Yellow Toenails: Causes, Treatment & Prevention Tips
They say your nails mirror the health status of the body, and that’s correct. A lot of times, the colour and appearance of the nails give clues to ailments and disease processes which might be ongoing.
Nails are part of the skin, and are made up of many layers of the protein keratin. Nails grow from under the cuticle and as new cells grow, the old ones thicken and are pushed out toward the fingertips.
Healthy nails are usually without discoloration, spots, or ridges. Although these changes might occur naturally in some people or as a result of the use of certain cosmetics, they may also suggest certain ongoing disease processes.
Diseases which could be diagnosed by examination of the nails include anaemia, malnutrition, hepatitis, and congestive cardiac failure in which the nails appear pale, emphysema in which the nails appear blue, kidney failure and HIV infection in which they appear dark, puffy nail folds as seen in connective tissue disorders such as lupus, dark lines beneath the nails in skin cancer, and cracked or split nails as seen in fungal nail infections.
It is however, imperative to note that these changes are only diagnostic clues and are not always indicative of the diseases they are paired with above.
This article discusses yellow discoloration of toenails, what causes it, what it suggests, the treatment options, as well as ways to prevent it.
What Causes Yellow Toenails
Advanced Age: The older one gets, the more the toenails begin to lose their colour, texture, and shape because of the low rate of growth and replacement of cells. Aging is a common cause of yellow nails of both the toes and fingers. In this case, it is completely benign and part of a normal physiological process.
Cosmetic Products: Such products as nail polish and dyes that colour your nails red or orange may give a subtle yellow discoloration of the toenails if applied on the nails for a long time. This yellow discoloration would only be reverted when the nail polishing is stopped.
Diseases: While, as mentioned above, yellow nails may be natural and completely harmless, it may also be ominous being indicative of an ongoing disease process, some of which are serious.
The following diseases can cause yellow discoloration of nails;
- Yellow Nail Syndrome.
Yellow nail syndrome is a rare condition which occurs mostly in persons above the age of 50. It is characterized by a triad of yellow discoloration of nails, lymphedema caused by excessive accumulation of lymph in the legs causing them to swell up, and pulmonary manifestations such as cough, pleural effusion, and bronchiectasis.
In yellow nail syndrome, the nails also appear curved, thickened, and with ridges and indentations.
Although, its cause is unknown, yellow nail syndrome is associated with certain diseases such as autoimmune diseases and certain cancers.
One of the commonest infective causes of yellow nails is Onychomycosis, a fungal infection of the toenails or fingernails.
It is caused by a group of fungi called dermatophytes and these fungi infect and damage the nail bed, causing pain, yellow discoloration, and disfigurement of the nail.
There are some types of onychomycosis that are more prevalent in those who suffer from HIV.
Factors which predispose to onychomycosis includes old age, sweating heavily, walking barefoot in moist communal areas such as swimming pools and shower rooms, obesity, diabetes, psoriasis, malnutrition, immunodeficiency, and cancer.
These not only increase an individual’s risk of onychomycosis, but makes the individual unresponsive to treatment of the nail condition. Research has also shown that some persons have a genetic susceptibility to onychomycosis.
Tinea pedis or athlete’s foot, an infection of the sole of the feet and the web spaces between the toes also predisposes to onychomycosis. People whose feet are often moist, such as athletes and those who put on boots and heavy footwear daily, are at risk of tinea pedis.
- Respiratory diseases
Respiratory diseases such as chronic bronchitis and pneumonia cause severe difficulty in breathing and poor oxygenating of tissues consequently.
In these conditions, energy is shifted from low-priority processes such as nail growth and shifted to the lungs to enable effective respiration. This, and the resultant poor oxygenation of tissues, causes the toenails to turn yellow.
Other diseases which cause yellow toenails include rheumatoid arthritis which is an inflammatory disease of the bones and joints, malignancies, diseases which impede blood circulation to the legs and feet, and chronic inflammatory skin diseases such as psoriasis.
When to see a doctor
One thing to note is that yellow toenails are always something to be concerned about because of its ominous nature sometimes.
However, if you develop yellow toenails as well as certain other symptoms or under certain circumstances, you should schedule a visit with your doctor. These associated situations under which you should visit your doctor include;
- If your nails get discoloured without having applied any cosmetic products.
- If there is an associated change in the shape and thickness of the nail
- If there is pain around the nail
- If you develop swelling of the nail bed or puffiness of the nail
- If there is a purulent discharge from around the nail.
- If there is any bleeding from the nail bed.
You will most likely get a referral from your primary care doctor to a dermatologist, a doctor who specializes in diagnosing and treating diseases of the skin and its appendages.
What questions should you ask when you visit the doctor?
After scheduling a visit to the hospital, you are likely to begin your consultation with a primary care doctor or a GP. After initial examination and taking details of the symptoms, the GP may refer you immediately to a dermatologist or a podiatrist (A doctor who specializes in the diagnosis and treatment of the diseases of the foot).
It is very essential to prepare for your first appointment with your doctor. Essential things to keep note of before going for the visit include the following;
- Ensure all your symptoms are clearly written, with details of onset, duration, and character of each.
- List key events in your life prior to onset of the symptoms
- List all the medications including supplements you have used or are currently on
- Write out your questions for the doctor.
Noting these details smoothen the consultation and makes it easier for the doctor to formulate a diagnosis, based on the information you provide your doctor.
Questions to ask your doctor on your first appointment include;
- What is most likely causing my yellow nails?
- What are the other possible causes of my yellow nails?
- Are the other nail symptoms part of the same disease process?
- What laboratory investigations do I need?
- What is the best course of action?
- What are other alternatives to the course of action suggested?
- I have other medical conditions, how best can I manage them altogether?
- What medicines will I be using, ad what are the side effects I should be expecting?
- Can you recommend a website or resource I could make use of to know more about yellow nails?
Treatment of Yellow Toenails
Yellow toenails are treatable, however the type, duration and intensity of treatment depends on the underlying disease process. There are a number of medicines as well as home remedies that effectively revert a yellow nail to its normal colour.
Medical treatment of Yellow Toenails
Yellow nails caused by fungus can be treated using antifungal medications. One common prescription antifungal medicine used in treating yellow nails is ciclopirox 8% solution. This solution is applied to the nails the same way you apply a nail polish to it.
It may take weeks to months for the old yellow nails to be replaced by new healthy ones. However, it is important to note that nail fungus recurs a lot and the discoloration may return.
In some cases where a yellow toenail is caused by a bacterial infection of the nails, antibiotics such as clarithromycin have been found to be very effective in replacing the yellow nails with healthy ones. In cases where the yellow nails result from bacterial lung diseases, antibiotics would also be necessary in clearing off the pulmonary symptoms.
Other medicines that can effectively treat yellow toenails include vitamin E, corticosteroids, and zinc. If these are applied on the nail, the nail destructive processes are inhibited and new healthy normal-coloured nails grow out to replace the yellow nails.
Vitamin E helps cells retain moisture and a healthy appearance. Vitamin E gives the skin, hair, and nails a rich appearance and promotes the growth of healthy nails. It has been found to be very effective in the treatment of yellow ail syndrome. Vitamin E can be applied topically or take orally to treat yellow nails.
Additionally, if laboratory investigations determine a medical condition to be the underlying factor causing the yellow toenails, treatment would be instituted for the condition concomitantly with the treatment for the yellow nail discoloration.
Home Remedies for Treating Yellow Toenails
There are a number of home remedies for the treatment of yellow nails and you should inform your doctor about any method you may wish to employ. Some of the home remedies for treatment of yellow nails include;
Tea Tree Oil
Tea tree oil has anti-inflammatory, antibacterial, and antifungal properties, such that swabbing the nails with a mixture of it and a carrier oil such as olive oil may yield a complete resolution of the yellow discoloration.
Other carrier oils you may use include coconut oil and jojoba oil.
Baking soda has an alkaline pH which is very unfavourable for the growth of fungus. Soaking your feet or fingers in hot water mixed with baking soda helps to keep fungi from growing, multiplying, and spreading.
This leads to their death consequently. Over time, healthy ails will sprout and replace the yellow ones.
Hydrogen peroxide is a common ingredient in toothpaste because of its teeth whitening effect. This is possible because hydrogen peroxide removes stains by oxidizing the stain-causing chemicals. Hydrogen peroxide seeps deep into the inner layer of nails removing stains and causing whitening.
Mixing hydrogen peroxide into warm water and soaking your nails in it will remove the yellow discoloration in them. Adding baking soda to the mix makes it even more effective.
Home remedies usually begin to cause resolution of the discolouration of the toenails within a week or two and complete replacement of the yellow toenails with normal ones occur within a month or two. If no improvement is noted after employing home remedies for this long, visit your doctor for further evaluation.
How to prevent yellow toenails
There are a number of ways you can prevent yellow toenails ad here are a few of them;
- Maintain good nail ad foot hygiene.
- Ensure your pedicurist or manicurist uses a clean and new kit for each person. Do not accept used objects for your pedicure.
- Use a mild nail polish remover, preferably those that do not contain acetone.
- Do not use nail polish remover more than once a week.
- Trim ad clean your nails regularly
- Ensure your socks are washed after each use, do not wear used or dirty stockings
- Wear dry socks only
- Avoid wearing tight footwear
- Ensure you alternate your exercise shoes, and dry them after use.
- Don’t soak your hands in water
- Ensure you keep your feet dry and reduce excessive moisture over them.
Yellow toenails may be caused by dyes, nail polishes, or as a result of aging, however, it could be a sign of something serious as occurs in yellow nail syndrome, fungal nail infections, diabetes, malignancies, and chronic inflammatory conditions such as psoriasis.
Treatment of yellow toenails depends on the cause and drugs used in treatment include antifungals such as ciclopirox, antibiotics, topical corticosteroids, and vitamin E. Olive oil, oregano oil, hydrogen peroxide, and baking soda are also effective home remedies one can employ to eliminate yellow toenails.
Preventing yellow toenails is more convenient and cheaper than treating it and as simple as maintaining proper foot and nail hygiene is what’s necessary.