The last time you went to the doctor, he probably wanted to see your fingernails and toenails. Surely it was not to draw conclusions about how well you had been taking care of yourself. Actually, your fingernails and toenails can speak on behalf of serious underlying health concerns. A purple tint usually indicates a lack of circulation. Yellow nails point to nail fungus, and clubbed nails—nails which draw down from the cuticle to concave tips—can point to lung cancer.
If your toenail is black, your doctor has a vast list of potential causes to sort through. He may refer you to a podiatrist, or oncologist, depending on the nature of the discoloration. For all practically purposes, let’s examine the most common causes of a black toenail first.
There are two types of injuries which may be responsible for a black toenail:
1. Blunt force trauma- This comes about when you drop something heavy on your toe or kick something more solid than your foot. Injuries of this nature are often so painful as to render you unable to walk. The nail bruises and eventually dies, turning black before it does so. In some rare cases, a broken toe can lead to discoloration of the nail because the bruise is so deep. With a broken toe, you may even notice bruising on the underside of your toes. Trace the coloration back to the darkest areas to find the break.
2. Runner’s Toe- This happens when you wear shoes that are too small. The repeated trauma keeps pressure on the nail bed. The adrenaline of running usually masks the pain, but it shows up when you’ve had the chance to rest up, and your cuticle is turning purple because circulation is running back to the bruise. Eventually, the bruise travels up the nail. The nail dies, turning black before it does so.
Toenail fungus is a likely culprit, though it is unsightly and embarrassing. While it depends on the nature of the infection, sometimes nail fungus can show up as black or dark gray and infiltrate the nail. It can also rupture blood vessels beneath the nail, leading to an abscess. In extreme cases, the fungus can cut off circulation to the nail by infiltrating the cuticle. When this occurs, the nail turns black, dies, and falls off.
In some rare cases, a black toenail points to melanoma. Sometimes the melanoma is benign, sometimes not, though the first signs are black spots beneath the nails, and black lines edging forward from the cuticle. If a black toenail has not been preceded by an injury, contact your doctor right away for an appointment.
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