Ava Monroe
Toenails growing outward, also known as vertically growing nails, can be caused by a variety of factors. One possible cause is injury to the nail matrix, which can lead to nail changes such as bruising, thickening, or nail loss. This injury could be due to repetitive rubbing against shoes, tight or loose footwear, or a sudden injury like stubbing your toe. Poor circulation in the feet has also been linked to vertically growing nails. Additionally, underlying medical conditions such as onychogryphosis, nail patella syndrome, and retronychia can contribute to outward nail growth. Onychogryphosis, often referred to as ram's horn nails, causes nails to thicken and curve abnormally. Nail patella syndrome is a rare genetic disorder that can lead to nail abnormalities, while retronychia occurs when the nail plate grows into the nail fold, causing the old nail to be pushed upward.
| Characteristics | Values |
|---|---|
| Cause | Could be hereditary, toenails' natural growth pattern, shoes pushing at the tips of toenails, profuse foot sweat, underlying normal phalanx, nail bed not adhering to the nail plate, injury to the matrix, fungal infection, inadequate personal care, foot injury, poorly fitting shoes, depressed nail beds, toenail trauma, bacterial infection |
| Symptoms | Thickening, bruising beneath the toenail, nail loss, pain, swelling, infection, redness or dark discolouration, inflammation of the nail fold, white or yellow discolouration of the nail plate, growth of new connective tissue, cracks in nails, white lines in nails, nail changes, toenail changes, nail abnormalities, skeletal abnormalities, kidney disease |
| Treatment | Trim toenails frequently, soak foot in an Epsom salt solution, massage the side of the nail, wear open shoes, maintain toenail hygiene, keep feet clean and dry, avoid cutting nails when they are wet, inspect toenails regularly, use a nail cleaner, wash and dry feet thoroughly, cut toenail straight across, leave the nail a little long, trim or file any rough edges, soak toe in cold water, apply petroleum jelly, cover with a bandage, trim off the detached part, cover with an adhesive bandage, see a healthcare provider, surgery, phenol treatments, treat toenail fungus |
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What You'll Learn
Genetics
Unusual nail growth, such as toenails growing outward, could be hereditary. The strength, thickness, and growth rate of nails are inherited traits.
Nail-patella syndrome, also called Turner-Kieser syndrome, is a rare genetic disorder that causes changes in the nails, elbows, kneecaps, and hip bones. The disorder affects multiple body systems, placing the affected person at an increased risk of developing numerous chronic conditions, including kidney disease and glaucoma. Symptoms of nail-patella syndrome typically appear at birth or in early childhood and may include missing or underdeveloped fingernails and/or toenails. It is caused by a genetic mutation and occurs in 1 in 50,000 people.
Onychogryphosis, also known as ram's horn nails, is a condition that can affect any of the toes but is most common in the big toe. It causes the nails to thicken and twist outward. While onychogryphosis can be caused by trauma to the feet, such as an injury or poorly fitting shoes, it is also often associated with toenail fungus. As many as 50% of people with onychogryphosis report having had toenail fungus for many years before developing onychogryphosis. Toenail fungus itself may also have a genetic component, as some people appear to have a genetic predisposition to it.
Other genetic factors that can affect toenail health include nail clubbing, which is an inherited trait in some people and is caused by underlying medical conditions, and iron deficiency, which can cause brittle nails.
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Footwear
Toenails that grow outward can be caused by several factors, including footwear. Here are some key points about how footwear can contribute to outward toenail growth:
Poorly fitting shoes are a common cause of outward toenail growth, specifically a condition called retronychia. This condition occurs when the toenail grows back into the nail fold, causing pain, swelling, and nail discoloration. Wearing shoes that are too tight or have high heels can exert frequent pressure on the toenail bed, leading to repeated microtraumas. This pressure can cause the toenail to grow outward and into the surrounding skin. Therefore, it is essential to wear properly fitted shoes that do not place excessive pressure on the toes or pinch them.
For individuals with ingrown toenails, which is a common condition where the corner or side of the toenail grows into the soft flesh, footwear choice is crucial. Tight or ill-fitting shoes can aggravate the condition and increase the risk of infection. It is recommended to wear shoes that provide ample space for the toes to move freely and avoid shoes that place too much pressure on the toes. Sandals or other low-heeled open-toed shoes are often recommended to alleviate pressure and promote proper toenail growth.
Additionally, protective footwear is advised for individuals who engage in activities that may pose a risk of toe injury. For example, those who participate in sports or work in hazardous environments should consider wearing steel-toed shoes or other appropriate protective shoes to safeguard their toes and toenails from trauma.
In summary, footwear plays a significant role in outward toenail growth. Wearing properly fitted shoes, avoiding tight or pinching shoes, and opting for protective footwear when necessary can help prevent toenail problems and promote healthy toenail growth. Consulting with a podiatrist or foot specialist is always recommended when addressing toenail concerns to ensure proper care and treatment.
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Foot sweat
Toenails growing outward could be due to several reasons. One possible cause is profuse foot sweating, which can impact the growth pattern of toenails.
Excessive sweating, or hyperhidrosis, can increase the risk of toenail fungus, which can cause toenails to thicken and grow outward. Toenail fungus, or onychomycosis, is a common condition that can affect toenails, causing them to thicken and change colour, appearing white, yellow, or brown. It is often challenging to treat and may require prolonged use of oral or topical antifungal medications.
To prevent and manage foot sweat and toenail fungus, it is essential to maintain good foot hygiene. Here are some recommendations:
- Wash your feet daily with soap and water, ensuring they are thoroughly dried, especially between the toes.
- Wear clean socks, preferably made from moisture-wicking materials. Change your socks once or twice a day, or more frequently if your feet tend to sweat a lot or get wet.
- Avoid walking barefoot in communal areas such as public showers, locker rooms, and swimming pools. Instead, wear flip-flops or sandals in these areas to minimise direct contact with potential sources of fungal infections.
- Use antifungal powder or spray on your feet and inside your shoes to help prevent and control fungal growth.
- If you have toenail fungus, consider throwing away old pairs of closed-toe shoes as fungi may be living in them, contributing to recurrent infections.
- Practise proper toenail hygiene by inspecting your toenails at least once a week. Use a nail cleaner to gently remove any dirt accumulated under your nails.
- Keep your toenails trimmed and cut straight across, avoiding cutting them too short or inward. Dry nails before trimming as they are less prone to cracking.
- If you have a family member with foot or nail fungus, consider using a separate shower or wearing protective footwear in the shower to avoid exposure to fungal spores.
- Visit a dermatologist or podiatrist if you notice persistent or severe symptoms of toenail fungus, as they can advise on treatment options and help prevent recurrence.
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Trauma
Toenail trauma may also result in a fracture (break) of the bone beneath the nail. It is important to have any toenail colour changes or loosening evaluated by a podiatrist or healthcare provider. Discolouration, particularly in black or brown, could be a sign of melanoma, a type of skin cancer.
Retronychia is a condition that occurs when the nail plate grows into the nail fold. It is caused by repetitive injury to the nail, often by wearing tight shoes or participating in activities that lead to toenail injury. It is characterised by inflammation of the nail fold, yellow or white discolouration of the nail plate, and the growth of new connective tissue on inflamed areas.
Treatment for toenail trauma ranges from home care to a trip to a healthcare provider, depending on the severity of the injury. Trimming or filing any rough edges can prevent them from catching on anything. Soaking the injured toe in cold water for 20 minutes after trimming and applying petroleum jelly before covering with a bandage is recommended. For large tears, it is important to trim off the detached part or cover it with an adhesive bandage until the nail grows out enough to protect the skin underneath. Keeping the area clean, dry, and covered is essential until the nail grows back or the nail bed becomes firm.
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Inadequate personal care
Toenail trauma, caused by repetitive injury or poorly fitting shoes, is a significant factor contributing to outward nail growth. Wearing tight or loose shoes can lead to friction and pressure on the toes, resulting in toenail injuries. This trauma can cause bruising, thickening, or even nail loss. Additionally, toenails may grow outward due to depressed nail beds, a condition where the nail bed fails to adhere properly to the nail plate, causing it to grow upward instead of outward.
To prevent and manage outward nail growth, meticulous foot care is essential. Keeping your feet clean and dry, trimming your nails regularly, and avoiding activities that injure the nails are crucial steps. It is also important to wear shoes that provide ample space for your toes, reducing pressure on the toenails. Consulting a healthcare professional, such as a podiatrist, is recommended for those experiencing ongoing issues or infections.
In addition to personal care, underlying medical conditions can contribute to outward toenail growth. Toenail fungus, or onychomycosis, is a common infection that can lead to complications if left untreated. Poor circulation in the feet is another factor that can cause onychogryphosis. Therefore, it is important to pay close attention to any unusual changes or growths and seek medical advice when needed.
While onychogryphosis may develop over time due to inadequate personal care, it is not merely a cosmetic issue. If left unmanaged, it can significantly impact an individual's quality of life, causing pain, inflammation, and difficulty in wearing regular shoes and performing daily activities. In some cases, surgery or partial nail avulsion may be necessary to correct outward nail growth and alleviate associated symptoms.
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Frequently asked questions
Toenails grow outward due to a combination of factors, including genetics, trauma or injury, and certain medical conditions. In some cases, it may be the natural growth pattern of the toenail.
The strength, thickness, and growth rate of nails are hereditary traits. Unusual nail growth patterns, such as toenails growing outward, can also be passed down through families.
Repetitive actions, such as rubbing against shoes that are too tight or too loose, can cause toenail trauma. This can lead to conditions like onychogryphosis, also known as ram's horn nails, where the nails thicken and curve outward.
Yes, certain medical conditions can contribute to outward-growing toenails. For example, Nail Patella Syndrome (NPS) is a rare genetic disorder that often includes nail abnormalities. Additionally, fungal infections of the toenail, known as onychomycosis, can also impact nail growth and health.
Proper toenail care is essential to manage outward-growing toenails. Keep your toenails trimmed, clean, and dry. Inspect your toenails regularly for any changes or signs of infection. If issues persist or become more severe, consult a healthcare professional for further guidance and treatment options.
