Onychodystrophy: Definition, Causes, Symptoms and Treatments of this Pathological Condition

It is a pathological condition of the nails that represents a malformation of the nails.

Onychodystrophy is the name given to a variety of nail disorders that can be caused by infection or even non-infectious causes of nail disorders such as:

  • Dermatophytic onychomycosis.
  • Nail psoriasis.
  • Contact dermatitis.

Onychodystrophy is a genetic condition that causes problems in the bones of the fingers, leading to nail deformation and onychodystrophy.

Onychodystrophy defines a wide range of conditions that affect the nails, including nail deformity, changes in nail dimensions, nails that become very brittle, and any bacterial infection of the nail.

The nature of onychodystrophy

Abnormal nails can be caused by various underlying conditions, such as fungal and non-fungal infections, various non-infectious inflammatory dermatological diseases of the nail unit, and tumors.

Nail changes can also be a sign of systemic diseases; they can occur secondary to systemic drug use and other infrequent or poorly defined factors.

In a more strict sense, abnormal nails represent changes in the nail plate characterized by dystrophy and dyschromia.


Onychodystrophy is a widely used term, although rarely defined. It refers to nail changes and changes in a color called nail dyschromia.

From the patient’s point of view, the partial or complete alteration of the various keratinous layers of the nail plate is the most relevant.

In everyday life, these changes are generally known as frailty. To better understand nail dystrophies, the origin of the disorder must first be considered. Exogenous factors can directly alter the nail plate.

In this case, the nail is mainly involved. But endogenous factors can also lead to nail plate dystrophy.

Subsequently, changes in the matrix, proximal nail fold, nail bed, hyponychium, or underlying bony phalanx secondarily result in abnormal nails.

Unfortunately, only little is known about the exact underlying pathophysiology that leads to nail dystrophies. However, onychodystrophy is common.

Causes of onychodystrophy

There is no clear etiology for onychodystrophy, although it is believed to be a genetic disorder. In some cases where there is no family history of onychodystrophy and still, an individual suffers from this condition, the reason given for this is fetal ischemic damage could be the trigger.

This ischemic damage occurs due to reduced blood flow and oxygen supply to the region.

In cases of onychodystrophy, this could be due to reduced blood flow to the fingertip region resulting in nail deformity throughout the formation of the fetus.

Symptoms of onychodystrophy

Onychodystrophy is characterized by a translucent discoloration in the nail bed that resembles a drop of oil under the nail plate.

The first signs that can accompany dystrophy include:

  • Thickening of the lateral edges of the nail bed with or without the resulting flattening or concavity of the nail.
  • Separation of the nail from the underlying nail bed, often in fine streaks from the edge of the tip to the cuticle; Sharp pointed “roof ridge” tips from cuticle to information.
  • Separation of the superficial layers of the nail, followed by the loss of patches of these external layers, leaving red and thin nails underneath; or pitted-dotted nails shifts along with the nail plate.

Treatment of onychodystrophy

Treatment for onychodystrophy depends on the underlying cause of it. To identify the leading cause behind onychodystrophy, nail cultures are required to determine if the reason is infectious or not.

If an infection is not identified despite repeating the tests a few times, a non-infectious cause is presumed to cause the onychodystrophy. In some cases, nail biopsies are done.

Once the condition is identified, treatment is performed to treat the underlying condition that results in onychodystrophy.

For definitive treatment for onychodystrophy, surgery is recommended, and this is for cosmetic reasons only. No other treatment is required for onychodystrophy, and research is still being done to find a better treatment methodology to cure onychodystrophy permanently.