Dark lines on the toenails are often seen in the office and asked about by patients. Although most cases of dark nails are benign melanin in the nail root, a small percentage may represent melanoma, a potentially fatal cancer. Pigmentary changes in nail appearance may occur from trauma, inflammatory disease, occupational exposure, fungal infections, etc.
What is toe nail melanin?
Nails and toenails are made up of keratin, like hair on the head. Although they are not “true” nails (like the nails on your fingers), they are very similar in shape and function. Like your fingers, your toes are used to grasp and hold things like shoes or furniture. In fact, toes are extremely important to your overall health and well-being. They are part of a complex web of the body called the “nail system” that connects your fingertips and your big toes. The nails of your toes are covered in keratin, like your fingernails, hair and toenails. The nails are covered in layers of nail root, nail matrix and nail plate. The nail plate is the “active” part of the nail. Nails grow at a steady rate and are replaced as they wear away.
Causes of toe nail melanin
– Trauma – Bruises in the nail matrix create an opportunity for melanin to be deposited. The greater the force, the deeper the bruise. This is called a “superficial bruise”. – Inflammation – The nail matrix is rich in blood vessels and nerves. When you have an inflammation anywhere in the body, it causes pain, swelling and redness. – Excessive nail growth – Although the nail matrix has the potential to produce melanin, the nail is not a place where melanin is normally produced. If the matrix is producing too much melanin, the nail will become dark. – Fungal infection – Fungal infections can cause dark bruises and nail discolourations. – Tinea versicolor – Also known as “jungle rot”, this fungal infection causes dark spots and mottling of the skin and nails. – Other metabolic diseases – A rare metabolic disease called acropachy, which causes nails to grow abnormally long and also cause discolouration, is usually easily treated with a nail polish remover. – Alopecia – usually caused by androgenetic alopecia, or male pattern baldness, this condition results in bald patches on the scalp and bald patches on the toes.
Signs and symptoms of toenail melanin
Dark nails on the toes may be associated with a variety of signs and symptoms. – discoloured nails – the nail roots become brown and even black in some cases due to trauma or fungal infection – mottled nails – caused by an underlying fungal infection – ungual hyperpigmentation – or darkened nails – onycholysis – or separation of the nail plates – white lines on the nail – often seen on the thumbs and big toes where people can go barefoot – toenail hematoma – or a dark bruise on the nail bed – onycholysis with toenail melanin – or separation of the nail plates with dark toenail melanin
Diagnosis in nails
The most common symptom that a doctor will see if dark toenails are present is the separation of the nail plates. This separation is called onycholysis, which can be caused by trauma, trauma or fungal infection, or is a sign of metabolic disease. The nail is examined by a doctor and a scraping of the nail (polish) is taken to look at under a microscope for signs of trauma, infection or metabolic disease. Laboratory tests may be ordered to look for an underlying metabolic disease or infection.
Treatment of toenail melanin
Treatment of toenail melanin is similar to treatment of toenail melanin. Examine your nails daily for signs of trauma, infection or metabolic disease. Call your doctor if your nails are yellowish, changing colour or changing shape. There are many nail polish removers on the market that are safe for nails. If the toenails are too raw or damaged to be painted, you can use polish. Go barefoot as much as possible, wear cotton socks and change shoes when you do. Avoid harsh cleansers, harsh scrubbers and heavy objects on your toenails.
Prognosis of toenail melanin
Most cases of toenail melanin do not represent melanoma. If the toenails are damaged and/or discoloured, the risk of melanoma increases. An exposed nail is like a “finger” in the air that can be exposed to sunlight. If you have toenail melanin, avoid going barefoot and wear shoes whenever possible. Try to stay in the shade and wear long-sleeved shirts and long pants when possible. Wear sunblock when you are outside. Follow these to reduce your risk of skin cancer.
Preventive Measures to Keep You Safe
– Stay hydrated. Dehydration can cause your nails to become brittle and easily break. – Wear gloves when working with harsh chemicals. – Wear socks when you are going outside. – Expose your nails to sunlight as little as possible.