Dark Color Changes To Toenails: Potential Causes and Treatment

Dark-colored streaks in toenails are common in the United States, especially amongst people with darker skin toes, particularly in African-Americans. For the most part, these streaks usually represent non-serious conditions. However, especially in fair-skinned people, the presence of these streaks could represent a deadly cancer. This article will discuss the common causes or dark streaks in toenails, and what condition is cause for alarm.
Before beginning, the reader should be aware while reading this article that the information contained is not meant to provide tailored medical advice specific for one's own medical condition, but is meant as a general discussion on this health topic. Any specific questions or concerns for the conditions described in this article should be directed to one's own general physician or specialist for proper diagnosis and treatment.
The toenail is a dense tissue made of compressed keratin. The nail plate itself begins in the nail matrix, which is essentially the root of the nail. The outer edge of the matrix is seen externally as the lunula, or the white semi-circular shaped area at the base of the nail just beyond the cuticle. The nail slowly grows outward, sliding semi-loosely along the skin. The color of the nail itself is a kind of opaque white or cream, with some clearness in it to see the skin below it. Discolorations in the nail plate, be they solid white, yellow, blue, brown, or black, are abnormal and represent a disease process. The most common sources of toe nail discoloration are due to keratin debris built up under the nail from natural nail thickening and aging, as well as discoloration from a fungus infection. These typically create a white, yellow, or yellow-brown discoloration. Since both of these lengthy topics have been covered by this author in other articles, the causes of darker shades of discoloration will be presented here.
Dark toenail discoloration has several causes, and properly diagnosing the cause is key to a successful treatment. The most common reason nails become darkly colored is because of bruising under the nail. Bruising is essentially blood left behind by bleeding. It can occur under the skin, and can also occur under and over the top of the skin located directly under the toenail. Bleeding under a toenail can be caused by dropping a heavy object onto the toe, by pressure from tight fitting shoes, by toes jamming into the end of the shoe as seen often in runners, and by stubbing injuries that cause blood vessels to burst. Spontaneous rarely if ever occurs, and often if one does not remember injuring the toe it usually means the injury was minor enough not to cause initial, memorable pain. The bruising under the nail stays in the nail plate until it grows out with the nail.
Bruises that do not grow out as the nail continues to grow are cause for concern, and a podiatrist should be contacted. The potential cause for this will be discussed later. When the bruising takes up less than a quarter or a third of the nail, it can likely be left alone and the nail can be allowed to grow out. If the bruising is more extensive, covering the entire area of the nail, the nail plate should be removed. This is done for two reasons. Firstly, it allows the blood to properly drain, and limit's the amount of damage the bleeding caused to the nail root when it slightly lifted the nail plate during the time of active bleeding. Secondly, the bleeding may have been caused by a deep cut to the skin underneath the nail plate during the initial injury, and this skin needs to be evaluated for any cuts that need to be stitched. Another concern, especially if a fracture has occurred to the bone under the nail, is pieces of bone sticking out into the skin externally. If these are not removed and the skin cleaned and treated properly, infection can develop which may spread to the underlying bone.
Another cause of dark discoloration is infection. As discussed before, fungus can enter the skin under the nail and cause discoloration, thickening, brittleness, and debris. This fungus is the same in the same group of organisms that causes Athlete's foot, and from a color perspective can change the nail from opaque to solid white, yellow, grey, brown, or even black in some cases. Treatment is somewhat complex, as only certain medications have any scientifically proven effectiveness, and there are many home-spun treatments still used that simply fail to show any real worth. Another source of infection is from bacteria, specifically bacteria from a family of organisms called Pseudomonas. This bacteria is prone to invade skin that has been kept moist for awhile, and is commonly spread in whirlpools and hot tubs. The bacteria creates a green color change in the skin and nail tissue, presumably from iron pigment. The so-called green nail syndrome is common, and is treated with a special diluted vinegar solution (acetic acid) soak, or with specific antibiotics targeted against pseudomonas. This infection rarely progresses to a more serious condition in otherwise healthy people, and is usually easily treated.
Nail discoloration that moves across the width of the nail in a thin line from one side to the other side has many different causes to numerous to discuss in detail. The causes can include disorders of the kidney, deficiencies of certain minerals, toxic metal poisoning, heart disease, chemotherapy for cancer, certain chronic medications, and major injury to the body. Due to the wide variety of causes, a visit to one's primary care doctor, dermatologist, or podiatrist is recommended. There is generally no immediate treatment for these lines, but one's physician may be able to diagnose another condition that needs treatment through examining the nail, especially if something like metal poisoning or mineral deficiency is undiagnosed.
Nail discoloration that travels in a streak from the beginning of the nail to the end is the one symptom that is cause for the most concern. This streak is typically brown, dark blue, or black, and can be found on one side of the nail or in the center. Usually, this streak takes up less than one quarter of the width of the nail itself, although in some cases it can be wider. The usual cause of this streak is the overproduction of the cells that produce skin pigmentation, otherwise called the melanocytes. These cells produce melanin, which gives darker-skinned people their skin tone, and Caucasians their skin tan. It naturally protects the skin from the harmful ultraviolet rays of the sun, although overexposure to sun can lead to a mutation in the production of melanocytes. This is technically a cancerous growth. In most instances of nail streaking and skin conditions such as moles, this is a benign growth. However, malignant cancer can develop which has the potential to spread to other organs, leading to death. This cancer is called melanoma, and it is deadly. Dark streaks beginning at the cuticle and traveling along the length of the nail are very common in those with darker skin tones, particularly African-Americans.
In fact, many people have streaks on nearly all their toenails, and have had them since birth. These do not generally represent melanoma of the nail, and are usually benign. When these streaks are newly developed in caucasians, or if there is a new growth or change in a preexisting streak in someone with darker skin, the nail and skin surrounding the nail needs to be assessed by a physician. This is especially true if a discoloration of the skin next to the nail is developing, no matter what the original tone of the skin. A biopsy of the streaked part of the nail, the nail root, and the surrounding area of skin needs to be performed to ensure there is no malignant cancer. This is a simple procedure, done usually in an office by a podiatrist, dermatologist, or sometimes a general surgeon or family doctor, and it heals quickly. The nail usually grows back healthy if the condition was benign. If melanoma is present, immediate attention must be made to the toe to prevent further spread. This usually includes amputation of the tip of the toe, or the toe in its entirety depending on the size of the melanoma. This is absolutely necessary to save one's life and prevent spread of the cancer.
As one can see, dark discoloration of the toenails can have numerous different causes. Most are benign, and resolve with simple treatment. Some are simply genetic, such as the common nail streaks in darker-skinned individuals. Others are dangerous cancers that need immediate treatment. Due to the potential for cancer, this author recommends that all areas of dark discoloration in one's nails be assessed by a physician to ensure the condition is benign. The least one wastes is a little time in the doctor's office, and at best one can save their own life.

By Scott Kilberg DPM

Does Sun Exposure Cause Skin Cancer?

There are a lot of tales told about skin health. One of the most damaging is that sun exposure causes skin cancer. As you'll see in a moment, this is simply not true.

Melanoma is the form of skin cancer the media likes to refer to when they want to scare the dickens out of the public about the dangers of sun exposure. There are a number of reports of the fact that melanoma has been steadily increasing over the last 20 years. Most dermatologists will say this increase is due to the fact that more people are getting far too much sun exposure in their younger years.

A closer look at the matter, however, reveals a far different story. Skin cancer awareness programs have been effective at increasing the number of people undergoing full-body screening exams, and the result is a huge increase in the number of skin biopsies being performed. It seems that even with biopsies there is still considerable confusion and disagreement among pathologists when it comes to identifying melanoma. It's apparently not a cut-and-dried diagnosis.

Looking at the same tissue, one pathologist will see a benign lesion while another will see it as melanoma. Thus, the dramatic increase in biopsies has led to more melanoma diagnoses, many of which are false, as a new study shows.

The study, conducted by doctors at Dartmouth Medical School, found that there has been a 250% increase in skin biopsies since 1986-which just happens to be roughly the same percentage increase in the number of people diagnosed with early-stage melanoma. These researchers became skeptical about the rise in melanoma after they noticed that over that time there hasn't been any increase in deaths from melanoma or any increase in the number of advanced cases of the disease.

Plain and simple, there has not been an actual increase in the overall incidence of melanoma. The apparent increase is due merely to improved detection because of the increased number of screening procedures and subsequent biopsies, which by the way, hasn't led to any increase in survival or cure rates.

Much like cancers of the prostate, breast, and lung, the more doctors look for cancer, the more likely they will find it and the number of false diagnoses will also increase.

If you or someone you know is diagnosed with melanoma, I would definitely suggest getting a second or possibly even a third opinion.

Obviously, excessive exposure that results in sunburn isn't a benefit at all. However, moderate amounts of sunlight, along with a varied diet containing nature's natural protective anti- oxidants, vitamins, and fatty acids (omega-3s) is actually beneficial and has been shown to help prevent many forms of cancer-including skin cancer.

Lifetime sun exposure was actually shown to result in a lower risk of developing melanoma. (I Invest Dermatol 03;120(6):1087-1093) Past studies have shown that individuals who utilize sun exposure reasonably have a lower incidence of colon and breast cancer, prostate cancer, multiple sclerosis, osteoporosis, hip and vertebra fractures, et cetera.

Over 20 years ago it was discovered that vitamin D has an "anti-proliferative" effect on cells. In other words, vitamin D can stop cells from multiplying out of control (i.e., from developing into cancer). The body has only two sources for vitamin D. The first is from oily foods (vitamin D is fat-soluble) such as oily fish, organ meats, and eggs. The second is from your own skin cells, which use the same "cancer-causing" UV rays from the sun to convert a form of cholesterol into vitamin D.

Not surprisingly, those who consume more fish and omega- 3 foods have a reduced incidence of melanoma, while those consuming more of the omega-6 oils (the vegetable oils that are now so pervasive throughout our food supply) have increased rates of melanoma and other skin cancers.

A couple of other chemicals that your skin makes when it has adequate exposure to the UV rays of the sun. The function of these two vitamin D-related compounds, lumisterol and tachysterol, isn't yet fully understood. It's possible that they're associated with helping prevent blood sugar problems and obesity.

Avoiding sunlight puts you at a far greater health risk than exposing yourself moderately. Dr. William Grant, one of the top researchers on this subject, has studied the relationship between sunlight and health for years. He's found that every year 47,000 individuals in this country die from 16 different types of cancer due to insufficient vitamin D, whereas 8,000 die of melanoma and another 2,000 die from other skin cancers.

Furthermore, pale skin, numerous moles, smoking, a diet high in fat and low in fruits and veg- etables, and frequent sunburns are all stronger predictors of later skin cancer than UV exposure. As with most things, moderation is the watchword. Enjoy your time in the sun every day and prepare your body with an adequate intake of the right fatty acids.

By Joni Bell

Nodular Melanoma

The awareness of the dangers of skin cancer, particularly melanoma, has doubtless increased. Still, the most fatal form of melanoma is frequently left undiagnosed in the fledging stages.
Nodular melanoma is the most serious and life threatening form of skin cancer, constituting around 35% of all thick melanoma cases. In comparison, the most general form of melanoma, the superficial spreading melanoma, is regularly diagnosed in its infancy and characteristically is a thin melanoma.
The dissimilarity between thick and thin melanomas is quite straightforward. Thin melanomas have a tendency to spread out over the top of the skin surface. Thick melanomas, on the other hand, are more penetrating and grow deeper into the skin.
Commonly, nodular melanoma is already invasive upon first diagnosis. This form of cancer is normally seen on arms, legs and upper torso of an elderly person. The scalp may be affected at any age.
This malignancy is characterized by a bump-like feature, generally black, but at times blue, white, gray, brown, red, tan or skin tone.
Nodular melanoma is far less common than any of the other sub-types. It accounts for only 15% of all melanoma cases. Reports suggest that this disease commonly affects people after the age of fifty. Medically, nodular melanoma appears as a consistent blue-red, blue-black or amelanotic nodule.
Nearly 5% of nodular melanomas do not have pigment. They are called amelanotic melanoma. The most affected areas for nodular melanoma are the head, neck and upper torso. It is important to remember that a nodular melanoma usually starts in normal skin, and not in an already existing lesion. Nodular melanomas are also characterized by rapid growth.

By Max Bellamy

HEALTH BENEFITS OF TURMERIC

Here are 20 reasons to add turmeric to your diet:

1. It is a natural antiseptic and antibacterial agent, useful in disinfecting cuts and burns.
2. When combined with cauliflower, it has shown to prevent prostate cancer and stop the growth of existing prostate cancer.
3. Prevented breast cancer from spreading to the lungs in mice.
4. May prevent melanoma and cause existing melanoma cells to commit suicide.
5. Reduces the risk of childhood leukemia.
6. Is a natural liver detoxifier.
7. May prevent and slow the progression of Alzheimer's disease by removing amyloyd plaque buildup in the brain.
8. May prevent metastases from occurring in many different forms of cancer.
9. It is a potent natural anti-inflammatory that works as well as many anti-inflammatory drugs but without the side effects.
10. Has shown promise in slowing the progression of multiple sclerosis in mice.
11. Is a natural painkiller and cox-2 inhibitor.
12. May aid in fat metabolism and help in weight management.
13. Has long been used in Chinese medicine as a treatment for depression.
14. Because of its anti-inflammatory properties, it is a natural treatmentfor arthritis and rheumatoid arthritis.
15. Boosts the effects of chemo drug paclitaxel and reduces its side effects.
16. Promising studies are underway on the effects of turmeric on pancreatic cancer.
17. Studies are ongoing in the positive effects of turmeric on multiple myeloma.
18. Has been shown to stop the growth of new blood vessels in tumors.
19. Speeds up wound healing and assists in remodeling of damaged skin.
20. May help in the treatment of psoriasis and other inflammatory skin conditions.

Turmeric can be taken in powder or pill form. It is available in pill form in most health food stores, usually in 250-500mg capsules.