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August 3, 2003

Other

Question from Gardnerville, Nevada, USA:

I am a 32 year old female, was diagnosed with diabetes at the age of 18 which my doctor was very mild and could be controlled with diet and exercise, and I haven't been treated or tested for it since. For years I have had a problem with yellow fingernails which I always assumed was stain from wearing fingernail polish, but I recently learned that it could be a result of diabetes. The nail is the normal pinkish color at the base, near the cuticle, it starts to turn a faint yellow about one-quarter of the way up the nail and then gets darker yellow towards the tip. Is there a way to get rid of the yellow on my nails? Is there a cream or other product I can use? Would a change in diet fix the problem? Any suggestion would be helpful.

Answer:

I am not familiar with diabetes specifically being the cause of nail discoloration. Nails, however, can reflect a person’s overall nutritional status. I would suggest that you confirm that your diabetes is in good control with a check up, a hemoglobin A1c check and a fasting blood sugar check. You may want to consult with a dietitian to see that your meal plan is nutritionally sound. Check with your physician — many are recommending a daily multivitamin. Your nails may just need to grow out — avoid nail polish. Check with a nail technician for recommendations about cuticle oils and buffing. These things may promote new healthy nail growth.

BS
Additional comments from Dr. Donough O’Brien:

One possible explanation is that the yellow colouring is due to non enzymatic glycation of the stratum corneum below the nail; but this would imply poorly controlled diabetes over a long period which does not seem to apply in your case. See Effect of non-enzymatic glycosylation and heating on browning of human stratum corneum and nail. Dermatologica. 1991;183(3):197-202. Sueki H, Nozaki S, Numazawa S, Aoki K, Kuroiwa Y, Fujisawa R.

The other possibility is that this is a fungal infection of the nails which can be treated topically or with a variety of oral medications. To make sure of the diagnosis and to specify treatment you will need to arrange to see your physician or a dermatologist.

DOB