Green nail syndrome or GNS is an infection of the nails that leads to a greenish discoloration of nails wherein the underneath skin of the nails discolors which makes the nails appear green. And this green discoloration varies from blue-green to dark green to bluish-grey and the discoloration depends on the extent of infection.
Since the discoloration is underneath the nail, it will not disappear with washing or scrubbing the hands. Green nail syndrome is usually confined to one or two nails or it can also involve all the nails and can involve fingernails or toenails.
Green nail syndrome is generally caused by bacteria called Pseudomonas aeruginosa. This bacterium grows and flourishes in wet environments. With the growth of this bacteria, a green pigment is produced which causes the greenish color of nails. These pigments are called pyocyanin and pyoverdin.
People of any age group can catch this infection but mostly it occurs in moist areas. Sometimes, the infection is very less and can be treated using over the counter medications and other times, it takes more than just over the counter medications and self-care to get rid of the infection. In extreme cases a consultation with your dermatologist becomes essential to get rid of the bacterial infection.
This bacterial infection affects various parts of the nail ranging from nail bed to the plate or the lateral proximities. The major effects of the infection are majorly on the appearance of nail in almost all the cases. But in extreme cases, you might feel pain in the affected area and on other times, the nail can be deformed.
4 Causes of Green Nail Syndrome
Below Mentioned Are The Possible Causes Of Green Nail Syndrome:
The most probable reason of occurrence of green nail syndrome is the bacteria Pseudomonas aeruginosa.
The bacterium is most commonly found in soil and water sources. Pseudomonas grows and multiplies rapidly in warm water than in cold water.
As mentioned above Pseudomonas aeruginosa is capable of producing a variety of pigments, the most well-known being pyocyanin and pyoverdin. The stratum corneum of the nail in this infection generally serves as a physical primary defense to the occurrence of infection. And any hyper hydration of the epidermis especially with the warm wetness interrupts the physical barrier created by the stratum corneum and lead to colonization, growth and proliferation of Plasmodium aeruginosa.
Familial history is considered as one of the important causative factors of green nail syndrome. The transmission of the autosomal dominant trait is responsible for the transmission of the disease genetically. When a single gene, or a group of genes responsible for certain specific traits are transferred from one individual to other, results in the transmission of a specific trait from one generation to another. The frequency and possibility of a gene to get transferred from parent to children is fifty percent which is irrespective of the sex of the child.
It has also been found that green nail syndrome occurs with greater frequency in individuals with certain forms of cancer and other conditions/disorders like immunodeficiency syndromes, nephritic syndrome, thyroid disease, and rheumatoid arthritis.
Trauma to the nail because of any external factor is the most common reason for the appearance of green nail syndrome. This injury when occurred on the nail leads to this pattern and is very common in children.
Various activities that can cause this kind of injuries or trauma can result from Manicure, pedicure, excessive nail biting, wearing a smaller size of footwear, which hurts the big toe, keeping large ail and wearing tight shoes or any kind of nail injuries may result in trauma to the nail and appearance of green nail syndrome.
Signs and Symptoms of Green Nail Syndrome
The Characteristic Features Of Green Nail Syndrome Are Mentioned Below:
- The nail stops growing when affected with green nail syndrome.
- A characteristic appearance of green and thickened nail instead of a normal appearing nail is one of the most common sign and symptom of green nail syndrome.
- The nail when affected with this syndrome will be excessively curved.
- Loss of the strip of hardened skin at the base and sides of a fingernail or cuticles may also occur once affected with green nail syndrome.
- In this case, the nail will be separated from the nail bed and might start falling out in worst cases.
- In some of the cases, the nail bed and the soft tissue is also affected. The entire soft tissue or the soft tissue at the edge of the nails is affected in many cases. And both toenails and finger nails can be affected by the condition.
- Green nail syndrome is also found to be present in greater frequency in individuals with certain forms of cancer and other conditions/disorders like immunodeficiency syndromes, nephritic syndrome, thyroid disease, and rheumatoid arthritis.
Diagnostic Tests for Green Nail Syndrome
Green nail syndrome is characterized by a remarkable change in the appearance of nail since it is not necessary for all of the above mentioned signs will be present in a single patient at the same time to confirm the disease. So, the diagnosis can also be based on the basis of remarkable changes in the size and shape of the nail.
When the physician sees a considerable change in the shape and size of the nails, other systemic diseases are also suspected. Green nail syndrome is also associated with fungal infections. All these conditions should be treated by a physician after proper consultation.
Culture of the nail plate is very helpful and helps to determine if there is an underlying dermatophyte infection.
Treatment of Green Nail Syndrome
There are several underlying systemic diseases which can be responsible for the occurrence of green nail syndrome. There are certain diseases which can lead to the occurrence of green nail syndrome of the nails.
Initial therapy generally is white vinegar or acetic acid soaks.
Method of Using White Vinegar:
- Use 1 part white vinegar and 4 to 10 parts water depending on concentration of white vinegar.
- Soak your nails in this solution for 10 minutes, twice daily.
- Make sure that you thoroughly dry your nails after washing your hands in water.
- Work with this treatment method for a few weeks twice a day for good results.
Other Medicinal Recommendations Suggested For The Treatment For Green Nail Syndrome Are Mentioned Below:
Gentamicin 0.3% solution: Put 1 to 2 drops of 0.3% of gentamicinsolution to the affected nail, twice daily like white vinegar mentioned above for a few weeks for best results.
Neomycin, polymyxin B and gramicidin solution: Put 1 to 2 drops of neomycin, polymyxin B and gramicidin solution to the affected nail, twice daily.
Oflaxacin 0.3% solution: Similarly put 1-2 drops of oflaxacin 0.3% solution to the affected nail, twice daily.
Home Remedies to Get Rid of Green Nail Syndrome
There are home remedies for the patient’s self-management of the syndrome. These home remedies are mentioned below:
Do Not Wear Tight Shoes
Wearing tight shoes can damage the nails to an extent that it turns blue and can ultimately come out causing a lot of pain. So, it is very important to keep the nails properly trimmed and wear a proper shoe size to avoid any discomfort of the nails and to avoid green nail syndrome.
Do Not Scratch Your Nails To Take The Nail Paint Off
Many of us have a habit of peeling our nail off to remove nail paint from out nails but little do we know, this scratching leads to the damage of the top most layer of the nails which makes it more prone to get damaged with the slightest trauma.
Do Not Keep You Nails Wet For Long Duration
Most of us feel relaxed after taking long hot baths in bath tubs and pools but we might not know that keeping the nails wet for a long duration of time makes them more vulnerable to the fungal infections.
So, if you enjoy long baths, make sure that you dry your nails well after the bath to stay away from infections.
Proper Nutritional Intake
Diet is a major factor which results in weak and brittle nails. Deficiency of protein in the diet leads can also impede the growth of nails and improper diet can also lead to the discoloration of the nails.
The vitamins which are quintessential for the proper growth of nails are Vitamin A, Vitamin C, Folic acid and Vitamin H. Deficiency of any of these vitamins lead to impairment in the growth of nails.
Massaging with Rosemary Oil
Massaging of the body is always very beneficial for the proper circulation of blood to all the organs of the body. Also, massaging the hands together with rosemary oils is considered very beneficial for the hands specifically and maintains the flow of blood to the ends and prevents the discoloration of nails.
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