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Brown Toe and Finger Nails: Causes, Symptoms & Treatment

What is Brown Toe and Finger Nail?

Toe and fingernails and the skin surrounding them are subject to everyday wear and tear. This results in the accumulation of germs, dirt, and fungi that further leads to infections and other related problems.

Fungal infection or some other underlying condition is the main reason behind brown colored finger and toe nails.

What causes Brown Toe and Finger Nails?

Most of the causes are external and are not at all associated with any medical condition. Some of them have been discussed below:

  • Tobacco Smoking: Brown and yellow discoloration of the fingernails and teeth are common in chain smokers.
  • Chemical Contact: Contact with harmful chemicals present in substances like dye, paint, varnish etc. leads to brown discoloration of the nails.
  • Mechanical Trauma: External trauma to the sensitive tissue beneath the nails could be a reason behind mild to severe discoloration of the nails. Heat damage and nail biting also fall under mechanical trauma that leads to discoloration of the nails.
  • Radiation Poisoning: Radiation poisoning and exposure to radioactive elements lead to brittle nail syndrome and brown colored nails.
  • Fungal Infection: Onychomycosis is the condition that causes brown colored fingernails. This is the after effects of fungal infection of the tissue beneath the nail and on the nail itself.
  • Nutritional deficiencies: Deficiency of both micro nutrient and macro nutrient elements results in discoloration of the nails. Examples of these essential elements are Vitamin B12, Zinc etc.
  • Blood Toxicity Levels: The discoloration of the finger and toes nails is the resulting factor of sudden or excessive intake of certain elements like iodine, arsenic, fluoride etc.
  • Drug Abuse: Abuse of some prescription drugs lead to the weakening of the teeth and discoloration of the nails. The drugs that should be used as per the doctor’s advice are tetracycline, lamivudine, corticosteroids, phenytoin, etc.
  • Hereditary: The DNA also plays a principal role in certain cases of nail discoloration. Acrodermatitis Enteropathica and Keratosis Follicularis are rare genetic diseases that result in the brown colored finger and toe nails. Individuals with these mutations in their genetic code do not possess the ability to absorb Zinc from food that results in zinc deficiency and ultimately results in brown nails.

Brown Toe and Finger Nail

Other causes

The following medical conditions can also lead to discoloration of nails and cause brown nails:

  • Hemosiderosis
  • Infective endocarditis
  • Porphyria
  • Peutz-Jeghers syndrome
  • Hyperbilirubinemia
  • Liver disease
  • Acquired immunodeficiency syndrome (AIDS)
  • Kidney failure
  • Systemic lupus erythematosus (SLE)
  • Malignant melanoma
  • Basal cell carcinoma
  • Addison disease
  • Cushing syndrome
  • Hyperthyroidism
  • Diabetes mellitus

Symptoms of Brown Nails

  • Emission of foul odor from the nail
  • Onycholysis (Separation of the nail from the nail bed)
  • Thickened nail
  • Fragile, ragged, or dull appearance of the nails

Diagnosis of Brown Nail

As soon as the above-mentioned symptoms are observed, the following tests can be carried out:

  • Microscopy lab tests to identify the fungal elements
  • Mycological culture for identifying the microbe species
  • Accumulation of samples of skin debris closest to the infected area

What does Brown Finger Nails Indicate?

  • Splintered, red or brown lines on the nail could be the resulting factor of Endocarditis (inflammation of the heart tissue)
  • Dark blue lines in the nail could be a symptom of skin cancer
  • Unusually shaped nails could be a result of iron deficiency
  • Fungal infections like Tinea could also cause discolored finger and toe nails
  • Changes in the composition of the proteins present in the nail bed results in brittle nails and instances of discoloration
  • Discolored nails could also be a resulting factor due to birth defects such as nail-patella syndrome
  • Certain diseases of the skin such as eczema, lichen planus, etc. can cause brittle nails, grooves on the nail surface etc.

Medical Treatments for Brown Nails

The severity of the condition dictates the type of treatment that one should go through. It also depends on the type of fungus that is causing the infection. Following are some recommended medications and procedures that aid in treating brown nails:

Medications

In most of the cases, oral antifungal medications are prescribed. On top of that, there are some medicated ointments that can be directly applied on the infected surface.

Oral antifungal medications

  • Terbinafine (or Lamisil)
  • Itraconazole (or Sporanox)

These medications, when applied to the infected area, supports the growth of new nail all the while removing the infected area.

[NOTE: Oral anti fungal drugs can lead to adverse side effects ranging from liver damage to skin rashes. It is advised to consult with the doctor before going ahead with this particular treatment.]

Medicated nail polish

  • Ciclopirox (or Penlac): This is a medicated nail paint that needs to be applied to the infected nail and the surrounding skin once on a daily basis.

Medicated nail cream

The medical professional can also prescribe medicated antifungal ointment that directly targets the fungus beneath the nail surface.

Surgery

Temporary removal of the infected nail through a surgical procedure is advised by some doctors to directly apply the antifungal drug on the infected area.

In certain cases where the infected area does not respond to medications, permanent removal of the nail is advised especially if the infection is causing severe pain and discomfort.

Tips to prevent Brown Nails

  • Keep the nail and the cuticles moisturized by applying moisturizing crèmes with urea, lactic acid or phospholipids
  • Avoid usage of strong detergents and soaps
  • Avoid nail polish removers containing formaldehyde or acetone
  • Avoid biting nails
  • Limit the handling of hair dyes
  • Avoid the removal of ingrown toe nails
  • Avoid smoking & usage of tobacco based products
  • Keep a balance on micro & macro nutrient intake
  • Keep the nails dry and well maintained
  • Wear shoes that are made from breathable material aids in minimizing chances of brown toe nails
  • Maintain personal hygiene
  • Do not share personal effects like towels both in the residential and public places like the gym or the swimming pool
  • Prompt treatment of skin infections like eczema
  • Always wear gloves while washing dishes
  • Don’t push back the cuticles while getting a manicure at home

When to Visit a Doctor?

It is advised to seek medical assistance as soon as the following conditions arise:

  • Painful swelling, redness & tenderness in the nails or surrounding skin
  • Red streaks on the nail surface
  • Pus discharge
  • High fever
  • Fungal infection visible in the skin under the nail & the surrounding skin
  • Thickened toenail
  • Questionable appearance of the nail

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