Does a Black Toenail Signal Diabetes?

Torn sock with toes peeking through

If you drop a heavy object on your feet, a subungual hematoma is likely to appear. The toenail gets discolored in the hues of black, green, red, or purple. This discoloration is referred to as black toenail. Ideally, a subungual hematoma is caused by chronic friction from heavy objects or friction against the shoe. It is a common condition among hikers due to increased shoe friction. A slow black formation around your toenail could be a sign of melanoma skin cancer. But what if it is a sign of diabetes?

What Causes Black Toenails In Diabetics

Different conditions characterize diabetes mellitus. With diabetes, high glucose levels over an extended period can damage kidneys, nerves, blood vessels, and eyes. These increased levels can also decrease the ability of your body to fight infections. When not properly controlled, diabetes impairs the immune system leading to foot problems which can sometimes be very severe. Poor blood circulation and nerve damage are often to blame for the development of black toe in the following ways:

Nerve Damage

When damaged, nerves begin to send signals too slowly, send at the wrong time, or stop sending the completely. They are also responsible for the loss of feeling senses in the feet. When this happens, you are not able to feel pain, cold, or heat in your lower extremities. Abnormal pressure can be created in the bones, joints, and the skin leading to the breakdown of skin in the foot.  The sores caused can then become infected. If your blood sugars are high during this time, the infected area becomes worse advancing into foot deformities, black toenail, changes in the bones, muscles and the shape of the feet.

An impaired immune system and damaged vessels resulting from diabetes make it very hard for wounds to heal. The infection could quickly develop into gangrene. As a result of the poor blood circulation, antibiotics may not be effective, meaning that amputation could be a possible form of treatment. This is because spreading of the infection to the bloodstream could be life-threatening.

Blood Flow

Poor blood flow also known as peripheral artery disease (PAD)causes the lower extremities to receive very little blood. This makes it hard for a bruise or a wound to heal. Once it develops into an infection, a black toenail is likely to emerge once the tissues around the toe die. Attending to sores and infections promptly can prevent the development of gangrene. 

Why Your Toenail is Turning Black

Paronychia is an infection that affects the nail fold. It can be sudden or longstanding. Although it is not caused by diabetes, it is common among diabetics. When the infection is longstanding, the damaged cuticle can distort the nail tissues.

Pseudomonas aeruginosa microbes can then infect the space left by the deformity. It can lead to a black toenail if you have diabetes.  Fusarium is the other microbe responsible for a black toenail. Diabetes can cause a lack of oxygen to reach the toes and the lower extremities, causing the toes to turn black. While red color can signal acute infection, black is often a indication of permanent damage. Usually, the blackness does not cover the whole toenail but most of it.

Because a black toenail is an indication of uncontrolled glucose levels, diabetics are advised to follow the right meal plan, have their sugars controlled, and check their feet regularly for signs of bruises or deformities.

Understanding Nail Fungus in Diabetics

At least 8 percent of the general population has a history of nail fungal infections resulting from nail polish, infection, trauma, or nutritional deficiencies. This number climbs to 30 percent in people with diabetes. Left untreated, it can spread and eat away the nail and separate it from the nail bed.

Toes are mostly affected because they are hidden away in the dark where there is a moist environment created by shoes and socks. If you notice your toenails becoming thicker with abnormal color, have them checked by a podiatrist or a medical professional. The severity of the problem depends on the number of toes affected and the percentage of the infected area.

Diabetes Black Toenail Treatment Stages

The severity of the fungus determines the mode of treatment. The treatment methods can range from topical OTC solutions to basic home remedies. Catching the fungus early gives you a good chance of avoiding a future amputation. If the fungus has caused the toenail to turn black, an antifungal ointment may be prescribed.

With diabetes, this fungus becomes very hard to control because of the poor circulation of blood. If the condition is severe, your doctor may prescribe a combination of topical and oral treatment solutions. As a last resort, your doctor may opt for the removal of the infected toe. This is because the risk of the fungus spreading to other toes is higher in diabetes.

looking after feet will keep them nice

Caring for your Feet

With diabetes, the most important thing to do is to take care of your feet. With the help of your doctor, you could use diabetic compression stockings to maintain a good flow of blood in the lower extremities. Because of the strong link between diabetes and black toenails, extra attention needs to be given to the feet.

Checking your feet daily can help you spot problems early. If you have diabetes, do not walk barefoot. Wear comfortable shoes and socks at all times to avoid hurting your feet. You can consider getting diabetic slippers for comfort and protection. Ensure the lining of your shoes is smooth and free of pebbles. Remember to follow your doctor’s guide regarding exercise, medication, and diet, being careful to keep your blood sugar levels within a healthy range.

If you have type 1 or 2 diabetes, you are likely to develop foot problems due to nerve damage and poor circulation. Sometimes, the blackening of toenails in diabetes or a black spot under the toe can signal the development of a fungal infection. The moment fungus gets to a point where it causes toenails to blacken, it becomes a major problem. If you have diabetes, be careful to look out for foot problems and report to your doctor immediately to prevent a possible amputation.