What's Causing My Toenail to Turn Brown? Podiatrist Tips

Getting to the Root Cause of Brown Spots on Toenails

Toenails take a lot of abuse. From cramming into shoes and socks daily to stepping on hazards underfoot, it’s no wonder issues like bruising, discoloration and thickening occur. When you look down and spot brown spots on a toenail, it’s normal to have concerns. However, while the first assumption may be a fungal infection brought on by injury, moisture or poor hygiene, there are actually various potential causes at play.

Common Causes of Toenail Discoloration

The appearance of any abnormality on a nail warrants attention to determine the underlying source. Some common culprits behind brownish toenail spots and related symptoms include:

• Toenail fungus
• Bruising under the nail
• Melanonychia
• Psoriasis
• Warts
• Skin cancer

Getting an accurate diagnosis from a podiatrist allows appropriate treatment to begin promptly. Left unchecked, some causes like fungal and yeast infections can worsen and spread to infect other nails.

Closer Look at Toenail Fungus

Ingrown toenails create ideal conditions for fungal organisms like dermatophytes to take hold under the nail bed. Symptoms associated with a fungal toenail infection include:

• Yellow, brown, white, black or green discolorations
• Thickened, brittle texture
• Debris accumulation under nail
• Foul odor
• Loose nail

Once a fungus penetrates the nail layers, over-the-counter liquid antifungals struggle to reach it. But leaving infection unchecked lets the discomfort and unsightly appearance spread. Seeing a podiatrist for customized treatment helps nip fungus in the bud.

Bruises Under the Nail

It may seem odd, but even toenails can become bruised when blood vessels underneath rupture from blunt force impact. Common mishaps leading to bruising under or on the toenail include:

• Dropping something heavy on your toe
• Stubbing your toe on furniture or other objects
• Jamming your toe playing sports
• Accidentally kicking a hard surface

Like bruises on the skin, bruised toenails change color as blood pools then gradually reabsorbs. The discoloration shifts from red to purple to brown/black until growing out with the nail over months.

What Is Melanonychia?

Latin for “black nail,” melanonychia occurs when melanocytes that produce skin pigmentation overproduce melanin that darkens the nail plate. Dark streaks or spots ranging from light brown to black appear under and within affected nails. Melanonychia sometimes stems from racial pigmentation and isn’t a concern. However, it can also indicate:

• Nail trauma
• Medications like chemotherapy
• Radiation exposure
• Vitamin deficiencies
• Autoimmune disorders
• Metabolic disease
• Skin cancer - rare but possible

When melanonychia involves single or multiple dark black lines that run vertically under the nail, it raises the risk of subungual melanoma – an aggressive form of skin cancer affecting nail beds. Any such pronounced changes warrant having your dermatologist rule out cancer.

Psoriasis Under and Around Nails

The raised, scaly red plaques associated with psoriasis can extend under toenails as well as invade nearby skin. In some cases, psoriasis presents first or solely in the nails. Signs to look for include:

• Pitting, crumbling or loose nails
• Discolored nails with white, yellow or brown spots
• Red spots in lunula at the nail base
• Detachment of nails from beds
• Thickened skin around nails

Another type of psoriasis called distal subungual onycholysis causes nails to separate from beds, increasing debris and infection risk underneath. Dermatologists tailor treatments like topical medications, phototherapy and biologics to ease symptoms.

Warts on Feet and Toenails

Caused by the human papilloma virus (HPV), plantar warts often creep under callouses on pressure points of feet – but sometimes pop up on or under toenails. You may notice a small white or skin-toned spot with a rough surface and surrounding inflammation. Multiple tiny black dots often appear on the surface caused by clotted blood vessels feeding the wart.

Seeing a podiatrist allows diagnosis to determine next steps for removing troublesome plantar and periungual warts. Treatments include salicylic acid applied daily, cryotherapy freezing, laser removal, or surgical extraction for stubborn growths.

When Toenail Changes Indicate Skin Cancer

Unusual toenail pigmentation, swelling, bleeding or new growth under or around nails can in rare cases indicate a squamous cell carcinoma. Risk factors for developing skin cancer on the feet include:

• Advanced age
• Ultraviolet light exposure
• HPV infection
• Repeated trauma or irritation
• Immune disorders like HIV or lymphoma

Catching squamous cell carcinomas early makes treatment with surgical excision, radiation or topical medications highly effective. But allowing them to penetrate deep leads to loss of limbs or death. Treat any growing mass, bleeding, oozing or major nail changes as urgent to confirm whether cancer’s at play.

When to Seek Podiatry Care for Toenail Changes

While discolored or irregular toenail spots commonly stem from transient injuries or fungal infections, more serious conditions can’t be ruled out without an exam. Consult your podiatrist or dermatologist if you observe:

• Nail fungus not improving with over-the-counter treatment after 3 months
• Sudden unexplained nail bruising or black discoloration
• Nail detachment, growths or bleeding around the nail
• Warts under or near nails persisting despite home treatment
• Rapidly changing pigmentation involving dark brown or black nails

Trust your podiatrist’s expertise to determine what's causing toenail issues and outline your best treatment options. Catching and tackling disorders early prevents complications down the road for your health - and peace of mind inspecting your toes.

What to Expect During Podiatry Consultation and Exam

A podiatry visit to evaluate brown spots or other irregularities involving toenails often starts with taking your detailed health history. Be prepared to note any relevant factors like family history of skin cancer or meds. Bringing photos showing how the toenail's appearance has changed over time gives your podiatrist visual context.

After taking your shoes and socks off for inspection, you'll discuss symptoms you’ve experienced like pain, thickening or change in nail texture and appearance. The podiatrist examines skin and nails to note characteristics that narrow down likely diagnosis.

Tests or next steps to confirm underlying cause may include:

• Fungal laboratory culture
• Biopsy of skin cells or nail tissue for examination
• Blood work to analyze vitamin or nutrient status as needed

Once determining the roots behind your toenail appearance, the podiatrist outlines possible remedies to resolve the condition and get your nail health back on track.

Create a Nail Care Routine for Healthy Feet

Fine-tuning some basic nail hygiene habits promotes healthy nails that reflect overall wellness. A sound nail care regimen includes:

• Trimming nails straight across monthly
• Using moisturizers to avoid excessive dryness or cracking
• Alternating shoes daily to reduce fungal risk
• Disinfecting pedicure tools at nail salons
• Wearing shower shoes in locker rooms or pools
• Treating wounds, cuts or hangnails on toes promptly

Schedule regular podiatry checkups to treat nail disorders early and discuss any unusual changes you spot under or around toenails. Catching issues before they worsen keeps your feet looking and feeling their best for the long road ahead.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.