Toenails can present with all sorts of patterns and a rainbow of colorations. It can be hard to know what discoloration and texture changes can mean. It is important to see your podiatrist for an evaluation and possible biopsy to determine the cause of discoloration. In many cases, a toenail biopsy can just mean taking a clipping of the nail or possibly removing the toenail to get a sample of the skin underneath. Below are some common reasons for toenail discoloration:

  • Black toenail – Black toenails are commonly referred to as “runner’s nail.” They can be caused by a type of fungus, or they are rarely caused by malignant melanoma. Black toenails present as darkness under the toenail that takes up a portion or the entire toenail. This is often secondary to trauma to the nail, even constant repetitive force in a shoe. It is important to have this evaluated, especially if it is painful. If the blackness is a line streaking up the nail, it is very important to have this evaluated ASAP.
  • Yellow toenail – Fungus is often the cause of yellowing toenails. Nail fungus presents as thickened nails with debris underneath that can be soft and crumbly. Less commonly, a pathology called Yellow Nail Syndrome can be present. This is very serious and often effects the finger nails, toenail, and is accompanied by respiratory symptoms and swelling. Come get your yellow nails evaluated, it can be treated by a topical medication, oral medication, laser therapy, or might need a further work up.
  • Green toenail – Green toenails can be caused by an infection called pseudomonas, which present as an ingrown toenail with green colored drainage. You must have this evaluated by a professional, as this type of bacteria is notorious for spreading.
  • Blue dot on the toenail – Sometimes a small blue mole can manifest under the nail. If you see a blue dot under the nail, it’s important to have this evaluated as your doctor might need to remove the toenail and take a sample of this mole to send to biopsy.
  • White spots and streaks – These can be caused by trauma to the nail, but also from a type of nail fungus called distal white superficial onychomycosis. Get this evaluated soon for treatment!
  • Cracking, splitting with reddish stripes – This can be significant for Darier’s disease, an anemia or blood issue. It’s important to have this evaluated by your doctor and perhaps order some blood work.


Don’t delay in getting a discolored toenail evaluated – stop into FAANT!

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