What is toenail discoloration?
Generally, the toenails should be more or less a transparent and partially translucent color. But occasionally, they can appear yellow, green, blue, purple, or black. Several things can cause toenail discoloration (also recognized as chromonychia). These range from minor injuries to possibly serious health conditions.
Symptoms of toenail discoloration
Toenail discoloration can cause the nail to change to one of several different colors, including:
- Green and black
- Dark red and black
Other symptoms associated with toenail discoloration include:
- Nail thickening
- Nails that break easily
- Nails peeling off the skin
- Pitting, which is the formation of small dents in the nail
- Blood under fingernails
- The buildup of dirt under the nails
Causes of nail discoloration
Toenails can change color for different reasons; some are more treatable than others. Before you can treat a discolored toenail, you need to know the cause. Common causes of nail discoloration include:
Fungal infection of the nails
Dirt, poor hygiene, and living in a damp area are all causes of a toenail fungus infection. Toenail fungal infections can cause discoloration, causing your nail to have any of these colors:
If a fungal infection is causing nail discoloration, you may be successful in treating it with an over-the-counter antifungal cream.
Medical conditions that cause discolored nails
Certain medical conditions, such as diabetes, poor circulation, or heart or lung disease, can cause toenails to change color. Talk to your doctor about any existing conditions you have that may affect the color of your nails.
If you play sports, run regularly, or participate in an activity that causes trauma to your feet, your nails may develop white spots. If the trauma is severe enough, your nail can turn black from blood vessel damage and eventually fall off.
Nail discoloration and aging
As you age, your toenails, as well as your fingernails, may begin to turn a light yellow hue. Nail staining is a normal part of the aging process.
Yellow nail syndrome
Yellow nail syndrome is a very rare condition. Often related to lymphedema, it can happen during cancer treatment.
Unfortunately, toenail discoloration connected to fungal infections is difficult to treat, rarely goes away on its own, and frequently requires medical interference. A toenail can take some time to heal. There are several over-the-counter (OTC) and prescription options to choose from to help you address the root of the problem.
Over the counter drugs
If you take a walk through the aisles of your local pharmacy, you will find many creams, polishes, and powders claiming benefits for nail repair. But a search for over-the-counter medications returns a mixed bag of results when it comes to treating toenail discoloration and nail fungus. Some sources state that you should expect to see results within a few days or weeks, while others say that over-the-counter medications are only for mild cases of toenail fungus. Also, keep in mind that you may not have a yeast infection so they won’t address your problem.
Your physician may recommend a medication to treat the underlying cause of the toenail discoloration. For example, your doctor might put you on a regimen of oral antifungal medications. These medications include Lamisil (terbinafine) and Sporanox (itraconazole). The downside to using oral medications is that they take several weeks or months to work, and you may not see results until a new toenail grows back. Additionally, oral antifungals can cause side effects, most commonly headaches, stomach upset, skin rashes, and liver toxicity.
Since some of these medications can affect your liver, your doctor may ask you to have regular blood tests to see if your body tolerates the treatment well. Unlike oral medications, many topical antifungal agents and creams are not as effective in treating toenail fungus. The main reason for this is that drugs cannot penetrate hard nails. Some experts suggest that the effectiveness of the creams can be improved by first cleaning the nails so that they are thinned. As with other treatments, you may need to wait a significant amount of time before results are visible.
Enter the nail lacquers, which you paint on the toenails and the surrounding skin. Ciclopirox is an antifungal drug that is mixed in a nail polish like Loprox and Penlac. But they are not very effective when used without oral medications. Using nail polishes requires commitment and compliance, because you may need to use the product daily for several months. However, there are some side effects associated with topical nail polishes, including itching, rashes, and peeling of the skin, among other things.
The Food and Drug Administration has approved a few different types of laser treatments for toenail fungus. Initial evidence suggests that they may help reduce symptoms. However, your insurance company may not cover the cost of laser treatments and you may have to pay a high price. While emerging research is promising, there is still a lack of general evidence to know if this technology works better than other types of treatment.
In some cases, medications may not resolve the condition and surgical intervention may be necessary.5 Your doctor may consider surgery to remove your toenail if you have an infection that is resistant to drug therapy. Or your doctor may determine that a nail removal is necessary to place the medicine directly on the infected part of the skin. Lastly, surgery may be the best course of action for your condition if you experience severe pain and discomfort.