Sophia Delgado
Toenail problems are quite common and can be caused by various factors, including injury, chemotherapy, or even just the shoes you wear. While some issues are harmless, others may indicate a more serious underlying health condition. For example, slow toenail growth can be indicative of vascular issues, peripheral artery disease (PAD), or poor circulation. Changes in colour, such as red or black lines, could be signs of infection or even cancer. Ingrown toenails, which occur when the nail grows into the surrounding skin, are one of the most common and painful toenail problems. To maintain healthy toenails, it's important to practice careful hygiene and toenail trimming techniques. If you notice any concerning changes in your toenails, it's recommended to consult a doctor or dermatologist for professional advice and early intervention.
| Characteristics | Values |
|---|---|
| Toenails grow upward | Vertical nails |
| May indicate a health issue | |
| Tend to rip more often | |
| Treatment | Trim toenails with strong, sharp nail clippers |
| Cut the nail straight across without cutting the edges inward | |
| Leave the nail a little long to prevent it from growing inward | |
| Maintain careful hygiene | |
| Discoloration | Caused by substances you come into contact with, such as nail polish, dye from shoes, drugs, etc. |
| May indicate a serious infection or condition, such as cancer | |
| Slow nail growth | May be caused by fever, injury, chemotherapy, major stress, or aging |
| Could be a sign of an underlying condition, such as peripheral artery disease (PAD) or poor circulation | |
| Washboard nails | Caused by picking or pushing back the cuticles |
| Ingrown toenails | Occur when the nail grows into the skin, causing tenderness, redness, and bleeding |
| Toenail fungus | A slow-growing infection of the nail and skin beneath it |
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What You'll Learn
Toenail not growing at all
Toenails are made of a protein called keratin, which is also found in hair. While toenail growth can slow down as you age, if your toenails have stopped growing altogether, it may be a sign of an underlying condition.
One possible cause of toenails not growing is peripheral artery disease (PAD), a serious vascular condition caused by plaque accumulation in the arteries. This restricts the flow of oxygenated blood to your lower extremities, which can cause leg pain, poor wound healing, and slow toenail growth. PAD can be indicated by cold feet and toes, a tingly or numb sensation, and yellow or brownish toenails. If you suspect you may have PAD, it is important to schedule a screening with a vascular specialist to ensure an accurate, early diagnosis.
Another cause of toenails not growing could be nutritional deficiencies, such as zinc or biotin deficiency. Zinc ions are important for stabilizing proteins, allowing them to hold the correct shapes for the body to use. Biotin, also known as vitamin B7, is involved in converting food into energy and is necessary for the production of fatty acids, sugars, and amino acids. Other nutritional deficiencies that can affect nail growth include folate (vitamin B9) deficiency and deficiencies in protein, iron, vitamins A, C, and D, as well as healthy fats.
In some cases, toenails may stop growing due to repetitive trauma or physical damage to the nail. This can occur from activities such as hiking, playing soccer, or wearing tight-fitting shoes. Constant pressure on the toenail can result in fluid accumulation below the nail, separating it from the root and leading to a new toenail growing underneath. This new nail may take 4-6 months to grow out to the end of the toenail.
It is important to maintain proper toenail hygiene and care, including keeping your toenails trimmed and moisturized. If you notice any changes in your toenails, such as a change in colour, texture, or shape, it is recommended to consult with a dermatologist or healthcare professional to rule out any underlying health issues.
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Toenail discolouration
Injuries can cause toenail discolouration due to a subungual hematoma, which involves blood and fluid collecting under the nail. A red area will appear that may turn purple, brown, or black over time. This can occur from stubbing your toe, wearing tight shoes, or any other activity that causes small blood vessels to break and leak blood under the toenail. Toe injuries can often heal with home treatments such as rest, ice, compression, and elevation. The body will usually absorb the pooled blood over time, and a healthy new toenail will grow out. However, it can take 6 to 9 months for the discoloured nail to completely grow out.
Nail fungus, also called onychomycosis, is one of the most common causes of toenail discolouration. The most common organism to cause toenail fungus is called dermatophyte, but mould or yeast can also infect toenails. Dermatophytes grow by eating your body's keratin. If you have nail fungus, your toenail colour might be yellow, green, blue, purple, or black. Mild fungal infections usually respond well to over-the-counter antifungal treatments or home remedies. Look for something that contains either clotrimazole or terbinafine. If you have a severe fungal infection that's painful or causes your nails to thicken or crumble, it's best to see a professional.
Yellow nail syndrome is a rare condition that causes nails to turn yellow. It typically affects older adults, and there is no known cause or treatment. Toenail discolouration can also be a side effect of certain medications or cosmetic use.
While toenail discolouration is often harmless, it can sometimes indicate a more serious condition such as melanoma, a severe form of skin cancer. If you notice a new or changing dark streak on your toenail, it's important to see a dermatologist for a skin cancer check.
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Toenail trauma
Causes of Toenail Trauma
Another cause of toenail trauma is repetitive strain or microtrauma, often seen in athletes, runners, and hikers. This is known as "runner's toe" and is caused by repeated friction or impact between the nail and footwear. Ill-fitting shoes can also cause toenail trauma and lead to deformities in the nails over time.
Additionally, underlying health conditions can contribute to toenail trauma. For example, poor toenail growth or the absence of growth altogether may indicate moderate to severe Peripheral Arterial Disease (PAD), a vascular condition. Age can also be a factor, as toenails tend to grow more slowly as we get older.
Symptoms and Complications
Prevention and Treatment
To prevent toenail trauma, it is essential to wear properly sized shoes that fit well and provide adequate room in the toe box. Silicone or gel toe caps can also help protect the toenails from trauma and reduce the risk of blisters and irritation.
If you experience toenail trauma, it is important to assess the severity of the injury. Minor injuries can often be managed at home with careful hygiene practices. However, if there is significant bleeding, or if the injury involves the base of the nail, it is important to seek medical attention. Your doctor will examine the injury and determine the best course of action, which may include X-rays or draining the blood under the nail to relieve pressure.
In the case of underlying health conditions causing toenail trauma, it is important to address those conditions with the help of a medical professional. This may involve lifestyle modifications, such as diet changes or increased physical activity, in conjunction with appropriate treatment.
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Ingrown toenails
- Tight or ill-fitting shoes: Shoes that are too tight or too short can cause pressure on the toes, leading the nail to grow into the surrounding tissue.
- Incorrect toenail trimming: Cutting toenails too short, especially on the sides of the big toes, or tapering the corners can cause the nail to curve and grow into the skin.
- Toe trauma: Injuries such as stubbing or banging your toe can lead to ingrown toenails.
- Congenital factors: In some cases, people may be born with nails that are too large for their toes, making them prone to ingrowing.
- Poor blood circulation: This can increase the risk of developing ingrown toenails.
- Nail infections: Pre-existing nail infections can also be a factor.
To prevent and treat ingrown toenails, it is important to practice proper toenail care:
- Trim toenails straight across: Avoid tapering or rounding the corners. Cut the nail straight across without cutting the edges inward, leaving it slightly longer than the edge of the toe.
- Wear comfortable shoes: Choose footwear that provides adequate room for your toes and avoids pinching or placing too much pressure on them.
- Maintain foot hygiene: Keep your feet clean and dry, especially after bathing or swimming, to reduce the risk of infection.
- Seek medical attention: If you experience severe pain, swelling, or signs of infection, consult a healthcare provider or a podiatrist for appropriate treatment.
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Vertical toenails
Toenails that grow upward are commonly referred to as vertical nails. This condition is not uncommon and can be caused by a variety of factors, some simpler than others.
One possible cause of vertical toenails is the shoes you wear. If your shoes are too tight, they may be pushing against your toenails, causing them to grow upward. Another potential cause is profuse foot sweating, which can create an environment that encourages upward nail growth.
In some cases, vertical toenails can be a sign of more complex medical issues. For example, onychogryphosis is a condition that causes thickening of the nails due to injury or infection, often affecting the big toes and resulting in a curved nail that resembles a ram's horn or claw. Nail patella syndrome (NPS) is another rare genetic disorder that can affect toenails, causing nail abnormalities.
While vertical toenails can be a natural growth pattern for some people, it is important to maintain proper toenail hygiene to prevent infections, especially since upward-growing toenails tend to rip more often. Keeping your feet clean and dry, inspecting your toenails regularly, and trimming them straight across with sharp nail clippers can help prevent and manage vertical toenails. If you notice any changes in your toenails, it is recommended to consult a dermatologist or your doctor for further advice and treatment options.
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Frequently asked questions
This could be due to a habit of picking or pushing back your cuticles, also known as onychotillomania. A dermatologist may be able to help you break this habit.
Toenail growth can slow down due to various factors such as age, overall health, and hormones. However, if your toenails have stopped growing completely, it may indicate an underlying condition such as Peripheral Artery Disease (PAD) or poor circulation, and you should consult a doctor.
Upward-growing toenails, also known as vertical nails, are not uncommon. While it may be due to simple causes, it could also indicate a health issue, especially since these nails tend to rip more often, exposing the area to infection.
Discolouration of the nail plates is usually not a cause for concern. It is often caused by substances your nails come into contact with, such as nail polish, dye from shoes, or certain drugs. However, red or black lines on the nails can indicate serious infections or conditions, including cancer.
This condition is known as ingrown toenails, which is one of the most common and painful toenail problems. It occurs when the corner or side of the toenail grows into the flesh, causing tenderness, redness, and bleeding.
