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Toenail Changes Are NOT Always Fungus

Your toenails can tell you a lot about certain physiological changes occurring in your body. People often associate abnormal toenail changes with fungal nail infections, such as onychomycosis. It is important to remember that not all toenail changes represent nail fungus.

Toenail abnormalities can include changes in:

  • Color
  • Shape
  • Growth
  • Pliability
  • Texture

Issues with your toenails can reflect problems with one or multiple changes from the list above. If you are experiencing toenail issues, we do not want you to immediately assume that they are fungal related because your efforts towards treating your nails will ultimately be hindered if the diagnosis is incorrect. So, here is a quick review over some common types of toenail changes that may be affecting your feet.

Leukonychia

Leukonychia

Leukonychia is usually the result of trauma to your nails. It is often characterized as White Spots, which form in different places on the nail and then slowly move outward towards the edges of the nail, forming a white dotted line appearance.

The trauma triggering this condition is usually the result of repeated manicures or chronic nail polish removal.

Onycholysis

Onycholysis

Onycholysis is characterized as the seperation of your toenail plate from the underlying nail bed. The seperation of the nail plate starts at the tip of your nail and migrates proximally towards your cuticle. This causes the nail to lift and develops an open space below the nail where dirt can enter and possibly cause infection to the nail.

This condition can be caused by multiple factors including trauma, eczema, psoriasis, diabetes, and allergic reactions to toenail cosmetics.

Terry’s Nails

Terry's Nails

Terry’s Nails is characterized by the majority of the nail plate turning white in color, the tip of the nail plate is typically reddish-brown and the lunula is usually absent.

Terry’s Nails is associated with liver disease, heart failure, diabetes and malnutrition.

Mees’ Lines

Mee's Lines

Mees’ Lines are also known as Transverse White Bands due to their white band appearance which usually transverses the entire nail. Mees’ Lines usually start near the cuticle and grow outward towards the tip of the nail.

Mees’ Lines are commonly seen as a result of arsenic poisoning, Hodgkin’s Disease, chemotherapy and leprosy

Beau’s Lines

Beau’s Lines 

Beau’s Lines, also known as Transverse Linear Depressions due to the Linear Depressions within the nail plate, which usually transverses the entire nail. The depressions resemble a transverse ridge across the nail and first appear near the cuticle, which grows outward towards the tip of the nail.

Beau’s Lines are usually the result of trauma, Raynaud’s disease or an illness, which causes poor nail keratin synthesis.

Pitting of the Nails

Pitting Nails

Pitting is usually characterized as small, dent-like depressions, scattered throughout the nail. These depressions are the result of defective layering of the superficial nail plate, which starts near the cuticle.

Pitting is mainly associated with Psoriasis, but is also seen in people with a condition that causes areas of hair loss, called Alopecia areata.

Koilonychia

Koilonychia

Koilonychia is often referred to as spooning of the nail due to the abnormal shape of the toenail, which is thin and curved upward along the sides of the nail plate. Spoon nails are commonly associated with iron deficiency anemia, pulmonary disease, and B12 deficiency.

Spoon nails usually develop in a sequential process which begins with thinning, brittle nails then the nail plate becomes straight, followed by an upward curving along the edges of the nail plate.

Brittle Nail Syndrome

Brittle Nail Syndrome

Brittle Nail Syndrome is the result of two specific nail conditions called Onychoschisis and Onychorrhexis. Onychoschisis (Nail Splitting) causes horizontal splitting within the nail plate and Onychorrhexis causes longitudinal splitting of the nail plate.

These conditions are usually the result of trauma to the nails, over usage of nail products, psoriasis, Vitamin C and Folic acid deficiency.

Discoloration of the Entire Nail

Discoloration of the entire nail can result from multiple factors. Some common nail discolorations include:

  • Yellowing of the Nails (Yellow Nail Syndrome) is typically associated with respiratory disease, chronic bronchitis, diabetes and liver problems.

 Yellowing Nails

  • Brown/Dark Red nail beds are typically associated with arsenic poisoning or a fungal infection.

 Brown Nails

  • Redness within the nail beds is typically associated with heart conditions.

 Red Nails

These are just a few common toenail changes, but it is important to note that changes to your toenails can occur from multiple contributing factors. At Austin Foot and Ankle Specialists, we commonly perform nail biopsy to accurately assess the nail change and formulate a tailored plan. If you are experiencing toenail changes, feel free to contact us at Austin Foot and Ankle Specialists. We can formulate and target a plan that works for your specific condition.