Nail Psoriasis vs Fungus: Which Do I Have?
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Nail Fungus vs Subungual Melanoma: Key Differences & Treatments
Nail fungus and subungual melanoma are both conditions that affect your toenails, causing discoloration and discomfort. It can sometimes be easy to mix the two conditions up, but they are actually very different conditions with different treatment options. Here’s a guide to help you understand the differences between nail fungus and subungual melanoma, as well as what treatment options are available.
Understanding the Basics of Subungual Melanoma
Subungual melanoma is a type of skin cancer in the toenail. It’s rare, affecting only 0.07-3.5% of people who have melanoma, and it is considered serious. Melanomas can easily spread to other parts of the body and, if left untreated, can even be life-threatening. Early detection and treatment are vital for the best prognosis.
Subungual melanomas are usually found on the thumb and the big toe, but they can appear on other digits. They are often painful. They look like brown or black discolorations in the nail bed. This discoloration sometimes looks like a long line along the nail, or it can also look like an irregular blotch.
The nails might also become more prone to damage, sometimes splitting or bleeding.
The Basics of Nail Fungus
Nail fungus is a common condition that is more common on toenails. It’s a buildup of fungus on and under your nails, which causes them to thicken and discolor. Nails infected with nail fungus might be white, yellow, or brown. There might also be buildup underneath the nail.
As well as thickening, the nail might become more brittle, misshapen, or crack easily. Nail fungus can cause the nail to lift and even fall off.
Nail Fungus vs Subungual Melanoma
If you want to determine whether you have toenail fungus or melanoma on your toenail, it’s best to get a diagnosis from a doctor. But this comparison table can help you see the difference yourself.
| Nail Fungus | Subungual Melanoma | |
|---|---|---|
| Toenail Pain | Yes | Yes, sometimes with pus |
| Discoloration | White, yellow, or brown irregular discoloration | Black or brown bands of color or an irregular black or brown shape |
| Nail Lifting or Loss | Yes | Yes |
| Skin Pigment | No | Skin under and around the nail may darken |
| Nail Texture | Thick and brittle | Splitting and bleeding, may become weak |
| Causes | Fungal Infection | Cancer of nail matrix (melanocytes) |
| Contagious? | Yes | No |
| Progression | Spreads gradually to multiple nails | Stays localized but invasive |
| Risk factor | Moisture, shared tools | Family history, trauma, sun exposure |
What Causes Subungal Melanomas vs. Toenail Fungus
Unlike other skin cancers, a melanoma in big toenail or other nails isn’t caused by too much UV radiation from the skin, although it can be caused by injuries or trauma. You might be at more risk if you have a family history of melanoma, you’re a person of color, or you’re elderly.
Toenail fungus is usually caused by mold, and risk factors include old age, diabetes, sweating, walking around barefoot, or a history of athlete’s foot. The types of mold and fungus that cause toenail fungus thrive in warm, damp environments.
How to Prevent Subungal Melanomas
It’s difficult to prevent subungal melanomas, but you can be aware of changes in your nails and see a doctor if you notice something that concerns you. You can also reduce the risk of developing it by making sure your nails don’t get damaged. Good general nail care will also reduce the risk of damage.
How to Prevent Nail Fungus
The best way to prevent nail fungus is to keep your feet clean and dry. If you have athlete’s foot, treat it as soon as possible. Keep your nails short and well-groomed. Change your socks everyday and, if possible, don’t wear wet shoes or socks for long periods of time.
Avoid having bare feet in public showers, as this can spread nail fungus.
How to Diagnose Subungal Melanoma
When trying to tell the difference between toenail fungus or melanoma, the best option is to go to the doctor. They can determine whether you have cancer in the toenail.
Because the two conditions are easily mixed up, a doctor will likely want to inspect the nail and they may perform a dermascopy or a biopsy to get a closer look and get a definitive diagnosis of subungal melanoma.
Treatment Options
Subungal melanoma and toenail fungus might have some similar symptoms, but they have very different treatment plans. Once your doctor has a diagnosis, they can treat the conditions.
Toenail fungus can be treated with topical antifungal treatments. Your doctor might also prescribe treatment to soften thick nails, which makes the medication more effective. In more cases that require more aggressive treatment, oral antifungals might be prescribed. A dermatologist might also scrape, trim, or even remove the nail in some cases.
While subungal melanoma can be severe if left untreated, there are a few treatment options. These include radiotherapy, targeted therapy, and removal of the abnormal tissue. If the cancer has spread, immunotherapy might be used to treat it, and in aggressive cases, the doctor might recommend amputation of the toe.
FAQs
How do I know if my nail streak is fungus or melanoma?
Fungus is usually yellow/white in color and flaky; melanoma appears as dark streaks or bruises that don’t grow out. Always consult your doctor.
Can a bruised toenail be mistaken for melanoma?
Yes. A bruise grows out with the nail, but melanoma does not.
Is subungual melanoma painful?
Often, painless at first, which makes early detection of melanoma tricky. Pain or nail distortion usually comes later.
Does nail fungus ever turn into cancer?
No. Fungus is an infection, while melanoma is a form of cancer. But the two can look alike.
Sources:
Swissklip Team
Our blog is authored by the Swissklip founders alongside our trusted medical advisors. What began as a heartfelt solution for Opa’s thick toenails blossomed into a full line of premium self-care tools, all designed with quality and safety in mind. Working closely with podiatrists and dentists, we ensure every article carries medical-grade insights you can trust. Expect practical, expert-backed advice every time.
Table of Contents
- 01. Nail Fungus vs Subungual Melanoma: Key Differences & Treatments
- 02. Understanding the Basics of Subungual Melanoma
- 03. The Basics of Nail Fungus
- 04. Nail Fungus vs Subungual Melanoma
- 05. What Causes Subungal Melanomas vs. Toenail Fungus
- 06. How to Prevent Subungal Melanomas
- 07. How to Prevent Nail Fungus
- 08. How to Diagnose Subungal Melanoma
- 09. Treatment Options
- 10. FAQs
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