Dystrophic Nails

What are dystrophic nails?

Dystrophic nails are fingernails or toenails that are deformed, thickened or discolored. They can have various causes, ranging from toenail fungus to a skin condition.

Who gets dystrophic nails?

Dystrophic nails are common in:

• People over age 65, who are more likely to have nail fungal infections.
• People who have a skin condition that affects the nails, such as psoriasis.

How do dystrophic nails affect my body?

Dystrophic nails can be painful, especially if they curve into your skin and cause ingrown toenails. You might also be bothered by how your nails look. Even if they don’t hurt, always tell your healthcare provider about any changes to your nails. You may need treatment for the underlying cause.

What are the symptoms of dystrophic nails?

Some people have one dystrophic nail, while others have several. Dystrophic nails may be:

• Cracked in multiple spots.
• Crumbly or peeling.
• Misshapen or curved in an unusual way.
• Pulling away from or coming off your skin under your nail.
• Thicker than normal.
• Yellow, white or brown in color.

What causes dystrophic nails?

Dystrophic nails happen when an infection or injury damages your nail or nailbed. Causes of dystrophic nails include:

• Infections from nail trauma or ingrown nails.
• Mycotic nails or other types of toenail fungus.
• Psoriasis.
• Trauma to your nail, such as slamming your finger in a door or dropping something heavy on your foot.

Are dystrophic nails contagious?

Dystrophic nails can be contagious if they’re caused by toenail fungus. But if the problem is caused by trauma or psoriasis, you can’t spread it to others.

How are dystrophic nails diagnosed?

Dystrophic nails aren’t a disease. They’re a sign that something else is wrong with your nails or nailbed. Your healthcare provider will look at your nails and discuss your health history to determine the cause.

What tests will be done to diagnose dystrophic nails?

Your healthcare provider may identify dystrophic nails after looking at your nails. The next step is diagnosing the cause or ruling out health conditions. Tests that can help determine the cause of dystrophic nails include:

• Blood tests: Your healthcare provider may test your blood to look for signs of certain health conditions like infections. They’ll collect a sample of your blood with a needle and send it to a lab for analysis.
• Nail biopsy: Your healthcare provider takes a small sample of your nail. They send the sample to a lab, where a lab technician looks at it under a microscope. Your healthcare provider may perform this test to check for psoriasis or other skin conditions that affect nails.
• Physical exam: During a physical exam, your healthcare provider examines you and evaluates your overall health. You’ll discuss how you feel and any health conditions you have.

How are dystrophic nails treated?

Treatment for dystrophic nails depends on the cause. Your treatment may include:

• Antibiotics if you have a bacterial infection from an ingrown toenail or nail trauma.
• Antifungal creams or pills if you have toenail fungus.
• Light therapy, medications or immune therapy if you have psoriasis.

Can I care for dystrophic nails at home?

Don’t try to treat dystrophic nails without your healthcare provider’s help. Nail problems can get worse and lead to serious infections, especially if you have diabetes or other health conditions.

If your nail was damaged by trauma, the damaged nail may take several months to grow out. See your healthcare provider so you can discuss the best way to treat your nail while it heals.

How can I prevent dystrophic nails?

There isn’t a guaranteed way to prevent dystrophic nails. But you can help prevent toenail fungus if you:

• Change into clean socks at least once a day and anytime your feet get wet. If your shoes get wet, change into a dry pair as soon as you can.
• Don’t share footwear, nail clippers or towels with others.
• Clip toenails straight across. Fungus can grow under longer nails, and clipping nails in a curved shape can encourage ingrown toenails.
• Wear flip-flops or other shoes in locker rooms and public bathrooms. Don’t go barefoot in public places.

What is the outlook for dystrophic nails?

Dystrophic nails usually aren’t serious. But some conditions that cause it, such as toenail fungus and psoriasis, require medical care.

If you have diabetes, check your feet regularly for cuts and small injuries, including nail problems. Even minor foot injuries and nail problems require medical care because they can lead to infections.

When should I see my healthcare provider?

Nails are an important indicator of your overall health. If you notice changes to any of your fingernails or toenails, make an appointment with your healthcare provider. Check all of your nails regularly for:

• Changes in nail color, such as spots or streaks.
• Nail shape changes, like becoming more curved or separating from your skin underneath your nail.
• Nail texture changes, such as becoming thicker, thinner or crumbly.
• Pain or soreness around or under your nail.

What questions should I ask my doctor?

You might want to ask your healthcare provider:

• What’s the cause of my nail problem?
• What treatment do you recommend?
• What are the side effects of this treatment?
• Will my dystrophic nails go away after I complete treatment?

A note from Cleveland Clinic

Dystrophic nails don’t have to become a serious problem. The common causes of dystrophic nails — like toenail fungus and psoriasis — are treatable. And if you have diabetes, early treatment of foot and nail problems can prevent complications like infections. Your healthcare provider can pinpoint the cause so you get the right treatment. In many cases, proper treatment will reveal healthy nails again.