Nail Thickening and Deformation: Causes and Solutions

Q: Nail Thickening and Deformation: Causes and Solutions

Hello： Based on the photo, a fungal infection causing onychomycosis cannot be ruled out. <br>Repeated trauma from pressure may provide an opportunity for the fungus to thrive. <br>It is recommended that you return for a follow-up appointment to confirm the diagnosis and discuss t

Nail deformity and thickening?

Hello, my left pinky finger has thickened and deformed nails, and the nail grows very slowly.
Previously, I had athlete's foot between my left foot's pinky toes, but after seeing a doctor and using medication, ointments, and washes, the athlete's foot cleared up.
At that time, I also had blisters, and although the doctor said it was healing well and quickly, I was advised to return for a follow-up, but I was fine within a week! I didn't go back to the doctor, but the nail hasn't changed, and it grows very slowly.
I'm unsure if it's a fungal infection or if the deformation is due to pressure.
The base of the nail has a slightly dark purple bruise, and I used to frequently have bruised nails because I love hiking and exercising.
Sometimes it would be severe enough to lose the nail, but usually, a new one would grow back.
I would like to know what is happening with my nail.
I took pictures of the nail before cutting it, and after cutting, I can see that the nail is not separated from the nail bed, but it does appear thickened.
The thickened part doesn't look like a normal nail because I can see a layer of thickening underneath my nail.
Thank you!

Zhenni, 20~29 year old female. Ask Date: 2015/10/09

Dr. Li Yufen reply Dermatology

Hello: Based on the photo, a fungal infection causing onychomycosis cannot be ruled out.
Repeated trauma from pressure may provide an opportunity for the fungus to thrive.
It is recommended that you return for a follow-up appointment to confirm the diagnosis and discuss treatment options.
Thank you!

Reply Date: 2015/10/09

More Info

Nail thickening and deformation can be concerning, especially when accompanied by slow growth and discoloration. Based on your description, it seems that you may be experiencing a combination of factors that could contribute to these changes in your left pinky nail.

Firstly, the history of fungal infection (commonly known as "athlete's foot") could potentially play a role in the current condition of your nail. Fungal infections can lead to nail dystrophy, which is characterized by thickening, discoloration, and deformation of the nail. Even if the fungal infection has resolved, the damage to the nail matrix (the tissue under the base of the nail) may have already occurred, leading to ongoing issues with nail growth and appearance.

The presence of a black or purple line under the nail could indicate a few possibilities. One common cause is trauma to the nail, which you mentioned has happened in the past due to your activities like hiking. Repeated trauma can cause subungual hematomas (blood collection under the nail), leading to discoloration and potential changes in nail growth. If the trauma is frequent, it can also affect the nail matrix, resulting in thickening and deformation.

Another possibility is that the thickened area you are observing could be a sign of a condition known as onychomycosis, which is a fungal infection of the nail itself. This condition can cause the nail to become thick, discolored, and brittle. However, since you have treated a fungal infection previously and are no longer experiencing symptoms of athlete's foot, it may be less likely that a new fungal infection is the sole cause of your current nail issues.

In terms of solutions, it is essential to consult a dermatologist or a podiatrist who specializes in nail disorders. They can perform a thorough examination and may recommend a nail culture to determine if a fungal infection is present. If a fungal infection is confirmed, antifungal treatments, either topical or oral, may be necessary.

Additionally, if trauma is a contributing factor, it would be wise to protect your nails during activities that may cause injury. Wearing appropriate footwear and avoiding activities that put excessive pressure on your nails can help prevent further damage.

In the meantime, maintaining good nail hygiene is crucial. Keep your nails clean and dry, and consider using a moisturizer on the surrounding skin to prevent dryness and cracking. If the thickened area is causing discomfort or pain, a healthcare professional may suggest trimming or filing the nail to alleviate pressure.

Lastly, patience is key when it comes to nail growth. Nails typically grow slowly, and it may take time for any changes to become noticeable. If the condition does not improve or worsens, follow up with your healthcare provider for further evaluation and management.

In summary, the changes in your nail could be due to a combination of previous trauma, potential fungal infection, and possibly damage to the nail matrix. Seeking professional advice is the best course of action to determine the underlying cause and appropriate treatment.

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