black nail discoloration

[indianna]

my middle toe nail has black patches near the nail bed.  My beautician at first thought it a bruise, but 5 months later it has not got any better, nor grown ou with the nail.  Therefore it must be under the nail.  Is this a fungus of some sort?  How should I treat it?

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks like fungal nail infection or trauma skin. An infection of nail fungus occurs when fungi infect one or more of your nails. Nail fungus can be difficult to treat, and repeated infections are common. Over-the-counter antifungal nail creams and ointments are available, but they aren't very effective. You need to get a KOH examination and fungal culture of the nail scrapings done and then oral antifungals prescribed. Topical antifungals can be used in combination with the oral antifungals.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Bhupinder Kaur, MD]

Hello,
It can be due to freckles or solar lentigenes. They are harmless, flat, brown discolorations of the skin which usually occur on the back of the hands, neck and face of people older than 40 years of age. They are caused by the skin being exposed to the sun over many years and are a sigh of sun damage. The only way to prevent age spots is to use liberal amounts of sunscreen before the age of forty, avoid the sun, and wear protective clothing. The newest treatment for age spots is an alpha hydroxy acid gel or beta hydroxy acid gel.  Retin-A cream, alpha hydroxyacid peels, and liquid nitrogen therapy are other options.

I hope it helps. Take care and regards.