Your concern
Nails changing colour
Not every nail change is a fungus: some need looking at early.
The nail is a recording surface: trauma, infections, medication and general conditions leave traces that stay visible for months, because the plate grows slowly. A change visible today may describe something that happened six months ago.
The commonest error is assuming every altered nail is a mycosis. Many are, but not all: repeated trauma from footwear, nail psoriasis, changes linked to general conditions or medication produce pictures that look alike to the naked eye. Treating a nail with no fungus with antifungals for months is one of the most frequent outcomes of self-diagnosis.
There is, however, one situation that stands apart and is worth knowing: a dark, longitudinal band appearing or widening in a single nail. It is almost never anything serious — in darker skin types pigmented bands are common and entirely benign — but it is the one nail picture in which timing matters, because a pigmented lesion of the matrix should be seen and not watched for seasons. And if the pigment extends onto the skin around the nail, assessment is not postponed.
A dark band in one nail alone gets examined
Of all nail changes, this is the only one this page asks you not to wait on. Longitudinal pigmented bands are frequent and in the great majority benign, especially in darker skin types and when several nails are involved. The picture deserving closer assessment is different: a single nail, a band that has recently appeared or is widening, irregular margins, and above all pigment crossing the cuticle onto the skin. It is not a reason to panic — it is a reason to book an appointment rather than photograph it every month.
How it shows
- Colour change: yellowish, brownish, whitish
- Thickening or splitting of the plate
- Separation of the nail from the nail bed
- Transverse or longitudinal grooves
- A dark longitudinal band in a single nail
- Pigment extending onto the skin around the nail
How we proceed
- 1Dermatological visit with dermatoscopic examination of the nail
- 2Distinction between mycosis, trauma, nail psoriasis and other pictures
- 3Mycological testing before starting long antifungal therapy
- 4Closer assessment if a single pigmented band is present
- 5Scheduled follow-up: the nail grows slowly and is judged over time
Available treatments
- Dermatology visit
- Dermatoscopic diagnosis
- Mycological testing
- Scheduled follow-up
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Frequently asked questions
Why do a mycological test if you can see it is a fungus?+
Because the eye is wrong more often than people think, and here the error is costly: antifungal therapy lasts months, and starting it on a nail whose problem is actually traumatic or psoriatic means months lost plus the pointless effort. Mycological testing costs little and comes first for exactly this reason: the length of treatment makes confirmation worthwhile.
How long before a nail returns to normal?+
Far longer than people hope. A fingernail renews in about six months, a toenail can take twelve or more: even once the cause has been removed, normal appearance returns only with regrowth. This is why review is scheduled some way off and why judging a treatment after a few weeks makes no sense.
Does gel polish ruin nails?+
Repeated application and especially removal can thin the plate and make it brittle, and in some people the products used cause a contact sensitisation that shows up away from the nails — on the face or eyelids, touched with the fingers. It does not mean giving it up, but if nails worsen progressively it is worth stopping for a period and having them assessed.
Related reading
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