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My son is 21; healthy food conscious; Sr. in college; has

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run for exercise in the...
My son is 21; healthy food conscious; Sr. in college; has run for exercise in the past, now calisthenics only; 6’, 150 lbs.; looks healthy; acts healthy, except for mild chronic sinus problems that he takes no drugs for; no unhealthy vices; he is type A personality, making all A’s and possibly does not get enough rest, (He has never been a good sleeper).

He has gray/brown toe nails. It began at least a year (or two) ago with his big toes last I looked; now it has spread to the other toes. He is home for Thanksgiving and I notice it has spread to the other toes. The big toe is ¾ gray/brown and the other toes are graying at the tips. They are not thick, yellowish or separating. He keeps them trimmed well. They look quite nice, except they are blue/brown.   Also they appear to be whitish near the cuticle.

So they are the darkest near the end and fading to white at the base of the toe nail. My other two sons and I have pink/flesh colored toe nails with white tips.

Is this a health concern? If so what type Dr. should we go to? What other information would you need?
Submitted: 9 years ago.Category: Health
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Answered in 1 hour by:
11/28/2008
Health Professional: Susan Ivy, Nurse (RN) replied 9 years ago
Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4,058
Experience: BSN, MSN, CNS
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Dear Mrs Ervin

Thank you for writing Justanswer with your concern.

I've been reviewing several sources, sorry for the delay.

The only thing that seems to fit with his profile is an atypical fungal infection. There are many types of fungal infections, and not all of them involve thickening or yellowing of the nails. Especially in a young, clean, and otherwise healthy individual. With his sports activity and the description you have given (some toes with the discoloration starting at the tips I really think this is likely.

Otherwise for "blue to grey" or "brown" nails other problems that can cause this would be silver poisoining (for grey or blue nails) or mercury poisoning (for brown nails) But if he had this degree of poisoning, he would certainly most likely have other symptoms at this point.

One of the best treatments for nail fungus, that does not treat the whole body (such as oral medications) is tea tree oil. This comes usually in a small glass bottle and you can buy it in any pharmacy. This oil is very concentrated and strong. It will actually soak through the nail to the underlying skin, which is needed to treat toe or fingernail infections. This can be applied directly to the nail, and after the first few nights, only a tiny bit will be required each night to each toe. You could also and soak the toes in a solution of warm water with several drops of the tea tree oil. Only take care not to get this in the eyes.

I have seen this (tea tree oil) work quite well, but according to the Mayo clinic there have not been enough scientific studies to yet prove the effectiveness in all cases.

See this article from the Mayo Clinic, regarding tea tree oil if you like:

http://mayoclinic.com/health/tea-tree-oil/NS_patient-teatreeoil

This is the Mayo Clinic's recommendation for treatment of nail fungus, that is based on empirical evidence. Description of toenail fungus is given as well, causes, treatment and prevention recommendations.

http://mayoclinic.com/health/nail-fungus/DS00084

If you are interested in alternative methods, this article by Andrew Weil, MD, a physician who studies complementary or alternative medicine, may be of interest to you. One of his recommendations is Tea tree oil. http://www.drweil.com/drw/u/id/QAA362690

With any medication for nail fungus, you will note that results will only be visible as the nail grows out, so, look for the new nail growing in to be clear, as well as there should be no increase in discoloration elsewhere if treatment is working. It will also be important to perhaps have an extra pair of clean, cotton socks to change into when he is away from home and is changing shoes to run for example. Washing the feet carefully daily and after sports with soap and water, and drying very thouroughly will help prevent further infection with nail fungus or other fungus.

If he does not see improvement within a few weeks of beginning the treatment that he chooses, or other symptoms appear, please see a physician for physical examination and work up.

I hope this is helpful. If you do have other questions or comments, please reply so that I or another expert can address them.

Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4,058
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Health Professional: Susan Ivy, Nurse (RN) replied 9 years ago
Thank you so much!
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Customer reply replied 9 years ago

One more bit of (important) information. He has been diagnosed with A-topical Dermatitis many years ago. It affects his feet the most (His brother, has severe Psoriasis). To keep under control he wears flip-flops most of the time, year – round. He wears shoe and socks when he needs to.

Are there other health concerns connected with this fungi to be on the look out for within the body? Can it affect other parts of the body? Internally or externally? I ask this because it obviously spreads from one toe to the other. All 10 toes are discolored. The last time I looked, it was just the big toes.

We will try the tea tree oil. If we went to a Dr., would it be a Dermatologist? Thank you for your time and information. Sincerely. You did get paid. They corrected the error message.

Health Professional: Susan Ivy, Nurse (RN) replied 9 years ago

Yes I saw that I got paid, and also thank you for the bonus.

There is a slight chance of it spreading, and therefore it is important for him to wash his hands after handling his feet, and it's a good idea to wash the socks in hot water. I think if he gets proper fitting shoes, which are breatheable, as well as wears the cotton socks, that this help to prevent spreading as well (or from him catching fungal infection). Although if his feet sweat excessively, then I can understand the necessity of the flip flops. The change of socks once to twice per day is important when he is wearing shoes, especially after sports activities and may mean buying extra socks and for him to get good instructions in the importance of this (with his type A personality, should not be a problem for him).

Back to the spreading or getting this internally, this would be rare in a healthy person - it can occur in people that are immuno-compromised such as those on chemo-therapy or with HIV.

Yes, a dermatologist would be the appropriate doctor. I'm sorry I thought I had mentioned it, I believe it is mentioned in the Mayo Clinic article.

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