Caleb Foster
Toenails growing upward, also known as vertical nails, are not uncommon. Unusual nail growth, such as toenails growing upward, could be hereditary. Toenails that curve and taper inward are known as pincer nails, a nail deformity that can lead to ingrown toenails. Pincer nails can be caused by certain medications and can increase the risk of ingrown toenails if trimmed too short.
| Characteristics | Values |
|---|---|
| Condition | Pincer nail or ingrown toenail |
| Causes | Could be hereditary, medication side effects, or friction from shoes |
| Concerns | May lead to ingrown toenails, which can be painful due to bacterial infections |
| Treatment | Avoid trimming the free end very short, let it grow out a bit, and consult a podiatrist for orthotics |
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What You'll Learn
Toenail growth and health issues
Toenails are made from a protein called keratin, which gives them strength and hardness. The growth of nails occurs through a process called keratinization, where cells multiply at the base of each nail, layer on top of each other, and harden. Toenails typically grow upward and curve under if they grow long, but unusual nail growth, such as toenails growing in a rounded shape, could be hereditary or influenced by external factors.
Causes of Rounded Toenail Growth
The shape of your toenails can be influenced by various factors, including:
- Genetics: Unusual nail growth patterns, such as toenails growing upward or in a rounded shape, can be hereditary. Nail patella syndrome (NPS), for example, is a rare genetic disorder affecting approximately one in 50,000 people.
- Footwear: Ill-fitting shoes, such as tight or loose shoes, can cause friction and pressure on the toenails, affecting their growth pattern.
- Foot Hygiene: Profuse foot sweating can impact toenail growth and increase the risk of fungal infections, which can affect the nail's appearance and thickness.
- Trauma or Injury: Activities like sports, running, or ballet dancing can cause trauma to the toenail. This can include acute injuries or chronic conditions like repetitive rubbing against shoes.
- Medical Conditions: Toenail abnormalities can be indicative of underlying medical conditions. For example, nail clubbing can be associated with heart disease, lung disease, gastrointestinal disorders, or cancer. Discoloration of the nail plates can also be a symptom of certain drugs or medical treatments.
Health Issues Related to Toenail Growth and Appearance
Changes in toenail growth and appearance can indicate various health issues:
- Vascular Conditions: Slow or stopped toenail growth can be a sign of poor circulation and vascular conditions such as Peripheral Artery Disease (PAD), which is caused by plaque accumulation in the arteries. Other symptoms may include cold feet and toes, discoloration of toenails, and pain or cramping in the legs.
- Infections: Toenails that grow in a rounded shape are more susceptible to becoming ingrown toenails, where the nail grows into the surrounding skin. Ingrown toenails can trap bacteria and debris, leading to infections, especially in individuals with diabetes or circulation issues.
- Fungal Infections: Toenail fungus, or onychomycosis, is a common condition that typically affects older individuals. It often starts as a white or yellow spot under the tip of the toenail and can cause thickening, crumbling, and discolouration.
- Nail Trauma: Trauma to the toenail matrix, the area below the skin where the nail grows from, can result in bruising beneath the toenail, thickening, and nail loss.
Treatment and Prevention
To maintain healthy toenail growth and address potential issues:
- Trimming and Filing: Keep your toenails trimmed and filed smoothly to prevent them from catching on socks or other surfaces. Trim your nails straight across and avoid cutting them when they are wet, as dry nails are less prone to cracking.
- Footwear and Socks: Choose properly fitting shoes that provide adequate room for air movement. Wear thick socks made of natural fibres to cushion your toenails and absorb sweat, reducing friction and moisture buildup.
- Hygiene: Practice good foot hygiene by keeping your feet clean and dry. Avoid sharing towels in public places, always dry yourself thoroughly, and wear protective footwear like flip-flops to prevent fungal infections.
- Medical Attention: Consult a healthcare provider or podiatrist if you notice persistent changes in your toenail growth or appearance, especially if you suspect an infection or underlying medical condition. They can provide treatments such as antifungal medications or, in severe cases, surgery to remove the nail matrix.
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Toenails growing upward
One possible cause of upward-growing toenails is footwear. If your shoes are too tight or loose, they can cause friction and pressure on your toenails, leading to changes in their growth pattern. Tight socks can also contribute to this issue. Additionally, physical activity can impact toenail growth. Running or ballet dancing, for example, can cause trauma to the toenail.
Another factor that can affect toenail growth is foot hygiene. Profuse foot sweat can impact toenail growth and increase the risk of nail fungus, also known as onychomycosis. This fungal infection usually occurs underneath the nail and can cause discolouration, thickening, and crumbling of the nail. Maintaining good foot hygiene is crucial to prevent nail fungus and other infections.
In some cases, upward-growing toenails can be a sign of underlying medical conditions. Onychogryphosis, also known as ram's horn nail or claw nail, is a condition that causes the nails to thicken and curve due to injury or infection. Nail patella syndrome (NPS) is another rare genetic disorder that can affect nail growth. It occurs in about one in 50,000 people.
If you notice that your toenails are growing upward, it is important to maintain proper toenail care. Upward-growing toenails tend to rip more easily, exposing the area to infection. Trim your toenails regularly with sharp clippers, cutting them straight across without cutting the edges inward. Inspect your toenails at least once a week to identify any potential issues. Maintaining good foot hygiene, including keeping your feet clean and dry, is also essential.
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Pincer nails
There are three types of pincer nails, as proposed by Baran et al. Type 1, or the "common" pincer nail, is characterised by an increase in the transverse curvature from the proximal to the distal nail, forming an omega or trumpet shape. Type 2, or the plicated nail, presents with lateral edges that are sharply bent, forming vertical sheets that press into the lateral nail groove and produce granulation tissues that mimic an ingrown nail. Type 3 is rare and is characterised by a larger increase in the transverse curvature along the longitudinal axis of the nail plate, forming a tile shape.
There is no standardised treatment for pincer nails, but options include conservative treatments, surgical procedures, or a combination of both. Conservative treatments are straightforward but associated with recurrence or temporary remission. Surgical treatments have a lower recurrence rate but carry risks such as pain, atypical nail appearance, secondary infection, wound necrosis, and sensory disruption. In some cases, no treatment may be necessary, as the condition can be managed by straightening the toenail. However, it is important to seek advice from a podiatrist or medical professional to determine the best course of action.
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Toenail discoloration
Another possible cause of discolouration is trauma or injury to the toe, such as stubbing your toe or dropping something on it. This can result in a subungual hematoma, which is a collection of blood and fluid beneath the toenail, causing it to appear red, purple, brown, or black. In some cases, toenail discolouration can indicate a more serious underlying health condition. For example, diabetes can affect the body's ability to break down sugar, changing the colour of collagen within the nail beds and turning them yellow.
Additionally, certain medications can cause toenail discolouration, including some cancer drugs, antibiotics, and drugs used to treat autoimmune disorders. Discolouration caused by medications is usually painless and will improve once the medication is stopped or as the nail grows out.
It is important to note that if you suspect an infection or notice any abnormal changes to your toenails, you should consult a healthcare professional or a podiatrist for evaluation and appropriate treatment.
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Toenail fungus
You may first notice a white or yellow spot under the tip of the toenail. As the fungal infection spreads deeper into the nail, it will become discoloured and thicken. The nail may also crumble and become jagged at the edges, and the infection can spread to other toenails. Toenail fungus is more likely to occur in older people, with half of all people over 70 developing this infection.
If you notice any signs of toenail fungus, such as discolouration, thickening, or deformity, visit a podiatrist as soon as possible. The earlier you seek treatment, the greater your chances of clearing the infection. While over-the-counter treatments are available, they may not prevent the fungal infection from returning.
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Frequently asked questions
Toenails growing upwards, also known as vertical nails, are not uncommon. Unusual nail growth such as this could be hereditary. However, it may also indicate a health issue, especially if accompanied by other symptoms such as pain, itching, and discolouration.
If your toenails have a curled appearance, you may have what is known as pincer nails. Pincer nails are a nail deformity that causes over-curvature in the nail, making it easier for toenails to grow into the skin, which can lead to ingrown toenails. Ingrown toenails can be very painful as trapped bacteria and debris can cause infections.
If you have pincer nails, you should refrain from trimming the free end very short as this can increase the risk of ingrown toenails. Instead, let the free end grow out a little bit and consult a podiatrist, who may fit you with a special orthotic to slowly straighten your nail plates.
