Nail discoloration occurs when the color of the fingernails or toenails is no longer within the normal color range. There are many forms and causes, but nail discoloration is usually a symptom of another disease and not a disease in its own right. Treatment is based on the cause.
What is nail discoloration?
Common whitish to yellow discoloration, leukonychia of the fingernails and toenails. On the tops of the fingers and toes are translucent platelets called fingernails and toenails. The nails are made of keratin, the corneal substance, and serve to protect the tops of the fingers and toes and improve scratching and gripping. The fingernails and toenails are usually translucent pink. If the nails discolor due to various causes, the physician speaks of pathological nail discoloration. The most common form of these are the white spots that appear on the nails and are medically called leukonychia. Other possible nail discolorations of pathological relevance are longitudinal stripes in shades of light brown to black, brown-green discolorations, and the yellowish discoloration and thickening of one or all nails known as yellow nail syndrome.
Causes
The causes of pathologic nail discoloration are varied and take different forms. Dark discoloration is often caused by hematomas under the nails. A mole can also cause the dark discoloration. Other causes are nail fungi, especially molds. Discoloration in multiple tones occurs when there is a mixed infection of the nails. A rare cause of black discoloration is a tumor under the nails, for example in black skin cancer. More common is whitish to yellow discoloration, leukonychia of finger and toe nails. Harmless and injury-related are small white dots. Complete whitening of the nail may be congenital or result from contact with nitric acid. Pathological causes of varying severity have white longitudinal and transverse stripes and so-called milk glass nails. They occur in liver cirrhosis, intestinal inflammation, severe metabolic diseases, heavy metal poisoning or skin and nail diseases.
Diseases with this symptom
- Metabolic disorder
- Cirrhosis of the liver
- Adrenocortical insufficiency
- Cyanosis
- Nail fungus
- Heart failure
- Diabetes mellitus
- Psoriasis
- Renal insufficiency
- Heavy metal poisoning
- Melanoma
- Yellow Nail Syndrome
Diagnosis and course
If one notices conspicuous and not by harmless causes explainable nail discoloration with itself, then the visit of a dermatologist is advised. This will try to exclude possible injury consequences in a detailed anamnesis again and inform himself about the health and professional background of the patient. Causative heavy metal poisoning or disease-related discoloration can be diagnosed in this way. The color, a possible change in shape and other symptoms provide further indications for diagnosis. If a nail infection with bacteria, fungi or a mixed form is suspected, swabs and tissue samples are used to confirm the diagnosis. The laboratory also determines the exact pathogens in order to initiate a specific therapy. In some cases, further examinations, especially blood analysis, are necessary to rule out internal diseases as the cause.
Complications
Discolored nails indicate nail fungus. If this remains untreated, there is an increased risk of infection. The so-called dermatophytes, which are responsible for the fungal infection, spread namely via contact or smear infections. In the worst case, the untreated person infects not only others but also himself and risks long-term changes in the nail bed. In addition, especially people with a proven immune deficiency (for example, due to HIV infection or chemotherapy), but also diabetics should consult a doctor as soon as possible in case of a discolored nail, because in this group the complications of athlete’s foot occur much earlier. Harmful bacteria can settle on the discolored nails and the surrounding skin areas if the findings are not taken care of properly.In this superinfection (for example, with streptococci), the patient suffers from severe redness of the skin, pain due to inflammation of the nail bed and fever. If the cause of discolored nails is not nail fungus, but a more serious disease. Then the possible complications and the course of the disease depend on the findings. In this case, it is advisable to regularly consult a medical professional and not to treat the affected area without medical help.
When should you go to the doctor?
Nail discoloration can be an indication of nail fungus, which is why it warrants a visit to the doctor, unless there are other possible causes. Characteristic of nail fungus are thickening of the nail plate, as well as extension to the skin when it occurs on the foot. In the case of nail discoloration, everything points to a fungus if there are no other explanations such as the consumption of cigarettes. Because this can also cause a yellowish color change to appear on the fingertips and toenails. However, this is not a reason to visit the doctor, because the condition would improve by itself if the person would stop smoking. If the nails gradually discolor on the hands and feet, without smoking or fungal disease seeming likely, the cause could be liver dysfunction. This changes the vascular structure of the nail bed and causes nail discoloration all over the body. This can only be clarified by a doctor, as extensive examinations of the liver functions are necessary for this. In this course, a doctor will also clarify the healthy function of the heart muscle, since a cardiovascular weakness can also lead to discoloration of the nails due to altered blood flow. If the nail discoloration occurs very suddenly and together with other typical symptoms of poisoning such as shallow breathing, rapid heartbeat, sweating, dizziness and nausea, they are an emergency and belong in the hospital, since there is very likely poisoning.
Treatment and therapy
Since not all nail discolorations are pathological, not all forms require specialist care and therapy. Hematomas and white spots heal by themselves after some time and grow out of the nails, moles require treatment only if cancer is suspected. Discolorations caused by nitric acid also do not require treatment. If discoloration requiring treatment is present, therapy is based on the diagnosed cause. Bacterial infections require oral administration of antibiotics, fungal infections must be treated with so-called antimycotics. These are usually given as tablets and additionally applied to the nail in ointment or tincture form. If canker sores and tumors are identified as the cause, surgery is usually unavoidable. If the nail discoloration is caused by internal diseases, these must be treated. The dermatologist will refer his patient to a specialist for this, but will continue to observe the nail discoloration himself. The treatment of liver cirrhosis is carried out by a gastroenterologist or internist and usually consists of sparing the liver with abstinence from alcohol and a balanced diet. Surgery may also be necessary. Chronic inflammatory bowel disease, ulcerative colitis, is treated with a bowel-sparing diet and corticosteroids. If the underlying diseases are well controlled, there is a good chance of normalization of the nails.
Outlook and prognosis
In most cases, nail discoloration is a harmless symptom. If the nail discoloration occurs especially after the nail has been hit with a heavy object, it is a bruise under the nail itself. This usually disappears after about a week and does not lead to further problems and complications. In other cases, the nail discoloration may be a fungal infection. In case of carelessness, the patient can also infect other people with the fungal infection. The affected area on the nail usually hurts and is somewhat swollen. The treatment itself is often carried out with the help of antibiotics and quickly leads to success. Surgery is necessary only in severe cases. If no medical treatment is possible, the nail can also be completely removed by the doctor. Since the nail grows back, this is also not a particular problem. Should the nail discoloration occur in a patient who smokes, they are relatively common.They disappear when smoking is stopped and can be removed with various home remedies.
Prevention
Basically, it is difficult to prevent nail discoloration due to the variety of causes. Good hygiene prevents nail infections and prudent management of injury risks can prevent hematomas.
This is what you can do yourself
Nail discoloration can be reduced with a few simple measures and home remedies. First, it helps to treat the nails with nourishing lotions: ointments from the drugstore are just as effective as tinctures made from tea tree oil and chamomile. To prevent nail discoloration from occurring in the first place, the nail polish should also be prepared with a base coat. Superficial discolorations can be removed with a polishing file from the drugstore, often typical home remedies such as lemon juice or toothpaste also help. For smokers, a bath of vinegar and water is recommended, which removes the yellow tint and makes the nails smooth and white again. Baking soda has the same effect. The natural bleaching agent is best rubbed directly onto the nails and then rinsed off with warm water, which should dissolve even deep discolorations. In general, nail discoloration can be reduced by avoiding harmful environmental influences as much as possible. Those who eat healthy, exercise and make sure to get enough rest can greatly reduce nail discoloration in the long run. Other home remedies: orange peel, tea tree oil or apple cider vinegar. Owners of tooth protests can resort to special dental care tabs, which also whiten nails. In case of severe or permanent nail discoloration, a doctor should be consulted for further clarification.