Keratin Granulations or Nail Fungus?

Keratin Granulations or Nail Fungus?


Do you have keratin granulations or nail fungus? Usually if polish is removed, 95% chance that this is something called a keratin granulation.




 What Are Keratin Granulations?

Keratin Granulations are white smudge marks on your nails that usually occur after you take off your nail polish, but are luckily very treatable!

Keratin granulations overview:

  • Nail polish polish contains compounds like acetone.
  • These compounds can dehydrate the nails underneath them leading to a protein called “keratin” to dehydrate.
  • These keratin molecules can clump together creating white smudges.
  • These are white fragments that are like curled up cottage cheese on top of your toenails and fingernails.
  • This can sound really gross but don’t worry, this is usually something that you don’t really have to worry about.
  • Simply moisturizing your toenails will result in an excellent recovery of keratin granulations.
  • Toenail and fingernail fungus usually appears more green or yellow in almost all cases.
  • There is a type of nail fungus called white superficial onychomycosis, but this is really much less likely to be your problem.


Keratin Granulations or Nail Fungus?
Keratin granulations are much more common than toenail fungus after toenail polish removal!

Keratin Granulation Causes:

  • Having dry toenails or fingernails.
  • Removing toenail or fingernail polish.
  • Using a acetone to remove this polish.
  • Extensive dishwashing without moisturizing your nails.
  • Repeated nail trauma such as rubbing against the front of your shoes.
  • Tight shoes at the front of your feet.
  • Having bunions and hammer toes and having these rub against the front of your shoes.
  • A dry home during wintertime.
  • Poor humidity inside your house.



Are Keratin Granulations Dangerous?

  • This condition is not very dangerous, it is basically just a fancy way of saying that you have dry nails.
  • The only downsides to not doing anything about it is that your nails are more brittle and more likely to chip in the future.
  • Think of this as being a completely cosmetic problem only.


Keratin Granulations or Nail Fungus?
Keratin Granulations are not dangerous. Just cosmetic!


Symptoms Of Keratin Granulations:

Keratin granulations can manifest themselves in the following ways:


  • White nails.
  • Dry and brittle nails.
  • Nail polish was just recently removed.
  • No pain or irritation.
  • Nails were previously healthy.
  • No real pain to the site.
  • If you don’t have any medical condition such as diabetes, it is much less likely that you will just have regular fungus by itself.
  • Check if you can scrape off the dryness off the top of your nail, if it’s not underneath the nail, then it is likely not fungus.




Why Favor Keratin Granulations Over Nail Fungus as a Diagnosis?


It is very difficult to know for sure without testing. But I recommend to initially assume the diagnosis of having keratin granulations:


  • If your toenail is white, it is overwhelmingly keratin granulations.
  • It still could be toenail fungus, but it likely is not.
  • Try to treat the keratin granulations for 2 weeks, if treatment resolves your white toenails then it was keratin granulations.
  • If it does not resolve after 2 weeks, then it is likely toenail fungus.



Keratin Granulation Diagnosis Guide:

Two choices are either toenail fungus, or keratin granulations. Follow the below rules to check with 95% certainty that you don’t have anything dangerous going on!

If there is ever any question, remember you do have to see your podiatrist.


Rule #1: If your toenails are thick and yellow. It is toenail fungus!

  • Especially if you cannot simply scrape off the white stuff from your nails.
  • If you can scrape the white crust off the top of your nails with a toenail file, then it is likely not fungus.
  • True fungus usually builds up underneath the nail, not on top of the nail.
  • If the actual nail is completely thick, and brownish yellow crust is built up underneath it: this is much more likely to be true toenail fungus.
  • If you are completely healthy person, who has used toenail polish in the past, then it is almost 100% likely that this is a keratin granulation.



Rule #2: If you have white on top of your toenail, it can be toenail fungus – but it probably is not!
The differential diagnosis of keratin granulations is a fungus called white superficial onychomycosis which should be treated by a podiatrist.

  • Luckily superficial white onychomycosis is the most easily treated fungus.
  • It can be treated very easily which topical anti-fungal medication.
  • It is extremely difficult to tell whether you have keratin granulations for sure rather than nail fungus.
  • Yet studies show it is rarely superficial white onychomycosis in these cases(using nail polish).


Since superficial white onychomycosis is not extremely urgent- try to cure your keratin granulations for a week and if they start to get better than you know it was not fungus.



The Best Keratin Granulations Home Treatment:

First make sure that it is keratin granulations!
  • Read above to make sure that it is not thick fungal toenail. If you are healthy person who recently used toenail fungus, and acetone to remove the polish, then it is almost for sure keratin granulations.


Are keratin granulations permanent?
  • No they are not permanent, even if you do absolutely nothing, your nail will eventually grow out without the keratin granulations and dryness. The only downside is that a nail can take up to a year to completely grow.
  • Most people don’t want to wait one year to get rid of this problem!


How can you speed up the healing time?
  • If you think about your toenail as a table, keratin granulations are just like dirt that build up on top of the table.
  • By using a nail file or curette, it is very easy to simply scrape off these dry keratin granulations.
  • An even easier way is to use something like Vaseline or moisturizing lotion to moisturize the top of your nails.


Why is a good home treatment plan for keratin granulations?
  • A great home treatment plan is to use a moisturizing lotion.
  • Personally I’m a big fan of Vaseline, because it is very cheap and effective.
  • If you want to make sure that you don’t have fungus, you can also use something like Vicks vapor rub. Vicks vapor rub has eucalyptus in it. This will also kill any fungus if it is there.
  • Just make sure to go see your podiatrist if something is not getting better over the first couple weeks.


Home Treatment summary of keratin granulations:
  • Keratin Granulations are very easily taken care of through moisturizing your nails with cuticle wax, oils and simply avoiding nail polish for a little while.
  • It is not necessary to buy anything expensive or online; it is fine simply using a product like Vaseline or any other petroleum oil in most circumstances.
  • So get yourself some petroleum jelly at your corner store and just apply it to your nails at night when you won’t be using your hands. In 2 weeks you should be in great shape!


Best Keratin granulations Home Remedy Treatment Video:



Treatment Guide Video
  • Make sure it’s not toenail or fingernail fungus and that it really is dehydration of your toenail or fingernail.
  • Once you know its just dehydration and damage, then you should have no problem moisturizing the site.
  • If it does seem green or yellow with very thick toenails, this makes it much more likely to be toenail fungus.


Is toenail fungus dangerous to my health?

In a short answer yes, it can be just like any other infection. Don’t want to have a growing for too long.

But toenail fungus is not always as bad as it seems. Most of the time when we see someone come in with suspected toenail fungus, it is usually thick crusty toenails from extensive rubbing.

Our goal is to avoid having you take expensive medications. With good podiatrist care, you can save a lot of money on your footcare, get rid of your fungus permanently rather than messing around with expensive medications.

It is very rare to ever truly need to take a dangerous oral medication, excellent footcare can generally have good toenail growth once again, as long as it has not been going on for many years uncontrolled.


About the author

The Modern Podiatrist (Foot and Ankle Specialist Doctor):Today's podiatrist is required to undergo rigorous medical training that licenses them as physicians with equivalent legal standing to the MD and DO degree (These are physician recognized licenses most common only in the USA). Although admittedly the training does differ between the three degrees. The differences are listed below.In Michigan Podiatrists are trained and authorized to perform surgery in the foot and ankle up to the tibial tubercle below the knee.All our podiatrists and foot doctors have undergone rigorous training including a 4 undergraduate college degree, writing the medical school entrance exam (MCAT), followed by a 4 year medical school degree (DPM - Doctor of Podiatric Medicine),Once podiatrists in the USA complete the rigorous 4 year medical school courses, they are required to complete a minimum of 3 years of a surgical and non-surgical residency program. Some podiatrists and foot doctors then choose to go on to further fellowship training specializing in various forms of specialty such as diabetic surgery or reconstructive foot and ankle surgery.The training is not over yet! Each podiatrist must be judged by a governing body where they submit their surgical cases and are reviewed regularly to ensure excellent results. This is a career long evaluation with board qualifications and certifications every few years.So have faith that today's podiatrist is your best choice for your foot and ankle problems! We are able to approach you foot and ankle problems from a non-surgery perspective, but that when necessary we can provide you with the treatment that you need!All articles written by this account are considered to be for educational purposes only. It is impossible for us to truly assess your condition and the advice we give here is meant to give you a basis to then follow up with your podiatrist and foot doctor later.If you have any questions at all, or there is anything that we can help you with, please feel free to contact our office or email us. Podiatrists provide medically necessary treatment which should be covered by valid insurance plans, we are not a cosmetic or elective medical specialty.