Ava Monroe
Toenails that grow downward can be caused by various factors, including lung issues, dietary issues, stress, or damage to the nails. Slow toenail growth or the cessation of growth can indicate underlying health issues such as poor circulation, peripheral artery disease (PAD), or fungal infections. Discoloration of the nail plates is usually the least concerning issue, often caused by substances like nail polish, shoe dye, or certain medications. However, red or black lines on the nails can indicate serious infections or conditions, including cancer, and should be evaluated by a doctor. Ingrown toenails, characterized by nails growing into the surrounding skin, can cause tenderness, redness, and bleeding. Proper toenail maintenance is crucial, and upward-growing toenails should be carefully trimmed to prevent ripping and potential infection. Consulting a dermatologist or a doctor is essential for addressing any concerns or abnormalities in toenail growth or appearance.
| Characteristics | Values |
|---|---|
| Condition | Onychogryphosis (Ram's Horn Nails) |
| Cause | Ageing, injury, poor hygiene, infrequent toenail trimming, bunions, biomechanical changes, skin conditions, nail infections, circulatory problems, neurological conditions, genetic factors |
| Symptoms | Abnormal growth, yellowish-brown colour, thickened nail, skin lacerations, inflammation, pain |
| Treatment | Removal of the affected nail, foot exercises, dietary changes, partial nail avulsion, laser or chemical therapy |
| Prevention | Proper toenail trimming, maintaining good foot hygiene, wearing properly fitted footwear |
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What You'll Learn
Toenail shape and health
Toenails serve an essential protective function for our feet, which are prone to injury. However, toenail health can suffer due to the daily stress our feet undergo. Toenail problems are quite common, and changes in toenail shape can indicate underlying health issues.
Ingrown Toenails
Ingrown toenails occur when the edges or corners of a nail grow into the skin next to it, causing tenderness, redness, and even bleeding. They are often caused by cutting toenails too short or on a curve instead of straight across. Injuring the toenail, for example, by stubbing a toe or wearing poorly fitted shoes, can also lead to ingrown toenails.
Pincer Nails
Pincer nails are a nail deformity that causes over-curvature in the nail. They taper inwards, making it easier for the toenail to grow into the skin. Pincer nails can be caused by onychomycosis, autoimmune diseases, or a family history of the condition.
Onychogryphosis (Ram's Horn Nails)
Onychogryphosis is a condition characterised by the abnormal growth of toenails, causing them to thicken and curve downwards. It can be a natural part of the ageing process or result from an injury to the foot. Poor foot hygiene, bunions, and skin conditions like psoriasis can increase the risk of onychogryphosis.
Spoon Nails (Koilonychia)
Spoon nails curve outward, away from the nail bed, and can become so soft that they can hold a droplet of water. In newborns, spoon nails may resolve without treatment, but in older individuals, they can indicate health issues such as iron-deficiency anaemia.
Nail Clubbing
Nail clubbing refers to changes under and around the toenails that cause the toes to take on a widened, club-like appearance. It is usually caused by underlying medical conditions, such as heart disease, lung disease, gastrointestinal disorders, or cancer.
Preventative Measures and Treatment
Maintaining good foot hygiene and wearing properly fitted footwear can help keep toenails strong and healthy. If you experience pain, severe thickening, or signs of infection, it is important to consult a doctor or podiatrist for evaluation and treatment. Mild cases of ingrown toenails can be treated at home by soaking the feet in a warm bath and carefully lifting the ingrown nail out of the skin.
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Toenail injuries
Toenails are a crucial layer of protection for our feet, which are susceptible to injury. Toenail injuries can be caused by stubbing your toe, dropping something heavy on your foot, or closing your toe in a door. Toenails can also be injured by wearing ill-fitting shoes, which can lead to deformities in the nails. This is known as "runner's toe" among athletes and hikers.
If the nail is torn or jagged, it is recommended to trim it to prevent further injury. In cases where the nail has completely lifted off the nail bed, it can be temporarily replaced and held in place with a bandage. However, nails will not reattach to the nail bed once they have separated, and a new nail will regrow slowly over several months. It is important to protect the toe during this time to prevent further irritation.
To prevent toenail injuries, it is crucial to wear properly sized shoes that provide adequate room and support. Keeping toenails trimmed and maintaining good foot hygiene can also reduce the risk of injury and infection. For those with conditions affecting healing or circulation, such as neuropathy or diabetes, it is especially important to seek medical evaluation for any toenail injuries.
In some cases, toenail injuries can lead to thick and curved toenails, a condition known as Onychogryphosis or "ram's horn nails." This condition can be caused by forceful injury, poor hygiene, bunions, biomechanical changes, skin conditions, nail infections, circulatory problems, or neurological conditions. Treatment for Onychogryphosis typically involves removing the affected nail to prevent regrowth, and it is essential to seek professional care for effective management.
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Toenail infections
Causes of Toenail Infections
- Bacteria: Bacteria is a common cause of toenail infections, leading to a condition called paronychia, which causes redness, tenderness, and even bleeding.
- Fungi: Fungal infections are another frequent culprit. Walking barefoot in communal areas like gym showers or swimming can increase the risk of contracting fungal infections.
- Cutting Nails Too Short: Cutting toenails too short can cause the skin on the sides to cover the corners, leading to ingrown toenails.
- Injury or Trauma: Injuring your toenail, such as through stubbing your toe or dropping something heavy, can result in a subungual hematoma (blood collection under the nail) or even an ingrown toenail.
- Poor Hygiene: Neglecting foot hygiene and not keeping your feet clean and dry can increase the risk of fungal infections and other issues.
- Underlying Medical Conditions: Certain medical conditions, such as diabetes, heart disease, or lung disease, can make individuals more susceptible to toenail infections. For example, diabetic nerve damage can prevent individuals from feeling minor traumas that could lead to infections.
- Genetics: In some cases, ingrown toenails may be due to inherited traits, such as naturally large or curved toenails.
Treatment of Toenail Infections
Mild infections may be treated at home, but it is always advisable to consult a doctor or podiatrist for proper evaluation and treatment. Here are some treatment options:
- Soaking: Soaking your feet in warm water for 15-20 minutes can soften the nails and skin, making it easier to manage the infection.
- Lifting the Nail: Using sanitized nail care tools, you can carefully lift an ingrown nail out of the skin and place a piece of cotton or gauze underneath to alleviate pressure and encourage healing.
- Antibiotics: For bacterial infections, your doctor may prescribe antibiotic cream or pills to clear up the problem.
- Antifungal Medication: Fungal infections are typically treated with antifungal pills or creams, which can be bought over the counter or with a prescription.
- Partial or Complete Nail Removal: In severe cases, especially with ingrown toenails, your doctor may need to partially or completely remove the affected nail to facilitate healing.
- Laser or Chemical Therapy: For recurrent ingrown toenails, laser or chemical therapy treatments may be effective in providing long-term relief.
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Toenail hygiene
Toenails serve an essential purpose: they protect your feet. Our feet are prone to injury, so having a hard layer on our toes is critical. Toenails help protect delicate soft tissues, nerves, blood vessels, and muscles. However, because our feet are put under a lot of stress throughout the day, our toenail health can sometimes suffer. Therefore, it’s essential to check the condition of your feet daily, especially if you have a history of toenail issues, such as ingrown toenails or fungus.
Ingrown toenails are a common issue, where the edges or corners of a nail grow into the skin next to it, causing tenderness, redness, and even bleeding. They can be caused by cutting your toenails too short, allowing the skin on the sides to cover the corners of the nail, which then causes the nail to grow back into the skin. Cutting your toenails with a curve instead of straight across can also cause ingrown toenails, as it causes uneven pressure on the sides of the nails, causing them to harden and grow inward instead of straight out. Other causes of ingrown toenails include toenail injuries, such as stubbing your toe, dropping something heavy on your foot, wearing poorly-fitted shoes, or activities like long-distance running or ballet dancing.
To prevent ingrown toenails, trim your toenails properly every few weeks. Trim them straight across, avoiding cutting the edges into a curve, and avoid trimming them too short. If you prefer a rounded shape, use a nail file to smooth out the ridges and give the edges a gentle curve, resulting in a square shape with rounded edges.
To prevent toenail fungus, practice good foot hygiene. Wash your feet with soap and warm water to cleanse them of sweat, dirt, and bacteria. Pay extra attention to the spaces between your toes, and gently wipe your feet with a towel afterward. Keep your toenails clean, especially if you wear sandals in the summer. Use a pumice stone to buff your feet and exfoliate your skin, and massage a moisturising lotion into your feet every day. Rub lotion or petroleum jelly on your feet before bed and wear socks to lock in moisture. Opt for good-quality socks made from cotton or wool, and change your socks often to prevent fungus from growing.
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Toenail treatments
Toenail Fungus Treatments
Fungal nail infections are often caused by fungi called dermatophytes or yeast, which infect the skin beneath the nail. Toenail fungus treatments include a range of options, from home remedies to prescription medications. Home treatments include tea tree oil, eucalyptus oil, ozonized sunflower oil, baking soda, Vicks VapoRub, vinegar, and hydrogen peroxide. While some of these treatments have been found to be effective in studies, they may not work for everyone. Over-the-counter treatments include creams, ointments, sprays, and liquids, and prescription topical medications are also available. In more severe cases, oral antifungal pills may be prescribed, although these can affect the liver and may interact with other medications. Toenail laser treatment is also an option but has a lower cure rate than oral medication. In very severe cases, the infected nail may need to be surgically removed to treat the nail bed, allowing a healthy nail to grow back.
Ingrown Toenail Treatments
Ingrown toenails occur when the nail grows into the flesh, causing tenderness, redness, and sometimes bleeding. Mild cases can be treated at home by soaking the feet in a warm bath for 20 minutes to soften the nails and skin. A clean, sanitized nail care tool can then be used to carefully lift the ingrown nail out of the skin, and cotton or gauze can be used to elevate the nail and alleviate pressure. An over-the-counter antibiotic ointment can then be applied to keep infection at bay. More severe cases may require a doctor to perform a partial nail avulsion, which involves partially removing the nail after numbing the toe. Recurrent ingrown toenails may require laser or chemical therapy treatments.
Onychogryphosis Treatments
Onychogryphosis, or Ram's Horn Nails, is a condition that causes toenails to thicken and curve downward as they grow, often taking on a yellowish-brown hue. It can be caused by personal care oversights, nail bed hypertrophy, injury to the toenail, poor hygiene, bunions, biomechanical changes in the foot, skin conditions, nail infections, circulatory problems, or neurological conditions. While there is no specific medical treatment for Onychogryphosis, the affected nail can be removed to prevent regrowth.
General Toenail Care
To keep your toenails strong and healthy, it is important to practice good foot hygiene and wear properly fitted footwear. Toenails should be trimmed regularly, and they should be cut straight across to prevent ingrown toenails. A balanced diet rich in essential nutrients like biotin, zinc, and iron can also support nail health.
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