ZocdocAnswers"What causes short, discolored fingernails?"

Question

"What causes short, discolored fingernails?"

My boyfriend's fingernails have started growing in (as of last year) short, stumpy, and discolored. He seems amazingly calm about the whole thing, but I really believe we should deal with it. What makes fingernails do that, and how can they be fixed?

Answer

This sounds to be most likely due to fungal infection of the nail bed, known as onychomycosis. Fungal infections lead to thickened, discolored nails that are often painless, but cosmetically concerning to patients (or to a patient's girlfriend!) The gold standard for diagnosing onychomycosis is to cut a piece of the infected nail of and send it to a lab for a specific fungal test (PAS test). this can be done at any doctor's office and the results are normally back in a few days. The treatment options for onychomycosis includes topical antifungal ointments, systemic oral therapy with anti-fungal pills, and even so far as surgical removal of the nails in addition to oral antifungal pills in very severe cases. Topical therapy is relatively ineffective because the nail plate is thick and impermeable to the medication. Oral therapy is normally the treatment of choice. however, there is a risk for liver damage with therapy and so patients need to have blood tests taken before and during therapy monitor liver function. The normal course of therapy for fingernail fungus is 6 weeks and the majority of patients remain fungus-free after treatment. recurrence of nail fungus may warrant further evaluation for associated diseases like diabetes. Hope this helps!

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