Yellow Nail Syndrome: What to Know

Medically reviewed by Brendan Camp, MD

Yellow nail syndrome is a rare disease that affects the fingernails and toenails. It typically affects people over 50.

Yellow nail syndrome gets its name from the buildup of lymph under the nails, making them appear yellow. People with this condition may develop pulmonary (lung) and lymphatic system (infection-fighting) problems.

This article covers everything you need to know about yellow toenails and fingernails, including causes, symptoms, treatment, and prevention. 

What Causes Yellow Nail Syndrome?

Many people with yellow nail syndrome wonder why their nails are yellow. Unfortunately, usually the cause is unknown. However, some causes may include:

• Genetic factors: If yellow nails run in your family, you may also be more likely to develop them.

• Certain forms of cancer: Rarely, it has been associated with multiple myeloma (bone marrow cancer), lung cancer, breast cancer, non-Hodgkin lymphoma, gallbladder cancer, larynx cancer, renal cell carcinoma, endometrial cancer, and melanoma.

• Immunodeficiency syndromes: Yellow nail syndrome is rarely associated with immunoglobulin G (IgG) deficiency (a type of antibody deficiency, in which your body does not make enough IgG) and common variable immunodeficiency (a condition marked by recurrent infections).

• Nephrotic syndrome: Rarely, nephrotic syndrome (when the kidneys don't function properly) can also present alongside yellow nail syndrome.

• Thyroid disease: Yellow nail syndrome is occasionally associated with Hashimoto's thyroiditis (damaged and enlarged thyroid), severe hypothyroidism (underactive thyroid), and hyperthyroidism (overactive thyroid).

• Rheumatoid arthritis (RA): Yellow nail syndrome can sometimes occur after beginning treatment for RA.

• Lymphatic disorders: Yellow nail syndrome is often associated with lymphedema (a buildup of fluid in tissues causing swelling) and breathing abnormalities.

Vitamin E can help treat yellow nail syndrome, so a vitamin E deficiency may also cause yellow nails and toenails.

What Are the Symptoms of Yellow Nail Syndrome?

While yellow nails are the primary symptom of yellow nail syndrome, there are other signs to watch out for. These signs and symptoms may include:

• Yellow, thickened, and curved nails

• Nails that no longer grow

• Cuticle loss

• Nail bed separation

• Infection in the soft tissue around the nails

• Fluid accumulation around the lungs and chest cavity

• Shortness of breath

• Chest pain

• Cough

• Bronchitis

• Sinusitis

• Bronchial tube inflammation

• Bronchiectasis (permanent airway widening)

• Recurrent pneumonia

• Arm and leg swelling

How Is Yellow Nail Syndrome Diagnosed?

Since there are so many things that can contribute to yellow nail syndrome, a diagnosis is important. Healthcare providers use the following criteria to diagnose yellow nail syndrome:

• Appearance of yellow nails

• Respiratory tract involvement

• Lymphedema

A healthcare provider will evaluate your symptoms and do a physical exam. They may also use a pulmonary function test and computed tomography (CT) scan to confirm a diagnosis.

Conditions with similar symptoms include the following:

• Infections

• Medication side effects

• Planus lichen (immune disease of the skin)

• Psoriasis

• Alopecia areata (an immune disorder characterized by hair loss)

• Chronic paronychia (nail infection)

• Onychogryphosis (ram's horn nails, in which nails become yellow and thick)

• Acquired pachyonychia (a genetic disorder that affects skin and nails)

Related: Causes of Thick Toenails and How to Treat Them

What Are the Complications of Yellow Nail Syndrome?

Complications of yellow nail syndrome may involve the respiratory and lymph systems. For example, if your lymphatic system doesn't drain properly, you may experience the following problems:

• Greater risk of infection in the swollen area

• Slow wound healing

• Self-consciousness about the swelling

• Stiff joints

You may be at greater risk of developing serious respiratory infections like pneumonia and bronchiectasis with respiratory system complications.

How Is Yellow Nail Syndrome Treated?

Yellow nail syndrome treatment is usually symptom-based, meaning healthcare providers cater therapies to whatever is causing problems for a person. Treatments may include:

• Antibiotics for respiratory infections

• Vitamin E for nails

• Corticosteroids for inflammation

• Surgery for pleural effusions (when the lining of the lungs and chest cavity fill with fluid)
  

Can You Prevent Yellow Nail Syndrome?

Genetics and chronic health conditions often cause yellow nail syndrome, so there isn't anything you can do to actively prevent it. However, if you develop yellow nail syndrome, the symptoms are manageable with various therapies targeting your situation.

Summary

Yellow nail syndrome is more than just yellow nails and toenails. The condition also involves the respiratory and lymphatic systems. If you have symptoms of yellow nail syndrome, a healthcare provider will carefully listen to your symptoms, perform a physical exam, and order diagnostic tests to rule out other conditions. While you can't prevent yellow nail syndrome, the good news is that its symptoms are manageable with different therapies.

Read the original article on Verywell Health.