The truth about discolored toenails

Your good friend calls you up to invite you for a pedicure. You think of how relaxing it would be to soak your feet in some sudsy water and get pampered. You deserve some time away, but suddenly you remember why you can’t get a pedicure today. You look down at your feet and see that black toenail.

Nails can discolor for a number of reasons, and it can make you feel a little embarrassed. But Christopher G. Browning, DPM, a podiatrist on the medical staff at Baylor Scott & White Medical Center – Temple, said most of the time it is harmless.

Why do toenails discolor?

It may seem a little strange to have nail discoloration, but it is actually fairly common, especially for those who are sick or elderly. Your nail may discolor to yellow, black, brown or even red.

Dr. Browning said nails can discolor for a variety of reasons, including but not limited to:

Trauma

If you have a dark or black toenail, it can be due to trauma. Did you drop something on your foot recently? Are you an avid runner and need some new athletic shoes? Your nail can turn black because there is blood trapped under the nail.

“Trauma can also damage the matrix or your nail root,” Dr. Browning said. “This can cause chronic thickness or an abnormal shape.”

It can be hard to know if this is due to a fungal nail infection or the trauma, so you may need a provider to take a look.

Fungus

This is the most common cause of brownish yellow, brittle, thickened nails.

Psoriasis

Dr. Browning said psoriasis causes pitting and yellow discoloration of the nail. According to the American Academy of Dermatology, other symptoms include a buildup beneath the nail, or the nail itself crumbling.

Chronic painting of the nails

If you’re constantly painting your toenails, the nail polish can leave residue or stains. To avoid yellowish nails, consider using a clear base coat before the polish to add a protective layer and prevent discoloration.

Malignant melanoma

If you see black streaks or discoloration, Dr. Browning said, in rare incidences this can actually be subungual melanoma, a type of malignant cancer. If you are seeing streaks on your nails, you should talk to your doctor to see if you need any tests.

Will my toenail fall off?

If you’re worried about the color of your nail, you may also be wondering if it will fall off.

“Toenails can fall off for a variety of reasons but the number one cause is trauma, or injury to the toenail,” Dr. Browning said. “This can be caused from tight shoes or bumping the toenails through repetitive trauma or even exercise.”

Usually if the condition is from trauma, the nail may grow back healthy and normal. However, your toenail may grow back thickened and misshaped.

Toenails can also fall off if there is a fungal infection. When fungal nails fall off, they usually come back with the same fungus, as the infection lies in the matrix or root of the nail. There are over-the-counter remedies available for nail fugus, and if these do not work then speak to your doctor about other options.

How to take care of your toenails

In order to know if there is a fungus or another serious condition affecting your nail, consider talking to your podiatrist or primary care doctor.

The role of a podiatrist is to diagnose the condition by taking a thorough history and having a look at your feet. Samples of your nail and/or skin may need to be collected and sent to the laboratory for more information. Remember not to mask the discoloration with nail polish or other means, because it may lead to further problems if you don’t address it.

“There are numerous treatment options available, ranging from topical lacquers, oral antifungals, laser nail treatment and nail removal,” Dr. Browning said. “To help put your mind at ease, visit your podiatrist and discuss treatment options.”

Find a doctor near you today.