Nail discoloration

A Nail discoloration occurs when the color of the fingernails or toenails is no longer in the normal color frame. There are many forms and causes, but nail discoloration is usually a symptom of another disease and not an independent disease. Treatment is based on the cause.

What is nail discoloration?

On the tops of the tips of the fingers and toes are transparent plates, the fingernails and toenails. The nails consist of keratin, the corneal substance, and serve to protect the tips of the fingers and toes as well as improve scratching and gripping. The fingernails and toenails are usually transparent pink.

If the nails are discolored due to various causes, the doctor speaks of a pathological nail discoloration. The most common form of these are the white spots that show up on the nails and are medically called leukonychia.

Other possible nail discolorations of pathological relevance are longitudinal stripes in the shades of light brown to black, brown-green discolorations and the yellowish discoloration and thickening of one or all of the nails known as the yellow nail syndrome.

causes

The causes of pathological nail discoloration are many and varied.

Dark discoloration is often caused by bruises under the nails. A birthmark can also cause the dark discoloration. Another cause is nail fungus, especially mold. The discoloration in several shades is caused by a mixed infection of the nails. A rare cause of blackening is a tumor under the nails, for example in black skin cancer.

The whitish to yellow discoloration, the leukonychia of the fingernails and toenails, is more common. Small white dots are harmless and caused by injury. The complete white coloration of the nail can be congenital or result from contact with nitric acid.

Pathological causes of varying severity have white longitudinal and horizontal stripes and so-called frosted glass nails. They occur in cirrhosis of the liver, inflammation of the intestine, severe metabolic diseases, heavy metal poisoning or skin and nail diseases.

Diseases with this symptom

• Metabolic disorder
• Cirrhosis of the liver
• Adrenal insufficiency
• cyanosis

• Nail fungus
• Heart failure
• Diabetes mellitus
• psoriasis

• Renal failure
• Heavy metal poisoning
• Melanoma
• Yellow nail syndrome

Diagnosis & course

If you notice conspicuous nail discoloration that cannot be explained by harmless causes, a visit to a dermatologist is advisable. He will try to rule out possible consequences of injury in a detailed anamnesis and inform himself about the health and professional background of the patient.

A causal 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 mixture of these is suspected, the diagnosis is confirmed with smears and tissue samples. The laboratory also determines the exact pathogen so that a specific therapy can be initiated.

In some cases, further examinations, especially blood tests, 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 through contact or smear infections.

In the worst case, the untreated person affected not only infects others, but also himself and thus risks long-term changes to the nail bed. In addition, people with a proven immune deficiency (e.g. due to HIV infection or chemotherapy), but also diabetics in the event of a discolored nail, should consult a doctor as soon as possible, as the complications of athlete's foot occur much earlier in this group.

Harmful bacteria can settle on the discolored nails and the surrounding skin areas if the diagnosis is inadequate. With this superinfection (for example with streptococci) the patient suffers from severe reddening of the skin, pain due to inflammation of the nail bed and fever. The cause of the discolored nails is not nail fungus, but a worse condition.

Then the possible complications and the form of the course depend on the findings. In this case, it is advisable to consult a doctor regularly 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, so it warrants a visit to the doctor unless there are other possible causes. Characteristic of nail fungus are thickening of the nail plate and, when developing on the foot, also the expansion onto the skin. 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 lead to a yellowish color change on the fingertips and toenails.

However, this is not a reason to see a doctor, as the condition would improve on its own if the person concerned stopped smoking. If the nails gradually discolour on the hands and feet without smoking or fungal infections appearing likely, the cause could be liver dysfunction. This changes the vascular structure of the nail bed and discolouration of the nails all over the body. Only a doctor can clarify this, as this requires extensive examinations of the liver functions.

At the same time, a doctor will also clarify the healthy function of the heart muscle, as cardiovascular weakness can also lead to discoloration of the nails due to changes in 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, it is an emergency and should be taken to the hospital as it is very likely poisoning.

Doctors & therapists in your area

Treatment & Therapy

Since not all nail discoloration is pathological, not all forms require specialist care and therapy. Hematomas and white spots heal by themselves after a while and grow out of the nails, birthmarks only require treatment if cancer is suspected. The discolouration caused by nitric acid also does not have to be treated.

If there is a discoloration that requires treatment, the therapy depends 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 also applied to the nail in the form of ointments or tinctures. If cancerous ulcers 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 monitor the nail discoloration himself. Cirrhosis of the liver is treated by a gastroenterologist or internist and usually consists of protecting the liver by avoiding alcohol and eating a balanced diet.

An operation may also be necessary. Chronic intestinal inflammation ulcerative colitis is treated with a diet that is gentle on the intestines and corticosteroids. If the underlying diseases are well controlled, there is a good chance that the nails will normalize.

Outlook & forecast

In most cases, nail discoloration is a harmless symptom. If the nail discoloration occurs mainly after the nail is 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 any further problems or complications.

In other cases, the nail discoloration may be a fungal infection. In the event of carelessness, the patient can also infect other people with the fungal infection. The affected area on the nail is usually painful and slightly swollen.

The treatment itself is often done with the help of antibiotics and quickly leads to success. Surgery is only necessary in severe cases. If medical treatment is not possible, the doctor can remove the nail completely. Since the nail grows back again, this is also not a particular problem.

If nail discoloration occurs in a patient who smokes, these are relatively common. They go away when you stop smoking 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 careful handling of the risk of injury can prevent hematomas.

You can do that yourself

Nail discoloration can be reduced with a few simple measures and home remedies. First of all, 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. In order to prevent nail discoloration in the first place, the nail polish should also be prepared with a base coat. Superficial discoloration can be removed with a polishing file from the drugstore, and typical home remedies such as lemon juice or toothpaste often help.

For smokers, a bath of vinegar and water is recommended, which removes the yellow tinge and makes the nails smooth and white again. Baking soda has the same effect. The natural bleach is best rubbed directly onto the nails and then rinsed off with warm water, which should also remove deep discoloration.

In general, nail discoloration can be reduced by avoiding harmful environmental influences as far as possible. Those who eat healthily, do sport and ensure sufficient rest can greatly reduce nail discoloration in the long term. Other home remedies: orange peel, tea tree oil or apple cider vinegar. Owners of dental protests can use special dental care tabs, which also lighten the nails. In the event of severe or permanent nail discoloration, a doctor should be consulted for further clarification.