Green discoloration on nails is most commonly associated with green nail syndrome, also known as chloronychia. This condition is typically caused by the bacterium Pseudomonas aeruginosa, a widespread microorganism found in various environments. The presence of this bacterium leads to a distinct greenish hue on the nails.
The Condition’s Identity
The nail plate discoloration can range from greenish-yellow to dark green or even blackish-green. This change in color is not due to the nail itself being stained, but rather to pigments produced by the Pseudomonas aeruginosa bacteria. Specifically, the bacteria produce blue-green pigments called pyocyanin and pyoverdin, which accumulate under the nail, creating the characteristic green appearance. The discoloration, often under or within the nail, will not disappear with washing or scrubbing.
It is primarily a superficial bacterial infection, affecting the outer layers of the nail unit. It is important to distinguish green nail syndrome from a fungal infection, which is a common misconception. While fungal infections can sometimes co-exist, the green color indicates a bacterial cause. The infection typically affects one or two nails, on either the fingers or toes.
What Leads to Its Development
This organism is prevalent in soil, water, plants, and on human skin. Pseudomonas aeruginosa thrives in moist, damp, and often nearly oxygen-free environments, making the area under a nail susceptible.
Several factors increase the likelihood of developing green nail syndrome. Prolonged exposure to water is a key risk factor, common for those with frequent water exposure, like homemakers, healthcare workers, or swimmers. Nail trauma, even minor injuries, can create small breaks or entry points that allow the bacteria to infiltrate the nail bed. Onycholysis, nail separation from its bed, also creates a warm, moist space for bacterial colonization. Wearing artificial nails or nail polish for extended periods can trap moisture and create an environment conducive to bacterial growth. Compromised nail integrity, often from underlying disorders like psoriasis or fungal infections, also makes the nail more vulnerable to Pseudomonas aeruginosa colonization.
Addressing and Preventing Discoloration
Addressing green nail discoloration involves strategies to reduce moisture and eliminate bacteria. Keeping affected nails dry is important. Avoiding prolonged water exposure, such as wearing waterproof gloves for wet tasks, can significantly aid in recovery.
Professional medical attention is advisable if discoloration persists, worsens, or causes pain or discomfort. A healthcare provider can confirm the diagnosis and rule out other conditions. Treatment options may include topical antibiotics, such as ciprofloxacin drops or gentamicin, applied directly to the nail. Antiseptic soaks, such as diluted vinegar or bleach solution, can also help eradicate bacteria. In some instances, particularly if the infection is deep or severe, oral antibiotics might be prescribed. Trimming the affected nail or, rarely, surgical removal may be necessary for proper treatment and healthy regrowth.
Prevention involves consistent good nail hygiene and minimizing risk factors. Thoroughly drying hands and feet after washing or swimming helps deter bacterial growth. Wearing protective gloves for activities that involve prolonged water exposure or chemicals can shield the nails. Avoid excessive nail trauma and ensure nail tools are disinfected regularly, especially when using artificial nails or visiting salons. Promptly addressing underlying nail conditions, such as onycholysis or fungal infections, also reduces the risk of Pseudomonas colonization.