Are your nails going green? Or have you seen people with green nails instead of the white color you are used to? Sometimes the color might not be green only. It might vary from blue-green to green-brown, or green-yellow. Usually, only one or two nails are involved. And in some cases, the whole nails change in color,

Quick Facts About Green Nail Syndrome

DefinitionGNS is an infection that leads to a greenish discoloration of nails, known as chloronychia
CausesInfection by Pseudomonas aeruginosa, a common bacterium found in soil, water, and moist environments
SymptomsGreen discoloration of the nail, thickening of the nail, pain and tenderness around the nail, separation of the nail from the nail bed
Risk FactorsProlonged exposure to water or moist environments, nail trauma or injury, use of artificial nails, pre-existing nail conditions
DiagnosisVisual examination by a healthcare provider, laboratory culture of nail clippings or swabs to identify Pseudomonas aeruginosa
Common InGardeners, janitors, plumbers, housewives, dishwashers, cooks, healthcare personnel
Treatment OptionsCutting the detached nail portion, keeping nails dry, avoiding trauma, topical antibiotics, diluted chlorine bleach, vinegar, and in severe cases, oral antibiotics
PreventionKeeping nails dry and clean, avoiding prolonged exposure to water, proper nail care and hygiene
PrognosisGenerally good with proper treatment; nails typically return to normal color and texture
ComplicationsRare but can include persistent infection or spread to other areas in severe cases

Now you are definitely wondering what causes this because that is why you are here, and today, Healthsoothe – your number one trusted health site will answer all your questions concerning this condition.

Now, you must have heard of a condition known as green nail syndrome. If you observe your nails going green or see people whose nails are green, this could be definitely due to this green nail syndrome.

Today, this article aims to explain all there is about this green nail syndrome; What causes it? How is it treated? And what can you do to prevent it? And we will also inform you of other vital or critical things you need to know concerning green nail syndrome.

Alright, enough intro. We move!


Green Nail Syndrome (GNS) – What is it?

Green Nail Syndrome - Healthsoothe

Green nail syndrome (GNS) which is known as chloronychia is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed.1 › wiki › Green_nail_syndrome This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area.

Green nail syndrome is a paronychial illness caused by Pseudomonas aeruginosa2Greene SL, Su WP, Muller SA. Pseudomonas aeruginosa infections of the skin. Am Fam Physician. 1984;29:193–200. [PubMed] [Google Scholar] that may develop in people who often soak their hands in water.   It may also appear as transverse green stripes, which are associated with occasional bouts of illness.

The bacterium “Pseudomonas Aeruginosa,” which thrives in damp circumstances, is the most prevalent cause. The frequent immersion of one’s fingers in water, detergents, and soils has been related to green nail syndrome. Several activities and accidents have been related to a higher risk of getting the illness.

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What are the Symptoms of Green Nail Syndrome (GNS)?

Green nail syndrome is a nail infection that causes a greenish coloring of the nails, also referred to as chromonychia. The shade of green ranges from blue-green to deep green to bluish-gray.

Because the discoloration lies under the nail, washing or scrubbing will not remove it. The illness generally affects either one or two nails and might affect fingernails or toes.  The nail is normally not painful, but the skin surrounding it, especially the cuticle, might become swollen, sensitive, or red.

The most typical sign of green nail syndrome is discoloration of the diseased nail, which becomes a dark green color as a result of bacteria cells or organisms secreting green pigments called pyoverdin and pyocyanin. The patient may also suffer soreness, redness, and swelling around the infected nail.


What Causes Green Nail Syndrome?

What Causes Green Nail Syndrome - Healthsoothe

Pseudomonas aeruginosa bacteria causes green nail syndrome. This bacterium thrives in moist conditions like hot tubs, contact lens solutions, drains, and bath sponges. When it grows, it creates the distinctive green pigments pyocyanin and pyoverdin. These same pigments give chloronychia its green hue.

GNS is predisposed to by two key risk factors. The first potential risk is when a nail lifts unnaturally from the nail bed, a condition known as onycholysis. The watertight seal established by the tissue on the nail is removed when the nail is separated from the nail bed. This generates a subungual area that gathers debris and dirt and may enable P. aeruginosa to enter.

Onycholysis is exacerbated by trauma to the region under the nail. Plumbers, gardeners, and janitors are in danger of having their nails split.

A wet atmosphere is the second most significant risk factor. P. aeruginosa seldom colonizes or infects dry skin. Nails that have been repeatedly dipped in water are vulnerable. GNS may be more common among chefs, dishwashers, healthcare workers, and housewives.

It should also be mentioned that using tight-fitting shoes for an extended period of time, particularly when exercising, has been linked to GNS. This has been seen in military recruits as well as soccer players. Fungal nail infections and nail psoriasis infections are minor risk factors for GNS.


Diagnosis and Treatment of Green Nail Syndrome

Green Nail Syndrome Treatment - Healthsoothe

A dermatologist may easily diagnose GNS based on its clinical presentation. In case of dispute, a nail sample might be collected for culture. Treatment for green nail syndrome is effective.

The detached piece of the nail is clipped, the nails are kept dry, and the region is not traumatized. Most patients will be cured if external antibiotics, such as polymyxin B or bacitracin, are used two to four times per day for one to four months.

When administered topically to affected nails, chlorine bleach mixed 1:4 with water is helpful in reducing P. aeruginosa development. Vinegar or acetic acid has also been found to be beneficial in this respect.

If more conservative therapy fails, the nail may have to be removed. An oral antibiotic, like ciprofloxacin, is often recommended during this time. There are several medical treatment options, depending on the severity of the infection and how long it has been present.

The least invasive treatment includes soaking the nail in alcohol and regularly trimming the nail back, to dry out the area and prevent bacterial colonization.

Moderate cases of Green Nail Syndrome are prescribed topical antibiotics (silver sulfadiazine, gentamicin, ciprofloxacin, bacitracin, and polymyxin B) or oral antibiotics (ciprofloxacin), antiseptic creams, tobramycin eye drops have also been reported to be effective.3 › page › GreenNailSyndrome

In severe cases, surgical removal of the infected nail may be required. The patient should always avoid further trauma to the infected nail regardless of the stage of treatment they received.

Patient Management and Recovery

In mild to moderate cases, where the infection clears with minimal medical intervention, the patient should ensure the nail is kept clean and dry and avoid hyper-hydration. Humid climates could lead to a longer recovery than dry climes due to the inability to expose the site to very dry air.

In cases where surgery is necessary, patients should follow their medical professional’s post-surgery advice.


Prevention of Green Nail Syndrome

Preventative measures should be implemented by those who are most at risk of contracting Green Nail Syndrome due to their predisposition or lifestyle and workplace choices.

Wearing waterproof gloves or gum boots can be effective in preventing prolonged exposure of the nails to water. Avoiding trauma that could lead to the destruction of the epidermis seal on the nails is a priority in preventing green nail syndrome recurrences.


A Word of Advice from Healthsoothe

There have been cases whereby green nail syndrome has been transmitted from an infected person to an uninfected person. Pseudomonas can be transferred among clients in a nail salon if appropriate hygiene standards are not kept up.

While the bacteria wouldn’t typically survive on the nail shaping equipment, unclean conditions could allow for it to transfer from the equipment to the client’s nails repeatedly. When technicians are presented with a client that has suspected green nail syndrome, they shouldn’t continue the normal treatment of painting nails, applying acrylic nails, or otherwise.

This is due to the application of liquids and oils creating an environment where the bacteria can be trapped and treatment will not be possible without the removal of these polishes. As chief science advisor at CND Doug Schoon states “it creates a nearly oxygen-free environment, which these bacteria just love”.

Nail technicians are not qualified to treat green nail syndrome and should educate the client on the condition and encourage them to seek medical treatment before returning to the nail salon.

A man working in a job where he was regularly mixing chemicals developed green nail syndrome. While he mostly wore latex gloves, he reported they would become moist, and often he would remove them to clean his hands and utensils.

The combination of moisture within his gloves and contact with chemicals caused his nails to lift from the nail bed. He developed severe green nail syndrome and was treated with topical antibiotics, which cleared up the infection within 6 months.

It was noted that latex gloves were not suitable for his line of work and more robust rubber gloves should be used. There have been cases where Basel Cell Carcinoma has been present in conjunction with green nail syndrome.

Carcinomas are not common in the area surrounding the nail bed. However, if a Carcinoma is suspected in conjunction with or in place of green nail syndrome, a biopsy should be conducted immediately.

Medical professionals with green nail syndrome have been reported to have transferred the infection to patients in hospitals. Five surgical site infections during 2001 were linked to a cardiac surgeon with the infection who didn’t routinely use double gloves. The surgeon’s infected nail was surgically removed and no further transfers of the infection were reported.

So all this signifies that one has to be careful and maintain proper hygiene while at home and while working, so as not to fall victim to green nail syndrome.

All right, guys, that is it for now for green nail syndrome. I hope Healthsoothe answered any questions you had concerning green nail syndrome. 

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Additional resources and citations

  • 1 › wiki › Green_nail_syndrome
  • 2
    Greene SL, Su WP, Muller SA. Pseudomonas aeruginosa infections of the skin. Am Fam Physician. 1984;29:193–200. [PubMed] [Google Scholar]
  • 3 › page › GreenNailSyndrome
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