Discoloured/Thickened Toenails

 

Causes

Discolouration is usually either as a result of abnormal thickening of the nail or staining from nail varnish.



Discolouration caused by cosmetic staining
Yellowing of the nail is also caused, ironically, by efforts to make them look more attractive. Frequent or over-use of nail polish can stain the nail as pigment from the nail polish leaches out and penetrates into the nails. The resulting yellowish stain cannot be removed with nail polish removers. This can then lead to a vicious cycle of applying more polish to cover up the yellowing

Discolouration cause by thickening
Abnormal thickening of the nail occurs when the speed of growth of the nail slows down or when nail cell production speeds up. A slower speed of growth of the nails can be caused by a number of factors such as age, disease or malnutrition, whereas increased nail cell production can be a result of the nails being exposed to pressure or banging against the footwear.The yellowish appearance occurs because the thicker area of the nail plate is no longer transparent and therefore pinkness of the nail plate is no longer visible through the nail.
 

 


Discolouration – other causes
Discolouration may also frequently be caused by fungal infections (onychomycosis), bacterial infection and other conditions such as yellow nail syndrome. If any of these conditions are suspected, advice must be sought from a healthcare professional


 


Dull Nails
Nails become less shiny with age. As the surface of the nail becomes less smooth with and therefore less uniform, it becomes less reflective



Brittle Nails
A low water content is usually the cause of brittle nails. The nail plate is very porous and can lose water at a similar rate to the palms or soles. A health nail contains about 18% water, however when this falls below 16% the nail becomes brittle and less flexible. Common reasons for nail dehydration include interruptions to the normal rate of nail growth or damage to the nail, dry environments, use of detergents or solvents on the nail, frequent or long term use of nail polish removers or hardeners, disease, diet or drugs.


 

Symptoms

Discoloured, thickened toenails will often have an unsightly yellowish appearance. A nail that has become thickened may also be associated with some discomfort, and they can be difficult to trim. There are a number of conditions that can affect the nail and make it appear unhealthy. These include the development of ridges across the width or down the length of the nail, dullness or brittleness Brittle nails can be recognised by splitting flaking or crumbling of the nail

 

 

Treatment

Discolouration caused by fungal infections (onychomycosis), bacterial infection and other conditions such as yellow nail syndrome should be treated by a healthcare professional and advice should be sought if you are in any doubt.

Treatment for thickened nails is to remove the cause of the thickening where possible e.g. if this is due to pressure or rubbing on footwear or if poor diet is affecting nail growth.

To remove the thick nail material that has already built up physical removal with a file may be effective.

The treatment for brittle nails is based on preventing water loss from the nail, particularly after they have been hydrated e.g. after immersion in water. Massaging the nail with oils or creams that can prevent the nail from drying out can help. The use of nail polishes can also prevent water loss by providing a barrier and can act as a splint, further strengthening the nail. Some products claim to harden the nails, however if the nails become stiff, i.e. have a reduced flexibility; they can be more likely to snap.
Keeping brittle nails short may reduce the chances of damage.

 

 

Prevention

Do wash your feet daily and clean between your toes drying thoroughly
Do wear clean socks or hosiery
Do trim your toenails regularly. The nail can also thicken and harden if not trimmed regularly.
Do use proper toenail scissors or clippers. The best time to trim the toenails is after a bath as nails will tend to be softer and easier to cut
Do cut the nail straight across, following the natural shape of the nail, without cutting down into the corners. Cutting incorrectly can lead to ingrown toenails
Do use a base coat before applying nail polish.
Do wear correctly fitting shoes. Wear shoes that have enough room to wiggle your toes and natural materials will help prevent feet and toes getting too sweaty
Do wear sandals or flip flops in communal showers and bathing areas.
Do seek advice from a podiatrist if you notice discolouration or thickening of the nail, as this may be a sign of fungal infections

Don’t poke or dig at dirt gathered under the nail edge with scissors, clippers, tweezers etc. Use a cotton bud soaked in surgical spirit to gently free any debris.
Don’t cut too close to the skin.
Don’t pull at a hangnail.
Don’t cut cuticles. Soften the cuticles in warm water and gently push them back with a wooden stick

 

 

Precautions

Consult your doctor or pharmacist or healthcare assistant for advice or if you have an underlying medical condition, are taking any other medication or complementary therapy, or if symptoms persist.

Also seek advice on footcare if you are breastfeeding, pregnant, planning to become pregnant, or suffer from diabetes or allergies

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