Isla Bennett
Crooked toenails, also known as ingrown toenails, are a common and often painful condition. They occur when the edges or corners of a nail grow into the skin, causing redness, tenderness, and even bleeding. Several factors can contribute to this issue, including trimming toenails too short, wearing ill-fitting shoes, genetic factors, and certain activities that cause toenail trauma, such as running or ballet dancing. In some cases, underlying conditions such as diabetes, poor blood flow, or peripheral artery disease can also increase the risk of ingrown toenails. Treatment options range from at-home remedies like soaking the affected area and lifting the nail to medical interventions such as partial nail avulsion, laser therapy, or antifungal medications.
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What You'll Learn
Toenail fungus
There are several reasons why your middle toenail might start growing crooked. Repeatedly hurting your feet or wearing shoes that are too small can cause foot trauma, leading to a condition called onychogryphosis, or "ram's horn nails". This condition causes one side of the nail to grow faster than the other, resulting in thick and curved nails that resemble horns or claws. Additionally, underlying conditions such as peripheral vascular disease (PAD) or hammer toe can also contribute to onychogryphosis.
Now, let's focus on toenail fungus:
If left untreated, toenail fungus can lead to more severe complications. The infection may spread, causing thicker nails that are challenging to trim and making it painful to walk while wearing shoes. In some cases, onychomycosis may be accompanied by secondary bacterial or yeast infections. Therefore, it is crucial to address toenail fungus early and seek professional advice if you notice any changes in your toenails.
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Poorly fitted shoes
Ill-fitting footwear can press on the toes, exposing the feet to friction, which can result in painful blisters, calluses, and corns. This friction can also lead to skin breakdown and increase the risk of foot ulcers, especially in individuals with diabetes. Additionally, poorly fitted shoes can contribute to toenail fungus by creating a warm, dark, and moist environment conducive to fungal growth.
To prevent these issues, it is essential to wear shoes that fit properly in both length and width. The toe box, the part of the shoe that covers and protects the toes, should be wide and deep enough to accommodate the toes and allow them to move freely. The shoe should fit snugly but comfortably, without pinching the toes or causing excess pressure.
It is recommended to get measured regularly to ensure shoes fit the current foot size and shape. Custom-made foot orthotics or off-the-shelf insoles can also help support the feet, increase comfort, and reduce callus build-up. Wearing shoes made from breathable materials and moisture-wicking socks can help reduce the risk of fungal infections.
In summary, poorly fitted shoes can cause various toenail issues, from ingrown toenails to fungal infections and nail trauma. To promote healthy toenails, it is crucial to wear properly fitted shoes that provide adequate room and comfort for the toes.
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Peripheral artery disease
There are several reasons why a toenail might grow crooked or curved. One of the most common causes is an ingrown toenail, which occurs when the edges or corners of a nail grow into the skin next to it, causing tenderness, redness, bleeding, and pain. Ingrown toenails can be caused by cutting your toenails too short, allowing the skin on the sides to cover the corners of the nail and causing it to grow back into the skin. Cutting your toenails with a curve instead of straight across can also lead to ingrown toenails, as it causes uneven pressure on the sides of the nails, making them harden. Genetics can also play a role; individuals with large or naturally curved toenails are more likely to experience ingrown toenails. Toenail injuries, such as stubbing your toe, dropping something heavy on your foot, or wearing poorly fitted shoes, can also lead to ingrown toenails. Certain activities like long-distance running, ballet, or tap dancing can cause toenail trauma and increase the risk of ingrown toenails.
Another condition that can cause toenails to grow abnormally is onychogryphosis, also known as Ram's Horn Nails. This condition causes one side of the nail to grow faster than the other, resulting in thick and curved nails that resemble horns or claws. Onychogryphosis mostly affects the big toes, but it can develop on any toe. It can be caused by repeatedly hurting your feet or minor foot trauma, such as wearing ill-fitting shoes. Underlying conditions like hammer toe or psoriasis can also contribute to onychogryphosis. Peripheral vascular disease, also known as peripheral artery disease (PAD), is another factor that can lead to onychogryphosis. PAD causes a build-up of plaque in the arteries of the legs, reducing blood flow to the legs and feet. This reduced blood flow can result in sores on the legs or feet and slow or unusual nail growth. Smoking is a significant risk factor for developing PAD.
To prevent and treat ingrown toenails, it is essential to practice proper nail care. Keeping toenails at a moderate length and trimming them straight across, so they are even with the tips of the toes, can help reduce the risk of ingrown toenails. Wearing properly fitted shoes that do not place excessive pressure on the toes is also crucial. For individuals with nerve damage in the feet, checking the fit of shoes regularly is essential to ensure they are not too tight. Engaging in activities that may injure the toes, such as certain sports or dancing, requires wearing protective footwear like steel-toed shoes.
In cases of mild pain and no immediate signs of infection, self-treatment for ingrown toenails can be performed at home. Soaking the feet in a warm bath for at least 20 minutes can soften the nails and skin, making them easier to manage. Using sanitized nail care tools, the ingrown portion of the nail can be carefully lifted and elevated with cotton or gauze to alleviate pressure and promote healing. Applying an over-the-counter antibiotic ointment can help prevent infection. For more severe or recurrent cases of ingrown toenails, professional treatment by a doctor may be necessary. Partial nail avulsion, laser therapy, or chemical therapy treatments may be recommended to provide long-term relief.
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Trimming toenails too short
Toenails that are trimmed too short can lead to ingrown toenails, which occur when the edges or corners of a nail grow into the surrounding skin, causing tenderness, redness, and bleeding. This happens because the pressure from shoes on the toes may direct the nail to grow into the tissue. Shoes that are too tight or place too much pressure on the toes can also cause this issue. Therefore, it is important to wear properly fitting shoes and trim toenails straight across, leaving them a little long to prevent them from growing inward.
To prevent ingrown toenails, it is recommended to maintain proper foot hygiene, keep toenails at a moderate length, and trim them so they are even with the tips of the toes. Additionally, wearing protective footwear during activities that may injure the toes can help reduce the risk of toenail problems.
Ingrown toenails can be treated through surgery or medication, depending on the severity of the symptoms. However, it is important to note that upward-growing toenails, which could be hereditary, tend to rip more often, exposing the area to infection. Therefore, careful hygiene and regular nail trimming with sharp clippers are crucial to maintaining healthy toenails.
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Genetics
Nail-patella syndrome (NPS) is a rare genetic disorder that affects about one in 50,000 people. People with NPS often have skeletal abnormalities involving the knees, elbows, and hips and are prone to developing kidney disease. NPS is characterised by thin and fragile nails that look concave or "scooped out", similar to a spoon. While fingernails are more commonly affected than toenails, it can cause changes in toenails as well.
Tuberous sclerosis complex (TSC) is another rare genetic disease that causes benign tumours to grow throughout the body. It is typically diagnosed due to associated skin problems, including nail deformities. While nail deformities may go away in some cases, they can worsen over time, turning into ram's horn nails.
Additionally, ichthyosis is a rare genetic condition that prohibits the body from shedding dead skin cells. A common symptom is thickened or deformed nails, which can turn into onychogryphosis, or ram's horn nails.
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Frequently asked questions
Crooked toenails are often caused by ingrown toenails, which occur when the edges or corners of a nail grow into the skin next to it. Ingrown toenails can be caused by trimming your toenails too short, wearing ill-fitting shoes, or genetics.
Mild cases of ingrown toenails can be treated at home by soaking your feet in a warm bath for at least 20 minutes, carefully lifting the ingrown nail out of the skin, and applying an antibiotic ointment. For more severe cases, a doctor may need to perform a partial nail avulsion, which involves partially removing the toenail after numbing the toe.
Ingrown toenails can lead to pain, redness, swelling, and bleeding. If left untreated, they can also result in infections, which may require extensive treatment. People with diabetes or poor blood flow to the feet are at a higher risk of developing complications from ingrown toenails.
