Isla Bennett
Toenails growing upward is a common condition that can be caused by various factors. While it could be your toenails' natural growth pattern, it may also be due to external factors such as tight shoes or profuse foot sweating. In some cases, upward-growing toenails can indicate more complex medical issues, including onychogryphosis, nail patella syndrome (NPS), or koilonychia. Upward-growing toenails require careful maintenance as they tend to rip more often, increasing the risk of infection. Maintaining good foot and toenail hygiene, including regular trimming, washing, and moisturizing, is crucial to prevent potential complications.
| Characteristics | Values |
|---|---|
| Cause | Could be hereditary, the natural growth pattern, shoes pushing at the tips of toenails, profuse foot sweat, or medical conditions such as onychogryphosis, nail patella syndrome (NPS), or koilonychia |
| Appearance | Thin, fragile, and concave or "scooped out," resembling a spoon |
| Maintenance | Trim nails regularly, inspect at least once a week, keep feet and nails clean, wash and dry feet thoroughly, moisturize, file nails, wear thick socks |
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What You'll Learn
Vertical nail growth may be hereditary
The shape of your nails, the speed at which they grow, and their thickness and strength are all determined by genetics. Toenails growing upward could be a natural growth pattern and may be hereditary. However, it could also be caused by external factors, such as shoes pushing on the toenails or profuse foot sweating.
There are also some medical conditions that can cause upward nail growth. Onychogryphosis, for example, is a condition where the nails thicken due to injury or infection, causing them to curve and resemble a ram's horn or claw. This condition mostly affects the big toes. Nail Patella Syndrome (NPS) is another genetic disorder that can cause nail abnormalities, although it is rare, occurring in only 1 in 50,000 people. People with NPS often experience skeletal abnormalities and are prone to developing kidney disease.
In some cases, upward-growing toenails may be a sign of iron deficiency anemia, malnutrition, celiac disease, heart disease, hypothyroidism, or liver conditions such as hemochromatosis. Additionally, certain congenital anomalies can cause curved nails, such as an autosomal recessive disorder that primarily affects Asian patients, resulting in a curved nail on the fourth toe accompanied by visible bone disorders.
While vertical nail growth may be hereditary, it is always a good idea to consult a doctor if you notice any changes in your nail growth or have concerns about your nail health. Maintaining good nail hygiene and care is also important, especially for upward-growing toenails, as they tend to rip more often, increasing the risk of infection.
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Toenails may grow upwards due to ill-fitting shoes
Toenails growing upwards is not uncommon, and there are several reasons why this may be happening. One of the causes could be ill-fitting shoes.
Wearing shoes that are too tight or narrow can force your toes against the front of your shoe. This can create cramped conditions for your toes, which can, in turn, affect the way your nails grow and lead to ingrown nails. Ingrown toenails are one of the most common and painful toenail problems, where the corner or side of the toenail grows into the flesh. The pressure on the toes from ill-fitting shoes can also cause other problems such as corns, calluses, and blisters.
Elevated shoes, such as high heels, can also cause upward toenail growth. Heels elevate the back of the foot, forcing the front of the foot to endure more pressure. This pressure can create similar cramped conditions for the toes as tight or narrow shoes.
To prevent toenails from growing upwards due to ill-fitting shoes, it is recommended to wear roomier shoes that fit well and do not force pressure against the toes. Trimming toenails straight across and not too short can also help prevent ingrown toenails. Additionally, thick socks can be worn to cushion against the friction between the toenails and the shoes.
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Onychogryphosis, a nail deformity, could be the cause
Unusual nail growth, such as toenails growing upwards, could be hereditary. However, if you notice that your nails are growing upwards, it could be indicative of a nail deformity called onychogryphosis. Onychogryphosis is a nail disorder resulting from slow nail plate growth. It is characterised by an opaque, yellow-brown thickening of the nail plate with elongation and increased curvature. The exact cause of onychogryphosis is not completely known, but it is more often observed in older people, people with poor personal care, and patients with senile dementia. It is also associated with peripheral vascular disease, which causes reduced blood flow to the legs and feet due to plaque buildup in the leg arteries. Without proper blood flow, you may experience slow or unusual nail growth.
Onychogryphosis is also known as ram's horn nail because it causes the nails to thicken, curve, and resemble the shape of a ram's horn or claw. The condition mostly affects the big toes. In the early stages, onychogryphosis may be difficult to recognise, as the only feature is the thickening of the nail plate, and the classical features usually appear in the later stages. Repeatedly hurting your feet or wearing shoes that are too small can cause foot trauma, eventually leading to onychogryphosis. Other underlying causes include tuberous sclerosis complex (TSC), a rare genetic disease that causes benign tumours to grow throughout the body, and ichthyosis, a rare skin condition that prohibits the body from shedding dead skin cells.
If you think you may have onychogryphosis, it is important to seek treatment as the condition will get worse over time. Surgery may be necessary to treat onychogryphosis, and the type and frequency of the surgery depend on the underlying cause. Conservative treatments include limiting pressure on the nail bed and using mechanical debridement. To promote nail health and prevent onychogryphosis, it is recommended to maintain good foot and toenail hygiene, including regular toenail trimming, nail cleaning, and wearing thick socks to cushion against friction between the toenails and shoes.
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Lack of attachment between the nail plate and bed may cause vertical growth
The nail plate is the visible part of the nail, and underneath it lies the nail bed. The nail bed is essential for nail growth, and in its absence, the nail cannot adhere and may grow vertically. The germinal matrix, which is part of the nail bed, is responsible for 90% of nail growth.
Lack of attachment between the nail plate and bed, also known as onycholysis, can be caused by several factors. Firstly, injuries or trauma to the nail or the nail matrix (the root of the nail) can cause onycholysis. Bumping or hitting nails, wearing ill-fitting shoes, or keeping nails in water for too long can all result in nail trauma. Additionally, fungal infections, which occur when fungi get between the nail and nail bed through cracks or cuts, can lead to onycholysis. Certain medications, such as chemotherapy, tetracycline, and non-steroidal anti-inflammatory drugs (NSAIDs), may also contribute to nail separation.
In some cases, underlying medical conditions may be the cause of onycholysis. For example, people with nail psoriasis may experience changes to the structure of their nails, including nail separation. Other conditions associated with onycholysis include eczema, thyroid disease, and bacterial or fungal infections. It is important to note that women are affected by onycholysis more frequently than men, and it is also common during pregnancy.
Treating onycholysis focuses on promoting new, healthy nail growth attached to the nail bed. Unfortunately, the detached portion of the nail cannot reattach, and it may take several months for the nail to grow out completely. Proper nail care and hygiene are crucial to prevent infections and maintain nail health during treatment. This includes trimming nails, washing and drying the nails and surrounding skin, and avoiding cutting nails when they are wet.
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Anemia, lung issues, dietary issues, or stress could be factors
Unusual nail growth, such as nails growing upward, could be hereditary. Toenails growing upward could be caused by shoes pushing at the tips of the toenails, profuse foot sweat, or more complex medical explanations.
Anemia, a condition caused by a lack of red blood cells, can cause nail irregularities. Signs of anemia include pale nail beds and spoon-shaped nails. Spoon-shaped nails occur when the center of the nail becomes sunken, giving it a spoon-like appearance. This can also be caused by low iron levels, known as iron deficiency anemia. Other causes of spoon-shaped nails include malnutrition, celiac disease, heart disease, hypothyroidism, or hemochromatosis. Treating anemia can help resolve these nail symptoms.
Nail clubbing, a condition where nails appear wider, spongy, or swollen, can be a sign of lung issues. It is often associated with lung diseases like lung cancer, lung infections, interstitial lung disease, cystic fibrosis, or cardiovascular disease. Nail clubbing can also be caused by digestive conditions, such as Crohn's disease, liver disease, or thyroid conditions. It is important to see a healthcare provider if you notice any nail clubbing or changes in your nails, as it may indicate an underlying health condition that requires treatment.
Dietary issues, such as vitamin deficiencies, can also lead to nail irregularities. For example, a lack of vitamin B12 can cause spoon-shaped nails. Maintaining a balanced diet and ensuring adequate nutrient intake can help promote healthy nail growth and prevent dietary-related nail issues.
Stress can also be a factor in nail growth and appearance. Emotional and physical stress can impact the health of your nails. It is important to practice self-care and stress management techniques to promote healthy nails and overall well-being.
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Frequently asked questions
It is hypothesized that the guiding restraint of the proximal nail fold, the inducting influence of the underlying phalanx, containment by the lateral nail folds, the adherence of the nail plate to the nail bed, and the direction of cell differentiation are all contributory factors to the flat growth of the nail. An imbalance in these components can result in an altered shape of the nail plate formed.
If you have always had this issue, it might just be the way your nail grows. You can try trimming and shaping your nails with poly gel to train them to grow more straight. You can also try artificial nails to change their appearance.
Some possible causes of nails growing upward include anemia, lung issues, dietary issues, or stress or damage to the nails. Toenails that grow upward could be hereditary, or caused by ill-fitting shoes, foot sweat, or more complex medical explanations such as onychogryphosis or nail-patella syndrome.
Toenails that grow upward tend to rip more often, exposing the area to infection, so careful hygiene is vital. Nails usually change when something is wrong with our bodies, so upward-growing nails could indicate an iron deficiency or a fungus.
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