Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
"Tho the world may be a jungle,
Not all funny nails are fungal."
Anonymous
People find funny-looking nails embarrassing, at least in part because many people assume that they are caused by fungus (fungal nails). This makes them sound contagious or as if they are caused by poor hygiene. In fact, up to 10% of all adults in Western
countries have fungal nails. This percentage increases to 20% of adults who are age 60 or older.
In reality, "fungal nails" are often not caused by fungus at all! There are many other reasons why your nails may look different.
Nail Fungus Treatment
How is nail fungus treated?
Treatment for a nail fungus may include topical creams or oral medications
(antifungal drugs), but topical antifungal drugs likely won't cure the
infection. Rarely, surgery may be required. Removal of the infected nail can be
performed to permit direct application of a topical antifungal. Oral drugs, such
as terbinafine, can cure about 50% of nail fungus infections.
Toenail infections are more difficult to treat than fingernail infections
because the toenail grows more slowly. In addition, a damp, warm environment of
a shoe or boot can encourage fungal growth.
What other conditions can be mistaken for fungal nails?
Here are some other conditions you may have instead of fungal nails:
Lines and ridges: These are common and may be
considered normal. They may worsen during pregnancy. A large groove down the center of the nail can be caused by nail biting.
Senile nails: As you age, the nails become brittle, develop ridges and separation of the nail layers at the end of the nail. Try to avoid cleaning solutions, and don't soak the nails in water to avoid worsening of the problem.
Whitish or yellowish nails due to onycholysis.
This means separation of the nail from the nail bed. The color you see is air beneath the nail.
The treatment is to trim the nail short, don't clean under it, polish if you
want to hide the color, and wait two to three months.
Red or black nails due to a hematoma, or blood under the nail, usually
occur from trauma (like whacking yourself on the thumb with a hammer). The discolored area will grow out with the nail and be trimmed off as you trim your nails. If you have a black spot under your nail that was not caused by trauma, you may want to see a dermatologist to make sure it is not melanoma.
Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed, thereby producing a green pigment. The treatment is to trim the nail short every
four weeks, don't clean it, polish if you want to hide the color, and wait two
to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.
Pitted nails may be associated with psoriasis or other skin problems
that affect the nail matrix, the area under the skin just behind the nail.
This is the area from which the nail grows. Nails affected by psoriasis can also be tan in color.
Swelling and redness of the skin around the nail is called paronychia.
This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute
(has a rapid onset), it
is usually caused by bacteria. It may respond to warm soaks but will often need to be drained by a doctor. A chronic paronychia occurs when a cuticle becomes inflamed or irritated
over time. Sometimes, yeast will take advantage of the damaged skin and infect the area as well. Therapy begins with keeping the skin dry and out of water. Sometimes a steroid cream such as hydrocortisone can be used with success. If the problem continues, a physician may prescribe antifungal medications.
Chronic nail trauma, such as repeatedly starting and stopping, kicking, and other athletic endeavors, can cause damage to the nails that can look a lot like fungal nails. This sort of repetitive trauma can also occur with certain types of employment or wearing tight-fitting shoes.
The term "ringworm" or "ringworms" refers to fungal infections that are on the surface of the skin. A physical examination of the affected skin, evaluation of skin scrapings under the microscope, and culture tests can help doctors make the appropriate distinctions. A proper diagnosis is essential to successful treatment. Among the different types of ringworm are the following: tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea faciei, tinea manus, tinea pedis, and tinea unguium.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staning granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.
Diabetes-related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Athlete's foot is a common dermatitis of the webs of the toes and soles of the feet.
When caused by a fungus, athlete's foot may spread to the palm, groin, and body.
Fungal infections of the feet are contagious and can be spread person to person or by
walking on contaminated objects and floors.
Athlete's foot may cause foot itching, burning, pain, and
scaling.
When athlete's foot is caused by a fungus and it can be treated
with antifungal medications, many of which are available over the counter.
Keeping the feet dry by using cotton socks and
breathable shoes can help prevent athlete's foot.
What is athlete's foot?
Athlete's foot is a very common skin condition that affects the sole of the foot and the skin between the toes. It is usually a scaly, red, itchy eruption and occasionally may be weepy and oozing. It affects the feet of ...
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