Non-Fungal Funky Nails (Onychodystrophy)

OTC antifungal solutions may not ever work on funky nails…if the funky growth has nothing to do with fungus. This phenomenon is quite frequent, as there are many other diseases that can cause nail thickening, discoloration, and abnormal growth.

Running, dance, years of pointed high-heels that squish your toes, aggressive manicures/pedicures, or even just the wear and tear of walking, can cause irreversible damage to the nail forming cells near the cuticle. If these cells suffer damage, toenails can grow in funny forever and there is not much one can do. So, take care of your feet! Wear shoes with wide toe-boxes and arch support if needed for your gait.

Onychauxis and Onychogryphosis are two common disorders among elderly, caused by genetics or poor fitting shoes over time. With both conditions, the toenails become quite thick and yellow. However, with onychogryphosis a “ram’s horn like deformity” is noted, where there is curving of the nails along with thickness.

Autoimmune diseases or even systemic medications may cause funky nail changes. Such conditions include psoriasis, eczema, lichen planus, lupus, or adverse reaction to medications (antimalarials, antiretrovirals, chemotherapy drugs, beta-blockers, retinoids, or certain antibiotics). Psoriasis may show in nails before patches ever show on the body. It rears its ugly head with nail pits, lifting of the nail, or thickening. Eczema or lichen planus may cause thinning, nail pulling/convexities, and weird growth patterns. Whereas, other illness or medications may cause horizontal ridges (Beau’s or Muehrckes’s lines), yellowing, raised nail beds, extension of nail white, or nail dips.

Dark green nail discoloration is caused by a bacteria called pseudomonas aeruginosa. This typically happens after damage to the nail that causes a lift, in turning causing a space for moisture and microbial intruders to grow.

OTC remedies for Funky Nails

Biotin or a Hair, Skin, & Nail multivitamin to assist with nutrient requirement for nail growth.

A topical called Dermanail Nail Conditioner by Summer Laboratories (http://www.sumlab.com/solutions/dermanail-nail-conditioner-for-brittle-nails/) has been touted for obtaining healthier looking nails.

An exfoliative moisturizer like Excipial 20% Urea Intensive Healing Cream may help to smooth nail feathering.

Pseudomonas can be addressed by the use of a 1 part vinegar to 1 part warm water soak for 10 minutes daily, until coloration disappears.

RX Treatments

There are limited prescription treatments to aid in nail appearance. Nonetheless, many are not covered by insurance as such a diagnosis is considered cosmetic. Topicals like Genadur which is promoted to “protect damaged nails from the effects of moisture, friction or shear” and Nuvail which is a water-proof protective film which assists in moisture retention are available.

For systemic illness, topical steroids rubbed near the cuticle skin may have some positive effect, while often for psoriatic nails, a life-long injectable biologic medication is needed (Humira).

Keryflex is an in-office procedure provided by podiatrists, that affords solely cosmetic improvement. It “is a painless, in-office application that restores the appearance of an individual’s natural nails. This system allows for a certified provider to remodel an individual’s damaged nails affected by fungus, defects and trauma. The composite resin creates a flexible, but durable, non-porous nail that allows the remaining natural nail to grow.”

Overall, OTC and RX topical therapies have limited ability to improve funky nails and systemic prescription products come with their fair share of side effects. Thus, when fungus is not the cause of funky nails, the appearance is likely something that one must chalk up to the glory of aging.

*The information provided above or in any blogs on this site is for educational purposes only. I does not replace advice or necessary examination and diagnosis from your healthcare clinician. Please see your healthcare provider for any and all concerns with changes in your health or treatment of disease.*

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