Preventing Yellow Nail Syndrome With Proper Nutrition

Fungal infections make up approximately 50 percent of all nail disorders and can be difficult to treat. More common in toenails than fingernails, they often cause the end of the nail to separate from the nail bed. Additionally, debris -- white, green, yellow or black -- may build up under the nail plate and discolor the nail bed. The top of the nail or the skin at the base of the nail can also be affected. Toenails are more susceptible to fungal infections because they are confined in a warm, moist, bearing environment.

The nails can reveal much about a person's overall health. Many diseases and serious conditions can be detected by changes in the nails. Most doctors will check the nails carefully during a physical examination.

The Yellow Nail Syndrome is a poorly understood syndrome in which hypoplasia of the lymphatics causes the triad of yellow discoloration and dystrophy of the nails, lymphedema of the lower extremities, and bilateral pleural effusions. The underlying cause of the syndrome is unknown, but congenital, hereditary, and paraneoplastic causes have been suggested.

The YNS is a rare condition. The incidence of this condition in the general population is not known; the pathogenesis is not yet fully understood. Pathologic examination of pleurectomy specimens from YNS patients have suggested lymphatic hypoplasia, or even frank absence of lymphatic vessels as the cause. It is believed that the pleural effusions and peripheral lymphedema are due to the same defect in the lymphatics. Lymphatic stasis in the lower extremities has been demonstrated in YNS patients; such stasis has been demonstrated lympho-graphically, revealing a variety of hypoplastic abnormalities. While no data exists concerning the status of lymphatics of the genitalia in these patients, it would not be unreasonable to assume that the pelvic lymphatic channels were similarly hypoplastic.

YNS may be associated with swelling of the hands and feet, a variety of respiratory diseases such as chronic bronchitis (Yellowing and thickening of the nail, slowed growth rate) or Diabetes (Yellowish nails, with a slight blush at the base).

Vitamins have been increasingly used to prevent and treat a variety of skin disorders. A new study in the October '99 issue of the Journal of the American Academy of Dermatology suggests that vitamins A, C and E are increasingly important because of their antioxidant capabilities.

The three antioxidants most commonly found in antioxidant supplements are vitamins A, C and E. Each works independently and in conjunction with other vitamins to reduce the effects of free radicals.

Vitamin A is found in many yellow and green vegetables, egg yolk, butter, liver and fish oils. Retinoids, the active ingredient in Vitamin A, are more commonly known as retinol in topical skin creams, lotions and ointments.

Retinoids, whether synthetic or natural, have many important biological effects such as regulating growth and differentiation in cells, diminishing malignant cell growth and strengthening the immune system. Most retinoid research has focused on acne treatments, the main treatment use of the compound since 1971.

Recently, multiple controlled studies have shown that retinoids can reduce and prevent wrinkles, brown spots and actinic keratoses. Patients reported noticeable improvement in skin texture and tone after starting a retinoic acid treatment program. The positive results can be reversed, however, if the patient discontinues topical application of the retinol products. At one time, retinoids were only available in prescription treatments. Now, many retinoids are available in over-the-counter preparations.

Ascorbic acid (Vitamin C), found in vegetables and citrus fruits, is considered by researchers to be the most important antioxidant in numerous cellular activities. It acts as an antioxidant by scavenging and quenching free radicals throughout the body.

Vitamin E is present in vegetables, oils, seeds, corn, soy, whole wheat flour, margarine, nuts, and some meats and dairy products. The antioxidant properties of vitamin E are well-documented, especially in relation to plasma and red blood cells. Vitamin E may also be important in reducing sunburn severity, as well as the lines and wrinkles associated with sun exposure.

The effects of vitamins A, C and E in the prevention and treatment of skin cancers show that each works independently to reduce skin cancers. They also work together to help prevent the formation of new lesions. Vitamin A was effective in the treatment of some premalignant and malignant skin conditions. The current consensus is that it probably does not cure skin cancer, but treatment may prevent the formation of new lesions as long as therapy is continued. This was true for a variety of skin cancers ranging from malignant basal cell carcinomas to premalignant actinic keratoses lesions when treated with oral retinoids.

One study found that regular supplements of both vitamins A and E were associated with a 70% reduced risk for basal cell carcinomas. In addition, an increase in dietary vitamin C has been shown to reduce UV-induced tumors in mice.

Wound healing is an important indicator of skin health. To enhance wound healing, it is important that patients receive adequate amounts of each vitamin. Patients whose bodies are vitamin A deficient experience diminished wound healing, which is correctable by vitamin A supplementation. Vitamin C is considered critical in wound healing because it acts as a cofactor for several enzymes, which stabilize collagen.

Through its antioxidant and anti-inflammatory effects, topical vitamin E may enhance would healing, although the benefits remain controversial. More research is needed to determine if and how vitamin E supports the wound healing process.

The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.

- Beer, D.J.; Pereira, W.; Snider, F.L. Pleural effusion associated with primary lymphedema: A perspective on the Yellow Nail Syndrome. Am Rev. Respir. Dis. 117: 595-599; 1978.

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