essential for maintaining healthy nail growth.
It is important to note that while vitamin B12, vitamin D, and protein deficiencies can cause dark lines on the nails, there are also other potential causes, including nail trauma, infection, or even cancer. Therefore, if you notice persistent discolouration or other changes in your nails, it is advisable to consult a dermatologist or healthcare professional for a proper diagnosis and treatment.
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Frequently asked questions
Brown nails can be caused by several factors, including melanonychia, fungal infections, bacterial infections, medication, and nail melanoma. Melanonychia occurs when there is an increased presence of melanin in the nail plate, resulting in brown or black lines. It is important to consult a doctor or dermatologist to determine the exact cause and receive an accurate diagnosis.
Melanonychia can be caused by several factors, including skin cancer, nail trauma, and other health conditions. It is more prevalent in people with dark skin, affecting up to 77-100% of African Americans and 20% of Japanese people. It can also occur during pregnancy and is more common in males.
The treatment for melanonychia depends on the underlying cause. If it is malignant, a doctor may suggest surgery to remove the affected nail unit or amputate the affected toe or finger. In some cases, further tests, such as onychoscopy, may be required for an accurate diagnosis.











































