From the Guidelines
Toe discoloration can result from various causes, including trauma, fungal infections, bacterial infections, poor circulation, systemic diseases, or skin conditions, and treatment depends on the underlying cause. The most common causes of toe discoloration include:
- Trauma, such as stubbing your toe or dropping something on it
- Fungal infections, such as onychomycosis
- Bacterial infections
- Poor circulation
- Systemic diseases, such as diabetes, liver or kidney disease
- Skin conditions, such as psoriasis
For trauma-related discoloration, rest, ice, elevation, and over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain while the bruising heals naturally over 1-2 weeks 1. Fungal infections typically require antifungal medications such as terbinafine (250mg daily for 6-12 weeks) or topical solutions like ciclopirox nail lacquer applied daily for up to 48 weeks 1. Bacterial infections may need antibiotics like cephalexin (500mg four times daily for 7-10 days) 1. For circulation issues, keeping feet warm, regular exercise, and avoiding smoking are important 1. If discoloration is related to systemic diseases, treating the underlying condition is essential. See a healthcare provider if discoloration persists beyond two weeks, is accompanied by pain, spreads, or if you have diabetes or circulation problems, as these conditions can make foot complications more serious 1.
Some key recommendations for preventing foot ulcers in persons with diabetes include:
- Screening for signs or symptoms of peripheral neuropathy and peripheral artery disease annually 1
- Educating patients on proper foot care, including daily foot inspections, washing feet daily, and wearing properly fitting footwear 1
- Providing integrated foot care, including professional foot treatment, adequate footwear, and education, for patients at moderate or high risk of foot ulceration 1
- Considering orthotic interventions, such as toe silicone or (semi-)rigid orthotic devices, to help reduce excess callus on the toe 1
It is essential to note that the treatment of toe discoloration depends on the underlying cause, and a healthcare provider should be consulted for proper diagnosis and treatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Toe Discoloration
- Decreased arterial flow, impaired venous outflow, and abnormal circulating blood can cause blue or violaceous discoloration of one or more toes, as seen in blue (or purple) toe syndrome 2
- Acrocyanosis, a functional peripheral vascular disorder, can cause bluish discoloration of skin and mucous membrane due to diminished oxyhemoglobin, and may be primary or secondary to various causes 3
- Systemic sclerosis can also cause blue toe syndrome, as seen in a case where a 57-year-old man presented with blue toe syndrome without underlying atheroembolic disease, and was found to have positive anticentromere antibodies 4
- Pernio, a condition caused by cold exposure, can also cause erythrocyanotic discoloration of the toes, as seen in a 35-year-old woman who was diagnosed with pernio and successfully treated with nifedipine and environmental management 5
- Fungal infections, such as tinea pedis and onychomycosis, can also cause discoloration of the toes, especially in patients with diabetes mellitus, and can be treated with antifungal agents 6
Treatments of Toe Discoloration
- Lifestyle modification, dietary and hygiene counseling, avoidance of cold, and reassurance may be sufficient for mild cases of acrocyanosis 3
- Nifedipine and rosuvastatin may be prescribed for blue toe syndrome caused by systemic sclerosis, as seen in a case where a 57-year-old man showed complete resolution of symptoms after 3 months 4
- Nifedipine and environmental management may be used to treat pernio, as seen in a 35-year-old woman who was diagnosed with pernio and successfully treated 5
- Antifungal agents, such as topical and oral agents, may be used to treat fungal infections of the foot, including tinea pedis and onychomycosis, especially in patients with diabetes mellitus 6