Yes, toenails can provide important clues about a person’s overall health. Like other parts of the body, toenails can reflect nutritional deficiencies, disease, and other issues that may be affecting a person internally. Knowing what to look for on the toenails can help identify problems early and prompt someone to seek medical care. Here are some key things toenails may reveal about health.
Discoloration
Changes in the color of toenails can signal different health problems. Some examples include:
- Yellowing or brown discoloration can indicate a fungal toenail infection.
- Bluish-gray discoloration near the nail bed may be a sign of inadequate oxygen supply and circulation.
- White spots or streaks on the nails can potentially indicate zinc or calcium deficiency.
- Black streaks or dots may signal melanoma, a serious form of skin cancer that can spread to other areas of the body if untreated.
- Red or brown streaks in the nail bed often occur with psoriasis, an inflammatory skin condition.
If you notice a new discoloration or your toenails changing color, it’s a good idea to show your doctor to find out if any underlying conditions need treatment.
Thickening
When toenails become abnormally thick, it’s known as onychauxis. In most cases, this signals:
- Fungal infection – Fungi can take hold under the toenail, causing swelling, debris buildup, and crumbly thickening of the nail.
- Psoriasis – Thick, pitted nails are common with this autoimmune condition. The skin underneath may become inflamed and tender.
- Reactive arthritis – An inflammatory response can trigger nail changes like thickening.
Trauma and aging can also sometimes contribute to nail plate thickening. It’s important to identify and address causes like fungus or psoriasis early to prevent additional complications.
Brittleness and Crumbling
Weak, brittle toenails that crack or crumble easily can be a sign of:
- Fungal infection – Fungi may eat away at the protein structure of the nail, causing brittleness.
- Thyroid issues – Both low thyroid (hypothyroidism) and high thyroid (hyperthyroidism) can make nails dry and brittle.
- Diabetes – Poor blood sugar control and circulation issues common with diabetes can impair nail growth and health.
- Aging – Nails tend to become more brittle with age due to slower growth rates.
If your toenails seem excessively dry and brittle, it’s a good idea to see your doctor. Bloodwork and other testing can help identify any underlying problems.
Shape Changes
Certain toenail shape changes may also provide health clues:
- Spoon-shaped nails can indicate iron deficiency anemia or other causes of low red blood cell count.
- Clubbed nails with rounded tips may arise with lung disease, cardiovascular disease, and gastrointestinal disorders that impair oxygen circulation.
- Pitting or horizontal ridges can show with psoriasis, inflammatory arthritis, thyroid disease, and certain medications.
Consult your doctor if you notice any unusual new changes in the shape of your toenails to understand the cause and any recommended treatment steps.
Separation from Nail Bed
Onycholysis refers to the separation of the nail plate from the nail bed beneath. This can stem from:
- Injury or trauma – If the toenail is damaged, it may detach from the nail bed.
- Allergic reaction – Severe allergies, especially to nail enhancement products, can cause onycholysis.
- Skin conditions – Psoriasis, lichen planus, and some blistering disorders may infiltrate and loosen the nail.
- Fungal infection – As fungi spread under the nail, they can progressively detach the nail plate.
See your doctor promptly if you notice a toenail separating from the nail bed. Leaving it untreated risks infection entering the gap and spreading.
Disappearing Lunula
The lunula is the white, crescent-shaped area at the base of the toenail. When it fully or partially disappears, it may signal:
- Anemia
- Malnutrition
- Chemotherapy side effects
- Kidney disease
- Zinc deficiency
Loss of the lunula is rarely cause for concern on its own. But it may contribute diagnostic clues for an underlying health issue that needs evaluation.
When to See a Doctor
Make an appointment with your doctor if you notice any of the following toenail changes:
- Discoloration, especially with new black or blue-gray dots
- Sudden thickening and distortion of shape
- Crumbling, brittle texture
- Detachment from the nail bed
- Disappearance of the lunula at nail base
- Redness, pain, warmth, or bleeding around nail
- Pus-filled blister or callus tissue near nail
- Any other unusual change in toenail appearance
While toenails alone don’t provide a diagnosis, they can offer important clues to help uncover hidden problems. It’s best to get evaluated promptly so any underlying medical conditions can be identified and treated early.
Common Causes of Toenail Abnormalities
Here are some of the most frequent medical causes of unhealthy-looking toenails:
| Cause | Signs |
|---|---|
| Fungal infection | Thickening, brittleness, debris under nail, yellow to brown discoloration |
| Psoriasis | Pitting, horizontal ridges, yellow discoloration with red streaks |
| Diabetes | Yellowing, clawing, overcurvature, detached from nail bed |
| Thyroid disease | Brittle, splitting, ragged horizontal ridges |
| Anemia | Spoon-shaped, pale, disappearance of lunula |
| Vitamin/mineral deficiency | White spots, streaks, brittle, spoon-shaped |
Risk Factors
You may be more prone to unhealthy-looking toenails if you have:
- Compromised immunity – Chronic conditions like HIV/AIDS and taking immunosuppressant medications impair the body’s defenses against fungi and other pathogens that can infect nails.
- Reduced circulation – People with diabetes, vascular conditions, and certain nerve disorders affecting the lower extremities have poorer circulation that inhibits nail growth and healing.
- Repeated nail trauma – Athletes and runners who regularly have friction and pressure on their toenails are more likely to experience splits, bruising, and related damage.
- Toenail fungus history – Having a fungal nail infection makes you more susceptible to future recurrences.
- Hyperhidrosis – Excessive sweating of the feet provides a moist environment that allows fungi and bacteria to thrive.
- Smoking habit – Smoking constricts peripheral blood vessels, reducing circulation to the extremities.
- Age over 60 – Older adults’ toenails tend to grow more slowly and become brittle due to reduced nutrition and circulation.
Paying attention to foot hygiene, wearing proper footwear, and managing any underlying medical conditions can help lower your risk for unhealthy-appearing toenails.
Diagnosis
To figure out the cause of unhealthy toenail changes, your doctor will likely:
- Ask about your symptoms and medical history
- Examine your toenails, feet, and any skin lesions
- Collect nail clippings or debris for lab analysis
- Order blood work to assess for nutritional deficiencies, diabetes, thyroid problems, kidney disorders, and other systemic issues
- Prescribe an x-ray or other imaging if bone infection or other foot problems are suspected
- Refer you to a dermatologist if necessary for specialized nail evaluation
Identifying whether an infection, inflammation, trauma, or other disorder is contributing to the unhealthy toenail changes guides appropriate treatment.
Treatments
Treatment depends on the underlying cause of unhealthy toenail changes. Some examples include:
- Medications – Antifungal pills or creams, antibiotics, injections for psoriasis, thyroid medications, iron supplements, zinc
- Nail removal – Surgical or chemical removal of the nail to treat severe fungal or psoriatic infections
- Laser therapy – Low-level lasers can help improve discolored, brittle nails
- Lifestyle changes – Improving foot hygiene, wearing appropriate footwear, quitting smoking
- Treating underlying condition – Getting diabetes, vascular diseases, kidney disorders, nutritional deficiencies under better control
Following your doctor’s treatment plan can help restore healthy toenails and address any related medical problems.
Prevention
You can help prevent toenail problems by:
- Practicing good foot hygiene – Wash and thoroughly dry feet daily, using a separate towel than for other body parts.
- Disinfecting pedicure tools – Never share instruments with others; ensure salon disinfects properly.
- Avoiding tight hosiery and footwear – Wear properly fitted socks and shoes with room for toes.
- Treating athlete’s foot promptly – This fungal infection of the feet can spread to toenails.
- Wearing shower shoes in public facilities – Reduces risk of exposure to fungi.
- Trimming nails properly – Cut straight across to avoid ingrown toenails; file sharp edges.
- Moisturizing nails and cuticles – Prevents excessive brittleness and cracking.
- Letting feet air out – Go barefoot when possible to reduce moisture-trapping socks and shoes.
- Maintaining healthy diet – Nutrient-rich diet supports good nail growth.
Caring properly for your feet and toenails can help ward off many fungal, inflammatory, and nutrient-deficiency related nail problems.
When to Seek Emergency Care
In rare cases, severely unhealthy toenails may require prompt medical attention. Seek emergency care for:
- Pus-filled blister surrounding nail
- Red streaks extending from nail up the foot
- Fever and chills accompanying nail changes
- Sudden, severe nail bed pain and swelling
- Nail completely separated from toe and won’t reattach
- Change in nail color after nail trauma
These can indicate a possible aggressive bacterial infection that needs urgent treatment to prevent serious complications like abscesses or sepsis. Prompt antibiotics and drainage of infection generally resolves the problem.
Outlook
In most cases, following your doctor’s treatment plan can successfully restore toenails to a healthy appearance. This may take anywhere from several weeks to a year or longer depending on the extent of damage and underlying disorder.
Some fingernail or toenail abnormalities only cause cosmetic concerns without health risks. But leaving fungal infections, psoriasis, diabetes, and other disorders underlying nail changes untreated can lead to more serious foot complications down the line.
Making healthy lifestyle choices, practicing good foot hygiene, and getting routine medical care can all help reduce the chances of unhealthy toenails while safeguarding your overall wellbeing.
Conclusion
Your toenails provide a helpful glimpse into your overall health. Unhealthy changes in toenail color, thickness, texture, and shape may signal a fungal infection, injury, nutritional deficiencies, or an inflammatory or vascular condition. Prompt medical evaluation can identify the underlying cause early so it can be properly treated before complications arise. Addressing any related disorders and following preventive foot care habits can help restore strong, healthy looking toenails.
