Are abnormal nails always caused by fungus?

(?) Frequently asked questions with answers from the dermatology specialist team

Q: Does an unhealthy-looking nail always mean it is a fungal infection?

A: Not necessarily. Abnormal nails do not always indicate a fungal infection. It is important to first observe the overall nail appearance. Normal nails should have the following characteristics:

Naturally light pink nail color

Smooth surface without ridges or pits

Nail edges are not swollen or lifted

Normal nail thickness

If any of these features are abnormal, the cause may vary and is not limited to fungal infection.

Q: What can cause abnormal nails?

A: Nail abnormalities can result from several factors, such as:

Infections, including fungal or bacterial infections

Repeated trauma or injury to the nail

Frequent exposure to water or chemicals

Side effects from certain medications

Skin conditions such as psoriasis

Underlying systemic diseases such as liver, kidney, or thyroid disorders



Q: What diseases can changes in nail color indicate?

A: Nail color changes may be associated with different conditions, for example:

Black nails: May result from trauma causing bleeding under the nail, fungal infection, or in rare cases, skin cancer

Partial white nails: May be seen in chronic kidney disease

Mostly white nails: May be associated with liver cirrhosis, heart failure, or diabetes

Green nails: Often linked to certain bacterial infections

Q: What causes rough or uneven nail surfaces?

A: Rough nail surfaces, such as small pits or ridges, may be seen in:

Psoriasis

Inflammatory skin conditions or eczema

Fungal nail infections

Side effects of certain medications

If nail lifting (separation from the nail bed) is present, it may also be associated with psoriasis, thyroid disease, or fungal infection.

Q: What causes swollen or lifted nail edges?

A: This is commonly seen in individuals whose hands are frequently exposed to water or cleaning chemicals, such as homemakers or people who wash items regularly.

This condition can weaken the skin around the nails and increase the risk of infection, including fungal infections.

Q: What does thick or thin nail growth mean?

A:

Thick nails: May be caused by fungal infection, psoriasis, or certain chronic conditions, often accompanied by changes in nail color

Thin nails: May be related to iron deficiency, leading to brittle nails that may appear spoon-shaped (spoon nails)

In older adults, nails may also naturally become thinner and more fragile with age

Summary

Abnormal nails can result from many different causes and do not always indicate a fungal infection. Accurate diagnosis requires a medical history and examination by a dermatologist to identify the true cause and determine appropriate treatment.