Sophia Delgado
Toenails growing downward is a common problem, often referred to as ingrown toenails. This occurs when the corner of the toenail grows into the skin, causing tenderness, redness, and bleeding. It is usually caused by improper nail cutting techniques, ill-fitting shoes, stubbed toes, or sports-related impacts. In some cases, it could be due to hereditary factors or underlying health conditions such as circulatory issues, psoriasis, fungal infections, or diabetes. To treat and prevent ingrown toenails, it is recommended to trim toenails regularly and correctly, wear comfortable and supportive footwear, and address any underlying health conditions that could contribute to abnormal nail growth.
| Characteristics | Values |
|---|---|
| Toenail growing downward | Ingrown toenail |
| Cause | Toenail growing into the skin |
| Occurrence | Common |
| Risk factors | Incorrectly cut toenails, improperly fitting shoes, tearing the corner of the nail, toe trauma, severe nerve damage, poor blood circulation, nail infection |
| Symptoms | Pain, swelling, redness, bleeding, discoloration, infection |
| Treatment | Home remedies, antibiotics, surgery |
| Prevention | Trimming toenails regularly and correctly, wearing comfortable and supportive footwear, keeping feet clean and dry, addressing underlying conditions |
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What You'll Learn
Trauma to the toenail
If trauma causes any part of the nail to become loose or separated from the nail bed, it can lead to a secondary bacterial or fungal infection. Toenail fungus, or onychomycosis, is a common condition that affects about 10% of people. It is a slow-growing infection of the nail and skin beneath it, usually occurring underneath the nail and beginning at the tip of the nail, where you trim it. The older you are, the more likely you are to experience it, with half of all people over 70 developing this infection. Fungi thrive in dark and damp environments, so people whose feet remain wet for extended periods are at an increased risk of toenail fungal infections.
To prevent and treat toenail trauma, it is important to avoid activities that injure the nail and wear shoes with more space around the toes to relieve pressure on the affected toenail. Wearing comfortable, supportive footwear that doesn't place excessive pressure on the toes can help. Keeping your feet clean and dry can also prevent fungal infections. If you experience signs of infection or a severe ingrown toenail, do not attempt to cut your toenails, as this may worsen the condition. Instead, see a healthcare provider for guidance.
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Poor nail care
Toenails serve the purpose of protecting your toes. They are made from a protein called keratin, which also makes up your skin, hair, and fingernails. Keratin gives nails their toughness and resilience to daily wear and tear. However, poor nail care can lead to various problems, including downward-growing toenails.
Additionally, activities that cause trauma to the toenail, such as running or ballet dancing, can contribute to downward-growing nails if not properly managed. This trauma can also be caused by poorly performed pedicures or wearing tight shoes that put pressure on the toes. Repetitive injuries to the nail, such as those caused by ill-fitting footwear, can lead to a condition called retronychia, where the nail plate grows into the nail fold.
Furthermore, underlying health conditions can impact toenail health. People with diabetes are at a higher risk of developing toenail fungal infections due to reduced sensation in their feet, making it easier to overlook injuries or infections. Certain medications can also cause nail discoloration, and conditions like clubbing can cause nails to curve downward.
To prevent and manage downward-growing toenails, it is essential to practice good nail hygiene. This includes regularly trimming nails, cutting them straight across, and avoiding cutting nails when they are wet. Inspecting your toenails weekly, washing your feet with warm water, and drying them thoroughly are also important aspects of proper nail care.
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Genetic factors
The shape, strength, thickness, and growth rate of nails are all influenced by genetics. Unusual nail growth, such as toenails growing downward, could be hereditary as well.
Nail-Patella Syndrome
Nail-Patella Syndrome, also known as Turner-Kieser syndrome, is a rare genetic disorder that occurs in 1 in 50,000 people. It causes changes in the nails, elbows, kneecaps, and hip bones. Symptoms of Nail-Patella Syndrome typically appear at birth or in early childhood and may include missing or underdeveloped fingernails and/or toenails. The condition is characterised by thin and fragile nails that look concave or "scooped out", similar to a spoon. This condition can also cause nail discolouration, with nail plates turning white.
Onychogryphosis
Onychogryphosis is a condition that causes toenails to thicken and grow outward, forming an oyster-like or twisted horn shape over time. It is often linked to trauma, genetics, or underlying health conditions. Some individuals may inherit a predisposition for thick, curved nails. Onychogryphosis can also be caused by ageing, poor nail care, or underlying medical conditions such as circulatory issues, psoriasis, fungal infections, or diabetes.
Clubbed Nails
Clubbed nails refer to changes in the toenails that cause the toes to take on a widened, club-like appearance. While it is usually caused by an underlying medical condition, clubbed nails can also be an inherited trait in some people.
Fungal Infections
Some evidence suggests that certain people may have a genetic predisposition to nail fungal infections, which can cause toenails to curve. However, it is unlikely that a toenail will curve in response to a fungal infection alone.
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Underlying medical conditions
Toenails growing downward, also known as ingrown toenails, are one of the most common and painful toenail problems. This condition occurs when the corner or side of the toenail grows into the flesh, causing tenderness, redness, and bleeding. Several underlying medical conditions can contribute to ingrown toenails, and maintaining proper toenail hygiene is crucial to prevent infection. Here are some of the underlying medical conditions that can cause toenails to grow downward:
Nail Patella Syndrome (NPS)
Nail Patella Syndrome is a rare genetic disorder that affects approximately one in 50,000 people. It causes abnormalities in the nails, kneecaps, hip bones, and elbows. People with NPS often experience thin and fragile nails that resemble a spoon, a condition known as koilonychia. While NPS primarily affects fingernails, it can also impact toenails and increase the risk of developing kidney disease and glaucoma.
Onychogryphosis
Onychogryphosis is a condition characterized by thickening of the nails, typically affecting the big toes. It is caused by injury or infection and results in curved nails that resemble a ram's horn or claw. Onychogryphosis can cause the toenails to grow downward and increase the risk of infection.
Toenail Fungus
Fungal infections are a common issue affecting about 10% of the population, with older individuals being more susceptible. Toenail fungus thrives in dark, damp environments, and people with diabetes are at a higher risk. Working in wet conditions or wearing sweaty shoes daily can contribute to fungal growth. Fungal infections can cause toenails to thicken and grow downward, requiring prescription antifungal medication or, in severe cases, nail removal.
Leukonychia
Leukonychia refers to the whitening of the nail plate, which can be caused by underlying medical conditions, injury to the toenails, or inherited gene mutations. Certain medical treatments, such as chemotherapy, and heavy metal poisoning can also lead to leukonychia. Red or black lines on the nails may indicate more serious infections or conditions, including cancer, and should be evaluated by a doctor.
Nail Clubbing
Nail clubbing describes changes under and around the toenails, resulting in a widened, club-like appearance of the toes. It is often indicative of underlying medical conditions such as heart disease, lung disease, gastrointestinal disorders, or cancer. If nail clubbing is present, it is important to consult a healthcare professional for further evaluation.
Retronychia
Retronychia occurs when the nail plate grows into the nail fold, causing pain, inflammation, and yellow or white discoloration. It is commonly seen in individuals who wear tight shoes or engage in activities that lead to repetitive toenail injuries. Proper footwear with ample space for the toes is recommended to relieve pressure on the affected toenail and prevent further complications.
Maintaining proper toenail hygiene is crucial for individuals with these underlying medical conditions. This includes regular toenail trimming, keeping the feet clean and dry, and wearing comfortable shoes that do not irritate the toes. Consulting a healthcare professional is advised if any unusual changes in the toenails are observed, as early intervention can help address the underlying condition and prevent further complications.
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Toenail fungus
Fungal nail infections often affect the toenails, but they can also occur in the fingernails. The infection usually starts at the edge of the nail, causing it to become thick, discoloured, and brittle. It then slowly spreads to the rest of the nail, which may eventually crumble and become jagged at the edge, spreading to other toenails and the surrounding skin. The nail may also turn white or yellow. In some cases, the whole nail can break off, causing pain and swelling in the surrounding skin.
To prevent toenail fungus, it is important to maintain good foot and toenail hygiene. This includes trimming toenails regularly, cutting them straight across, and leaving them a little long to prevent them from growing inward. Inspect your toenails at least once a week, and use a nail cleaner to remove any dirt. Wash your feet in warm water and dry them thoroughly. Avoid cutting nails when they are wet, as dry nails are less prone to cracking.
If you think you have a fungal nail infection, you can visit a pharmacist or consult your GP. Antifungal tablets may be prescribed for up to 6 months, although they may not be suitable for those with liver or kidney disease, pregnant women, or breastfeeding women. In some cases, badly infected nails may need to be removed under local anaesthetic.
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Frequently asked questions
Downward toenail growth, also known as ingrown toenails, is caused by the corner or side of the nail growing into the flesh. This can be due to incorrect trimming, improper footwear, tearing of the nail, or trauma to the toe.
Symptoms include pain, swelling, redness, and tenderness at the side of the toe. There may also be bleeding and infection, which can cause redness or dark discolouration.
You can try a home treatment by gently lifting the edge of the nail and placing cotton or dental floss between the nail and skin. Change this daily and apply an antibiotic cream with a bandage. Take pain relievers if needed. If symptoms don't improve, see a healthcare provider.
To prevent ingrown toenails, cut your nails straight across without tapering the corners. Leave the nail a little long to prevent it from growing into the skin. Wear properly fitting shoes that don't place excessive pressure on the toes.
In some cases, downward toenail growth may be related to underlying health conditions such as circulatory issues, psoriasis, fungal infections, or diabetes. Onychogryphosis, characterised by excessively thick and curved toenails, can also cause abnormal nail growth.
