Causes of Yellowing and Thickening Toenails: When to Worry?

Q: Causes of Yellowing and Thickening Toenails: When to Worry?

Hello： Yellowing and thickening of the nails should be evaluated based on the degree of thickening and how many toenails are affected. <br>Generally, considerations include localized long-term pressure, fungal infections, or genetic factors, and a dermatologist should make the as

Yellowing of toenails?

I previously had a history of athlete's foot, which later healed, but I noticed that my toenails started to turn yellow and thicken over time.
I personally dislike cutting my toenails and usually wait until they reach a certain length before trimming them.
I'm not sure if this is related.
Could you please explain the possible causes of yellowing and thickening toenails? Is there a need to remove the toenails? Additionally, I read a report stating that individuals with black lines on their nails should be concerned about the possibility of melanoma.
If melanoma occurs beneath the nail, does the black color always extend from the nail matrix, or can it appear in any part of the nail, such as extending downward from the tip? Thank you, doctor.

Wuming, 20~29 year old female. Ask Date: 2009/06/28

Dr. Jiang Yujiao reply Dermatology

Hello: Yellowing and thickening of the nails should be evaluated based on the degree of thickening and how many toenails are affected.
Generally, considerations include localized long-term pressure, fungal infections, or genetic factors, and a dermatologist should make the assessment.
If a melanoma is located under the nail, the black discoloration may not necessarily extend from the nail matrix; it depends on the location of the tumor.
Clinically, one can observe a black tumor under the nail that can spread quite rapidly.
Response by Jiang Yujiao.

Reply Date: 2009/06/28

More Info

Yellowing and thickening of toenails can be concerning, especially for individuals with a history of fungal infections like athlete's foot (tinea pedis). The changes in your toenails could be attributed to several factors, including fungal infections, trauma, or underlying health conditions.
1. Fungal Infections: One of the most common causes of yellowing and thickening toenails is a fungal infection. Fungi thrive in warm, moist environments, making the feet particularly susceptible, especially if you have a history of athlete's foot. The infection can cause the nail to become discolored, thickened, and sometimes crumbly.
2. Trauma: Repeated trauma to the toenails, such as from ill-fitting shoes or not trimming the nails regularly, can lead to changes in the nail's appearance. Over time, this can result in thickening and discoloration.

3. Health Conditions: Certain health conditions can also affect nail health. For instance, psoriasis can lead to nail changes, including pitting, discoloration, and thickening. Additionally, systemic conditions like diabetes or circulatory issues can affect nail growth and appearance.

4. Hygiene and Care: Poor foot hygiene and infrequent nail trimming can exacerbate nail problems. If you tend to let your toenails grow long without trimming, this can create an environment conducive to fungal growth and other complications.

Regarding your question about whether you need to have the toenail removed, this typically depends on the severity of the condition. If the nail is severely infected or causing pain, a healthcare provider may recommend removal. However, if the issue is mild, antifungal treatments or topical medications may be sufficient.

As for your concern about melanoma, it is crucial to be vigilant about changes in your nails. Melanoma can indeed present as a dark line (melanonychia) under the nail. While it can start at the nail matrix (the base of the nail), it can also appear anywhere along the nail. If you notice a new, dark line or any changes in the pigmentation of your nails, it is essential to consult a dermatologist for evaluation. They may perform a biopsy to determine if it is melanoma or another condition.

In summary, yellowing and thickening of toenails can result from fungal infections, trauma, or underlying health issues. Regular foot care, including proper hygiene and nail trimming, can help prevent these issues. If you notice significant changes in your toenails or have concerns about melanoma, it is advisable to seek medical attention promptly. Early diagnosis and treatment are key to managing nail conditions effectively.

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