Ava Monroe
Toenail discoloration can be caused by various factors, ranging from minor injuries to severe underlying health conditions. Typically, toenails are translucent, but they can sometimes appear yellow, green, blue, purple, or black. A change in toenail color can be harmless, but it can also indicate a disease. For example, a toenail that has turned white or has large powder-like patches could indicate a fungal infection called white superficial onychomycosis. Toenail fungus, also known as onychomycosis, is a prevalent cause of toenail discoloration, affecting around 5.5% of people globally. It can be challenging to treat, and relapses are common. In some cases, toenail discoloration can be a symptom of subungual melanoma, a severe form of skin cancer that appears as a dark stripe running lengthwise down the toenail. It is important to consult a dermatologist or healthcare provider if you notice any changes in your toenail color to determine whether it is harmless or requires medical attention.
| Characteristics | Values |
|---|---|
| Cause of toenail discolouration | Minor injuries, nail polish, fungal infections, skin infections, serious health conditions, underlying medical conditions |
| Treatment | Oral antifungal medication, home remedies, laser treatment, debridement, avoiding staining cosmetics |
| Colour of discoloured toenails | Yellow, green, blue, purple, Black, brown, White, Red, Orange |
| Potential health conditions indicated by discolouration | Subungual melanoma (skin cancer), bacterial infections, fungal infections, nail injury, Darier disease, HIV, psoriasis |
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Nail polish
While changes in toenail colour can be harmless, they can also indicate an underlying health condition. Toenails are typically a clear, partially translucent colour, but they can sometimes appear yellow, green, blue, purple, or black.
Yellow toenails can be caused by a fungal infection, overuse of nail polish, or an underlying medical condition. Toenail fungus, also called onychomycosis, is one of the most common causes of toenail discolouration. It can turn the nail brown, white, or black, and cause the nail to thicken and become fragile and separated from the nail bed. A toenail fungal infection typically develops on the big toe first and can spread from athlete's foot, or when yeast or mould enter the nail through cracks or breaks in the skin or nail.
Red and white stripes on the toenails are usually indicative of Darier disease, an inherited disease that affects the skin and causes greasy, warty, foul-smelling blemishes. White patches on the toenail could be indicative of white superficial onychomycosis, a fungal infection that causes the nail to become rough and crumbly. Proximal subungual onychomycosis is another fungal infection that causes white or yellowish patches starting at the base of the toenail, near the cuticle. This type of infection is rare in healthy people and more common in those with weakened immune systems. It can also be a sign of HIV.
Black toenails can be caused by a bruise under the nail, known as a subungual hematoma, which can result from stubbing a toe or wearing tight shoes. A subungual hematoma will usually start out red, then turn purple, brown, and finally black. Alternatively, black toenails can be caused by melanoma, a rare and severe form of skin cancer that can appear as a dark stripe running lengthwise down the toenail. Melanoma can develop slowly beneath the nail bed, and people with darker skin may notice dark patches under their toenails.
While nail polish can cause toenail discolouration, it is not harmful and may not require treatment unless the appearance is disliked.
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Injury
Toenail discoloration can be indicative of a range of factors, from minor injuries to potentially serious health conditions.
Minor Injuries
Minor injuries, such as stubbing your toe or wearing tight shoes, can cause a subungual hematoma. This injury results in blood and fluid collecting under the nail, leading to a red or purple appearance that may eventually turn brown or black. The nail will likely feel sore and tender, but subungual hematomas usually heal within a few days with home treatments like rest, ice, and over-the-counter pain relief. It takes about 6 to 9 months for the discolored nail to completely grow out and be replaced by a healthy new toenail.
Major Injuries
In cases of more severe trauma or blunt force injuries, toenails may turn black. A doctor may treat this by using a needle to make a small hole in the nail. While black toenails are usually not a cause for concern, it is recommended to seek medical advice if the condition persists or is accompanied by other symptoms.
Infections
Toenail infections, known as paronychia, can be caused by bacteria or fungal organisms. They often result in redness, swelling, and pain around the nail. If left untreated, the infection can worsen and spread to other parts of the foot and body. Fungal infections, specifically onychomycosis, are a common cause of toenail discoloration, affecting about 50% of nail diseases. The discoloration typically starts under the tip of the nail and spreads as the infection progresses. While some fungal infections can be treated at home, it is important to seek medical advice for more severe or persistent cases.
Underlying Health Conditions
Toenail discoloration can sometimes indicate a more serious underlying health condition, such as melanoma or psoriasis. Melanoma, the most serious type of skin cancer, can develop slowly beneath the nail bed, causing a dark streak or patch that may be confused with bacterial or fungal infections. Psoriasis, a chronic condition affecting skin cell production, can also lead to nail symptoms in 40% to 50% of cases. It is important to consult a dermatologist or healthcare provider if you notice any persistent or concerning changes to your toenails, as early diagnosis and treatment are crucial for managing these conditions effectively.
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Fungal infections
Toenail discoloration can be a sign of many things, ranging from minor injuries to potentially serious health conditions. While it may sometimes be harmless, it can also indicate an underlying health condition and should be examined by a board-certified dermatologist.
The most common organism causing toenail fungus is called a dermatophyte, which eats the body's keratin. Other causes include nondermatophyte molds and yeast. If left untreated, the discolored area will grow as the infection spreads.
The symptoms of a fungal infection include toenails turning yellow, white, brown, or black. The nail may also get thick and fragile and can separate from the nail bed. White superficial onychomycosis is a type of fungal infection that causes the entire nail to become rough and crumbly. Proximal subungual onychomycosis is another type that presents as a whitish or yellowish patch starting at the base of the toenail near the cuticle. This type of infection is rare in healthy people and often occurs in those with weakened immune systems.
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Skin conditions
Toenail discolouration can be indicative of several skin conditions. Typically, toenails are clear and partially translucent. However, they can sometimes appear yellow, green, blue, purple, or black.
Nail fungus
One of the most common causes of toenail discolouration is a fungal infection, also known as onychomycosis or mycotic nails. This infection causes the nail to turn brown, white, or black, and can lead to the nail becoming thick and fragile, and separated from the nail bed. It is more common in toenails than in fingernails, with dermatophytes being the most common organism responsible for toenail fungus. However, mould or yeast can also be the culprits.
Subungual hematoma
Toenails can also turn black due to a subungual hematoma, which is caused by blood and fluid collecting under the nail following an injury. This usually occurs when someone stubs their toe or wears tight-fitting shoes. The discolouration typically starts as red, then turns purple, brown, and finally black.
Paronychia
Paronychia is an infection of the skin around the nail, not the nail itself. It can cause redness and swelling around the nail, and without treatment, the infection can worsen.
Darier disease
When toenails display red and white stripes, it is usually indicative of Darier disease. This is an inherited disease that primarily affects the skin, resulting in greasy, warty, foul-smelling blemishes.
Subungual melanoma
In rare cases, toenail discolouration can be a sign of subungual melanoma, a severe form of skin cancer. It often presents as a dark stripe running lengthwise down the toenail and can be mistaken for other conditions such as bacterial and fungal infections or nail injuries.
While toenail discolouration can be harmless, it is always advisable to consult a dermatologist or healthcare provider to determine the underlying cause and receive appropriate treatment if necessary.
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Underlying health issues
While changes in toenail colour can be harmless, they can sometimes be indicative of underlying health issues.
Toenail discoloration, also known as chromonychia, can be caused by fungal infections, which can turn the nail brown, white, yellow, or black. This is one of the most prevalent causes of toenail discolouration, with dermatophytes being the most common organism responsible for toenail fungus. Other types of fungal infections include white superficial onychomycosis and proximal subungual onychomycosis, which can cause whitish or yellowish patches on the toenail. Fungal infections can usually be treated at home and often do not require a doctor's diagnosis. However, if left untreated, they may spread to other parts of the body.
In some cases, toenail discolouration can be a symptom of a subungual hematoma, which is caused by blood and fluid collecting under the nail due to an injury. This usually occurs after stubbing the toe or wearing tight shoes. Subungual hematomas typically heal on their own within a few days, but it can take up to 6 to 9 months for the discoloured nail to completely grow out.
Additionally, toenail discolouration can be a sign of melanoma, a severe form of skin cancer. Subungual melanoma, in particular, develops under the toenail and can be fatal if left untreated. It is characterized by a dark black, vertical band in a single toenail, which can be mistaken for other conditions such as bacterial and fungal infections or nail injuries. Melanoma can also cause pigmentation changes under the toenails, leading to darker patches on the nail bed.
Other potential underlying health issues that can cause toenail discolouration include psoriasis, which affects the growth and appearance of nails, and paronychia, an infection of the skin around the nail.
It is important to consult a board-certified dermatologist or healthcare provider if you notice any persistent changes in your toenail colour, as they can help diagnose and treat any underlying conditions.
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Frequently asked questions
Yellow toenails are most commonly caused by a fungal infection. Other causes include the overuse of nail polish or an underlying medical condition.
White toenails are often caused by a fungal infection called white superficial onychomycosis. This infection causes the nail to become rough and crumbly.
Black toenails are usually caused by a bruise or a stubbed toe, but they can also be caused by a rare form of skin cancer called subungual melanoma. It is best to contact a doctor if the discolouration is sudden or does not heal over time.
Yes, toenail discolouration can be a warning sign of a specific disease. It is always good to have a dermatologist examine any changes to your toenails.
If you notice any discolouration, it is important to see a board-certified dermatologist. They will be able to tell you whether the change is harmless or requires medical testing and treatment.
