Sophia Delgado
Toenails grow out of the matrix, a small pocket under the skin that constantly creates new cells, pushing out old ones and causing the nail to lengthen. The nail plate is the visible part of the nail, made of a hard substance called keratin. The nail bed is the area under the nail plate, and the cuticle is the thin tissue over the base of the nail plate where it grows out of the finger. Toenails grow up to four times slower than fingernails, and unusual nail growth, such as toenails growing upward, could be hereditary or the result of external factors such as ill-fitting shoes or profuse foot sweating.
| Characteristics | Values |
|---|---|
| Parts of the nail | The nail itself, the underlying structure that supports nail growth, and the skin tissue that surrounds it |
| Nail structure components | The nail plate, the nail root, the nail bed, the germinal matrix (nail matrix), the eponychium tissue, the cuticle, the paronychium |
| Nail root | Visible as a white crescent called the lunula; produces most of the nail volume; extends several millimetres into the finger |
| Nail bed | Extends from the edge of the nail root to the hyponychium tissue; contains blood vessels, nerves, and melanocytes |
| Germinal matrix (nail matrix) | Lies beneath the skin at the inner edge of the nail plate; responsible for most of the nail's growth |
| Growth rate | On average, a healthy person's fingernails grow about 3 to 3.5 millimetres per month; growth rate varies between fingers and toes, and is affected by circulation and aging |
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What You'll Learn
Toenails grow out of the matrix, a small pocket under the skin
The growth of toenails, much like fingernails, can be attributed to the nail matrix, also known as the germinal matrix or the nail bed. This structure lies beneath the skin, at the inner edge of the nail plate, and is responsible for the growth of the nail. It is where new cells form and then move forward to create the nail plate until it reaches the outer edge, where it is eventually shed. Without the nail matrix, nail growth is not possible.
The nail matrix is part of the underlying structure that supports nail growth, along with the nail bed and the surrounding skin tissue. The nail root, which is part of the nail matrix, contributes about 80% of the length of the nail, while the nail bed determines the thickness, contributing about 20% of the nail. The nail root is the white crescent-shaped portion known as the lunula, which is visible at the base of the nail.
As the nail root grows, it extends several millimetres into the finger or toe, producing most of the nail's volume. The nail bed, or sterile matrix, extends from the edge of the nail root to the hyponychium tissue. It contains blood vessels, nerves, and melanin-producing melanocytes. The nail streams down the nail bed as it grows, adding substance to the underside of the nail and making it thicker.
The growth of the nail is not limited to the nail matrix and nail bed. The eponychium tissue, which is part of the skin surrounding the nail, produces the cuticle. The cuticle is found between the skin and the nail plate, providing a waterproof seal and fusing these structures together. It includes the proximal fold of the skin, closest to the body.
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Toenails grow up to four times slower than fingernails
Toenails grow much more slowly than fingernails, and this has been a subject of curiosity for many. Scientists have studied the difference in growth rates between toenails and fingernails, and found that toenails grow at a rate of 1.62 mm per month, while fingernails grow at a rate of 3.47 mm per month. This means that, on average, fingernails grow about twice as fast as toenails. However, some sources claim that the discrepancy could be as high as four times.
There are several theories as to why this difference in growth rate occurs. One theory is that nail growth is related to the length of the bones in the finger or toe. As a result, longer fingers will have faster-growing nails. Another theory is that nail growth is related to use and trauma to the nail bed. This theory, known as "terminal trauma", suggests that the more a digit is used, the faster the nail grows. This is because greater use leads to more wear and tear, and the body tries to regenerate the nail accordingly. This theory is supported by the observation that the nails on an individual's dominant hand tend to grow faster, as they are subject to more trauma.
The evolution of nails from claws, which occurred around 55 million years ago, may also play a role in the baseline rate of nail growth. Nails first appeared in primates and helped them grasp tree branches. In modern times, nails continue to serve a purpose, such as allowing us to tap on a smartphone screen. However, toenails have become less relevant, as humans have only recently started wearing shoes, and so they may not have had enough time to phase out.
While the exact reason for the difference in growth rate between toenails and fingernails remains unknown, it is clear that toenails grow significantly more slowly than their finger counterparts.
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Toenails can grow upward, which may be hereditary
Toenails typically curl under if they grow long, but it is not uncommon for them to grow upward. This unusual growth pattern may be hereditary. The nail matrix is the root of the nail, growing out of a small pocket under the skin. The matrix is constantly producing new cells that force the old ones to bunch up and get pushed through the skin. The nail plate is the visible, hard part of the nail, made of the protein keratin. The nail bed is under the nail plate, and the lunula is the small, white crescent shape sometimes visible at its base.
If a toenail grows upward, it could be due to more complex medical issues. Onychogryphosis, also known as ram's horn nails, causes the nails to thicken, curve, and resemble a ram's horn or claw. This condition mostly affects the big toe and can develop at any life stage, though older adults are especially susceptible. It can be caused by trauma to the feet, such as injury or poorly fitting shoes, and often results in yellow, hardened nails with a veined, curvy appearance.
Nail patella syndrome (NPS) is a rare genetic disorder characterised by thin and fragile nails that appear concave or "scooped out." While it primarily affects fingernails, it can also involve skeletal abnormalities in the knees, elbows, and hips, and increase the risk of kidney disease.
Another condition, retronychia, occurs when the nail plate grows into the nail fold, causing multiple layers of new nail plates to stack under the old one. This condition most often affects the big toenails and results from repetitive injury to the nail, such as wearing tight shoes. It can cause inflammation, yellow or white discolouration, and the growth of new connective tissue.
To manage upward-growing toenails, careful hygiene and regular trimming with a strong, sharp nail clipper are essential. Cut each toenail straight across to where it begins to curve upward, leaving it a little long to prevent inward growth. Inspect your toenails at least once a week, and maintain good foot hygiene by removing dirt under your nails and washing and drying your feet thoroughly.
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Toenail health can be affected by conditions like fungal infections
Toenail health can be affected by various conditions, including fungal infections. Fungal toenail infections, or onychomycosis, are a common problem, affecting up to 20% of people. They are caused by fungi that thrive in warm, moist, and dark environments, such as around swimming pools, in public locker rooms, or on communal shower floors. These fungi can infect the toenails through direct contact or by touching contaminated surfaces.
Toenail fungus often starts as a small, white, yellow, or brown spot under the tip of the nail. As the infection progresses, the nail may become thickened, brittle, crumbly, and discolored. It can spread to adjacent nails and, in rare cases, cause a serious infection called cellulitis. Toenail fungus is notoriously challenging to treat and often recurs, even with treatment. Healthcare providers may recommend topical antifungal treatments or, in more severe cases, antifungal tablets.
To prevent toenail fungal infections, it is essential to practice good foot hygiene and avoid walking barefoot in public areas. Keeping toenails trimmed and avoiding damage to the nails can also help reduce the risk of infection. If you suspect a fungal infection, it is essential to seek medical advice, as prompt treatment can prevent the spread of the infection and potential health complications.
Additionally, maintaining overall toenail health involves keeping the nails clean, dry, and trimmed. Wearing well-fitting shoes and regularly inspecting the nails for any changes can also help identify potential issues early on. Good foot hygiene practices, such as washing and drying the feet thoroughly, can contribute to overall toenail health and reduce the risk of fungal and other types of infections.
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Toenail abnormalities can indicate serious health issues
Toenails are prone to various issues due to the daily wear and tear they experience. While some toenail problems are minor, others can indicate serious health issues. Toenail abnormalities can be caused by friction from shoes, physical activity, heat and moisture, and underlying health conditions. Here are some common toenail abnormalities and the potential serious health issues they may indicate:
- Nail Fungus (Onychomycosis): Nail fungus is a common condition, affecting about 10% of people, with increasing prevalence in older individuals. While it may start as a subtle scattering of white spots, it can progress to discolouration, thickening, crumbling, and jagged edges. If left untreated, fungal infections can lead to severe pain, numbness, tingling, and difficulty walking. Additionally, fungal infections on the toenails can be challenging to cure and typically require prescription antifungal medication or, in some cases, nail removal.
- Ingrown Toenails: Ingrown toenails occur when the nail grows into the surrounding skin, causing tenderness, redness, and even bleeding. While this condition can often be treated at home with proper foot soaking and gentle trimming, recurring or infected ingrown toenails may require medical attention. Diabetic individuals with ingrown toenails should seek immediate medical care as they are at a higher risk of infection and complications.
- Toenail Trauma: Injuries to the toenails can result from various causes, including accidents or underlying conditions like diabetes, a weak immune system, or peripheral artery disease. Left untreated, toenail trauma can lead to infections and other serious complications. In some cases, healthcare providers may need to drill or surgically remove a damaged toenail to relieve pressure from swelling.
- Nail Abnormalities: Certain nail abnormalities can indicate underlying health issues. For example, nails that curve inward like spoons may indicate severe iron deficiency. Thick and pitted nails can be a sign of psoriasis, while nail clubbing, where the nails turn downward, is rarely idiopathic and usually indicates an underlying condition. Red or black lines on the nails can be indicative of various serious infections and medical conditions, including skin cancer.
It is important to consult a healthcare professional if you notice any abnormal changes to your toenails or experience signs of infection, such as redness, severe pain, or drainage of pus. Proper toenail care, including good hygiene and wearing properly fitted footwear, can help maintain strong and healthy toenails.
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Frequently asked questions
Toenails grow out of the matrix, a small pocket under the skin that constantly creates new cells. As the root grows, the nail moves down along the nail bed, adding material to the underside to make it thicker.
Scientists believe toenail growth, which is up to four times slower than fingernail growth, is connected to blood flow and the production of keratin.
Toenails growing upward could be due to hereditary factors, ill-fitting shoes, or profuse foot sweating. In some cases, it may indicate a more complex medical issue, such as Onychogryphosis or Nail-Patella Syndrome.
The white crescent shape is called the lunula, and it is part of the nail matrix. While it is usually visible, some people do not have a visible lunula, which is normal.
To stimulate toenail growth, you can take biotin supplements to improve keratin infrastructure. Natural remedies involving coconut oil, olive oil, orange juice, and lemon may also help.
