Nail - Any idea what is it?

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Hi everyone: I just uploaded on pic of ny nail. I think it happened after a trauma with my foot. Any idea what is it and if I need a specific treatment? Many thanks.

- Peter

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  • Posted

    Hi peter67369. I've seen nail injuries where the whole nail plate became loose and detached from the nail bed. For minor injuries there is usually a blood cloth below the nail plate turning the nail dark. The new nail that grows back should look normal (translucent and pink).

    Injured nails are prone to be infected by fungi. If this has happened months ago you may consult a dermatologist since it might be an infection of the nail.     

    It would help if you can mention how long ago the trauma happened and what portion of the nail was injured. From the picture it looks like the root of the nail was injured and the portion of 'new nail' started turning white/yellowish. 

     

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  • Posted

    Hi danR: Many thanks for your answer. The trauma happened 1 month ago when I hit an item placed on the floor with the distal phalanx of my finger. I had no injury in the nail itself but maybe the violent impact has been transmitted to the matrix. I have also never seen blood under the nail. I have been diagnosed with a dermatophytic fungus (Trichophyton rubrum) in my foot (between fingers) a few years ago so maybe the impact which affected the matrix could have spread the infection to this part - what do you think?
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    • Posted

      That kind of injury could have easily damaged your nail. My wife lost a toenail after walking downhill in a mountainous area wearing boots that were a bit too large.

      In one month your toenail will have grown around 3-4 mm. So the white area seems to be 'fresh' nail. 

      I would suggest to have it checked out and treated as soon as possible. Otherwise the whole nail will become discoloured and brittle. 

      With fungal infections is often happens that first the skin is affected and then the nail. Do you remember the medicine you used to treat your skin infection?

       

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    • Posted

      danR: Thanks for your reply. I was supposed to take an oral treatment for my dermatophytic fungus but I never used it. I just had a check-up to know which was the fungus infection at laboratory.
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    • Posted

      The standard treatment of toenail fungul infection is oral medication for example with Lamisil. The treatment period is about 12 weeks. This is the easiest way. The only downside is that oral medication puts some strain on your liver. If you are healthy and have no previous history of liver problems you should be ok.

      I was treated with lamisil and got nauseous a few weeks into the treatment. 

      If it is just the one nail you can try to use an occlusive bandage with Lamisil. I have successfully treated a toenail that way. For that one toenail the fungus came back some time after the oral treatment with Lamisil and I didn't want to take tablets again. 

      Applying the occlusive bandage is a bit laborious.  Basically, you have to squirt a bit of Lamisil into a small rubber 'sock' and pull it over the nail. Just enough antifungal cream to cover the nail. You have to do this every evening until the nail grows back. As a rubber sock I used the finger part of a (non-latex) disposable glove. To prevent the sock from slipping off I used micro-porous tape ( a normal plaster will work). You will have to use a new 'sock' every evening. 

      By soaking the nail in cream overnight the affected part of the nail becomes soft and can be (very) gently scraped away.  I used this method until the nail grew back smooth and pink. Be warned it will take months. 

      (Caution: Do not fix the bandage too tight. If you notice any irritation of the surrounding skin then leave the bandage off for a few nights. If the irritation gets worse it's best to discontinue the use of this method. )

      It might be obvious but it is equally important to prevent the spread of the infection. Some tips include: Use socks only once and then wash them (preferably on a hot cycle). Use a laundry disinfectant instead of fabric conditioner. Don't wear the same pair of shoes on consecutive days. Use an antifungal spray for your shoes. Use a different set of nail scissors, clippers, ... for your healthy nails. Be meticulous about disinfecting your nail scissors and clippers. And very important keep a watchful eye on the healthy nails. 

       

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    • Posted

      Many thanks danR for all your advices.

      You're right - I was supposed to take oral treatment for months and to do a check-up of my blood at laboratory (I guess it was to check the liver).

      I will have to follow this treatment I guess... Anyway - I will see a dermatologist at hospital next week so I will ask him his opinion regarding what I have. I will keep you posted :-)

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