Understanding Black Toenails and Diabetes

Black toenails can be a troubling sign for those with diabetes. This condition, known medically as onychomycosis, occurs more commonly in those with diabetes due to high blood sugar levels and poor circulation.

What Causes Black Toenails?

Onychomycosis is most often caused by a fungal infection under or inside the nail. The fungi thrive off of high blood sugar levels and inhibited blood flow. As the infection spreads, it causes the nail to thicken and discolor, often turning black.

In addition to fungal infections, black toenails can also be caused by repeated trauma, such as ill-fitting shoes that rub against the nail bed. However, those with diabetes are more prone to developing infections and other complications from these minor traumas.

The Link Between Diabetes and Black Toenails

Those with diabetes have a harder time fighting off infections due to high blood sugar levels and poor circulation. When blood sugar is elevated, fungi and bacteria thrive. Additionally, excess sugar interferes with white blood cells' ability to efficiently heal wounds and fight infection.

Many people with diabetes also struggle with peripheral artery disease (PAD) and neuropathy. PAD causes narrowing of blood vessels which limits blood flow to the feet and toes. Neuropathy is nerve damage often affecting sensation. Combined, these complications make it difficult to notice and treat infections before they progress.

Signs Your Black Toenail May Be Infected

In addition to the nail turning black, here are some other signs your toenail may be infected:

Thickened nail
Crumbly nail debris
Foul odor
Pain or tenderness
Swelling or redness around the nail
Draining pus

Getting an Infection Diagnosed

While some cases resolve without treatment, it's important to get properly diagnosed. If the infection is left untreated, it can lead to permanent nail damage or spread to other toes and nails.

See your doctor if you notice any signs of an infected nail. They will examine your nails and feet to assess for infection. In some cases, they may clip part of the nail or scrape debris out from under the nail to be sent for further testing.

Available Treatment Options

Treatment will depend on the severity of your infection:

Medicated nail polish or creams. These are applied directly to the nail 1 to 2 times per day.
Oral antifungal medication. These medications are taken daily for up to 12 weeks.
Nail removal. In severe cases, the nail may need to be partially or fully removed to treat the infection.

Tips to Prevent Black Toenails with Diabetes

In addition to treatment, those with diabetes should take preventative steps to avoid complications like black toenails. Here are some tips for nail care:

Wash feet daily using mild soap and water.
Be gentle when trimming nails to avoid injury.
Apply foot cream daily to prevent drying and cracking.
Wear clean, breathable socks.
Never walk barefoot, even indoors.
Wear properly fitted shoes.
Check feet daily for any cuts, sores, or irregular nail changes.

When to See Your Doctor

In addition to possible toenail infections, those with diabetes need to have their feet examined annually for signs of neuropathy and PAD. Catching issues early can prevent further complications down the line.

See your doctor right away if you notice any of the following:

Changes in nail color or texture
Draining wounds or ulcers on the feet
Tingling or loss of feeling in the feet
Sores, blisters, corns, or calluses

Taking care of your feet should be a top priority with diabetes. Left untreated, even minor wounds can lead to dangerous infections and complications. Being vigilant about foot health and responding quickly when issues arise can help prevent further problems.

Coping with Black Toenails

In addition to physical complications, conditions like black toenails can also take an emotional toll. Coping with both diabetes and its effects on your body can be difficult.

Understanding Your Emotions

It's natural to feel frustrated, angry scared, or depressed after an unexpected diagnosis like black toenails. Allow yourself to process and validate these complex emotions. Diabetes requires significant lifestyle adjustments which impact your physical health and self-image.

Seeking Out Support

Friends and family who understand what you're going through can provide invaluable comfort and assistance. Consider joining a local diabetes support group as well. You may establish friendships with others who truly understand the day-to-day challenges posed by managing diabetes.

Establishing a Self-Care Routine

Make time for activities unrelated to your diabetes, even if just for a few minutes per day. Read a book, meditate, or do anything else you find relaxing. Maintaining your mental health is just as important as managing your physical symptoms.

While black toenails can be upsetting, the most constructive approach is focusing your energy on prevention and treatment. With proper foot care and working closely with your doctor, you can keep your feet healthy and avoid further complications.

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.