Isla Bennett
The accessory nail of the fifth toe, also known as a double nail of the fifth toe (DNFT) or a petaloid toenail, is a physical trait where a minuscule sixth toenail is present in the outer corner of the nail bed of the smallest toe. This condition is an inherited, genetic trait and is observed in people from all ethnicities and races, with a prevalence of 51-79% in certain parts of China. While the accessory nail typically does not cause pain or require treatment, it can sometimes lead to discomfort, especially when it protrudes vertically. In such cases, surgical or chemical matricectomy may be considered.
| Characteristics | Values |
|---|---|
| Name | Accessory nail of the fifth toe, double nail of the fifth toe (DNFT), petaloid toenail, accessory nail, double toenail |
| Description | A minuscule sixth toenail is present in the outer corner of the nail situated on the smallest toe |
| Size | 2-7 mm |
| Treatment | Surgical or chemical matricectomy (complete removal or destruction of the nail matrix) |
| Occurrence | Common but underreported |
| Cause | Genetic, possibly a mild form of hexadactyly |
| Prevalence | Equally common in all ethnicities, races, and genders. Prevalence in certain parts of China is between 51% and 79% |
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What You'll Learn
Pinky toes are an inherited trait
The accessory nail of the fifth toe, or double toenail, is an inherited, genetic trait. It is a physical trait of the small toe, where a minuscule sixth toenail is present in the outer corner of the nail. This additional nail is typically 2-7mm in length and can be observed on one or both feet. The condition is equally common in all ethnicities and races and is observed in both males and females.
Double toenails are most likely the initial form of hexadactyly, a condition characterised by an extra finger or toe. It is a recessive feature, so it may skip a few generations. While hexadactyly is the most common hereditary limb anomaly, it is still a rare condition. It is caused by defects in the anterior-posterior patterning of limb development, with at least 10 loci and six genes identified as causing non-syndromic polydactyly.
The growth of nails is influenced by genetics, with the strength, thickness, and speed of nail growth being hereditary. Unusual nail growth, such as toenails growing upward, could also be inherited. This upward growth could be the natural growth pattern of the toenail, or it could be caused by external factors such as footwear or foot sweat. In some cases, toenails growing upward could indicate more complex medical issues, such as onychogryphosis or nail patella syndrome.
While most people with double toenails do not seek treatment, the condition can sometimes cause discomfort or pain, particularly when the accessory nail protrudes from the nail bed. Treatment options include surgical or chemical matricectomy, which involves the complete removal or destruction of the nail matrix. However, it is important to note that ripping out the extra toenail at home is not recommended as it will not work, and it increases the risk of fungal infections.
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Accessory nails are common but underreported
The accessory nail of the fifth toe, also known as a double nail of the fifth toe (DNFT) or a petaloid toenail, is a physical trait where a minuscule sixth toenail is present in the outer corner of the nail on the smallest toe. This additional nail, which can be cut with a nail clipper, averages 2–7 mm in length. The entire nail of the small toe is usually short and wide, and both nails often share the same nail bed.
Accessory toenails are observed in people from all ethnicities and races and are equally common in males and females. They are, however, stereotypically endemic to the Han Chinese, with a prevalence in certain parts of China of between 51% and 79%. Chinese mythology attributes this prevalence to a story about the descendants of the Yellow Emperor and the nomadic Qiang people.
The accessory nail is an inherited, genetic trait and is typically a mild and recessive form of hexadactyly (a sixth finger or toe). It may skip a few generations, and in some cases, may be caused by trauma to the toenail. While it usually does not cause pain or interfere with everyday activities, the condition can sometimes lead to discomfort or pain, particularly when the accessory nail protrudes vertically from the nail bed.
Although accessory nails are common, they are underreported and understudied. This may be because most people do not seek treatment, and the nails can simply be cut with clippers. However, for those who do choose treatment, options include surgical or chemical matricectomy, which involves the complete removal or destruction of the nail matrix.
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Toenails can grow vertically
The accessory nail of the fifth toe, or double toenail, is a physical trait where a minuscule sixth toenail is present in the outer corner of the nail bed of the smallest toe. This condition is an inherited, genetic trait and is observed in people from all ethnicities and races. It is also equally common in males and females. The additional nail can be cut with a nail clipper, but it will continue to grow back.
Retronychia is another condition that can cause toenails to grow vertically. It occurs when the nail plate grows into the nail fold, causing the growth of new connective tissue and the nail to be pushed upwards. This condition is often caused by repetitive injury to the nail, such as wearing tight shoes or participating in activities that lead to toenail injury.
To prevent toenails from growing vertically or getting worse, it is important to keep your feet clean and dry and to trim your nails frequently. It is also recommended to cut each toenail straight across without cutting the edges inward and to leave the nail a little long to prevent it from growing inward. Inspecting your toenails at least once a week, using a nail cleaner to remove dirt, and moisturising your feet and nails after washing them are also good practices for maintaining good foot and toenail hygiene.
If your toenails are growing vertically and causing discomfort or pain, it is advisable to see a doctor or a professional podiatric surgeon for treatment options.
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Treatment options for accessory nails
Accessory nails, or double toenails, are usually painless and harmless. However, if they are causing discomfort or affecting your quality of life, there are several treatment options available.
Firstly, it is important to note that accessory nails can be safely trimmed with nail clippers, just like regular toenails. This can help to keep them neat and reduce snagging. Following this, a nail file can be used to smooth down the nail. Additionally, keeping the surrounding skin moisturized can improve the appearance of the nails and reduce snagging.
In some cases, accessory nails may require more invasive treatments. If the nail is constantly catching on clothing or socks, causing it to rip or tear, it may be advisable to consider podiatric surgery. This is especially important as the open wound created by a torn nail can be a breeding ground for bacteria and fungi, leading to potential infections. One surgical option is a matricectomy, also known as nail matrix phenolization, which involves the partial or complete removal or destruction of the nail matrix to prevent regrowth. This procedure can be performed surgically or chemically and is usually conducted under local anesthesia. Alternatively, excision, or total nail removal, can be considered. In some cases, lasers may also be used for removal.
It is important to consult a medical professional, such as a podiatric surgeon or chiropodist, to determine the most appropriate treatment option for your specific case. They can help diagnose any symptoms and provide safe and effective treatment plans.
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Toenail hygiene tips
The accessory nail of the fifth toe, or pinky toe, is a physical trait where a minuscule sixth toenail is present in the outer corner of the nail. This additional nail is often referred to as a double toenail and is an inherited, genetic trait. While it is a common condition, it is understudied and underreported.
To maintain overall toenail hygiene and health, the following tips can be implemented:
- Toenails should be cut straight across, avoiding cutting them too short or inward to prevent ingrown toenails. Leaving the nail a little long can be beneficial. It is recommended to cut nails when they are dry as they are less prone to cracking.
- Inspect your toenails at least once a week. Use a nail cleaner to carefully remove any dirt accumulated under the nails.
- Wash your feet regularly with soap and warm water, paying extra attention to the spaces between the toes. Ensure that you dry your feet thoroughly afterward, especially in the areas between the toes.
- Moisturize your feet with a foot cream or lotion after washing them. This helps to keep the skin soft and supple.
- Use an emery board to file your nails and ensure they are smooth. This prevents them from catching on socks or other fabrics.
- Wear properly fitting shoes to maintain good nail health and prevent friction and rubbing, which can lead to ingrown toenails and encourage fungal growth.
- Opt for socks made from natural, moisture-wicking materials such as wool or bamboo. These materials draw moisture away from the skin, creating an environment that discourages fungal growth.
- Avoid wearing damp socks as they provide an ideal environment for fungi to thrive. Change your socks frequently, especially if you tend to sweat a lot.
- Expose your feet to fresh air and sunlight. Removing your shoes while seated or spending time in the sun can help prevent moisture buildup and provide your toenails with breathing space.
- Visit a podiatrist for regular check-ups and advice on maintaining healthy toenails and addressing any specific concerns.
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Frequently asked questions
In podiatry, an extra nail on the pinky toe is called an "accessory nail" or a "double toenail".
The accessory nail is an inherited, genetic trait. It is believed to be a mild form of hexadactyly (a sixth finger or toe). According to Chinese mythology, the descendants of a Qiang woman who was abducted by the Henan people were born with double nails on their small toes.
Accessory toenails are observed in people from all ethnicities and races, and they are equally common in males and females. Studies suggest their prevalence in certain parts of China is between 51% and 79%.
While most people do not seek treatment as the accessory nail typically does not cause pain, it can sometimes cause discomfort or pain. Treatment options include surgical or chemical matricectomy, which involves the complete removal or destruction of the nail matrix. However, it is important to refrain from attempting to remove the extra nail with tweezers as this can lead to fungal infections and unnecessary pain.
