Ava Monroe
Toenails that grow weird can be caused by a variety of factors, including injury, infection, or genetics. For example, tight-fitting shoes can cause nail trauma, resulting in pain and possibly leading to permanent damage to the nail bed and abnormal growth. Ingrown toenails are another common issue, causing the nail to expand sideways into the skin and resulting in inflammation, swelling, and tenderness. In some cases, fungal infections may be to blame, leading to thickened, yellowish, inflexible, and crumbly nails. Additionally, accessory nails, or sixth toenails, are a genetic trait observed in people from all ethnicities and can sometimes cause discomfort or pain. Maintaining good foot hygiene and toenail care is important, and in more severe cases, medical or surgical intervention may be required.
| Characteristics | Values |
|---|---|
| Cause | Toenail trauma, fungal infection, accessory nail, genetic disorder, or injury |
| Symptoms | Thickening, yellowing, loss of flexibility, crumbly texture, upward growth, pain, inflammation, swelling, tenderness, splitting, distortion, or protrusion |
| Treatment | Antifungal medication, prescription medication, topical medication, oral medication, toenail removal, matricectomy (surgical or chemical), or aesthetic solutions |
| Prevention | Trimming toenails, wearing well-fitting shoes, cutting toenails straight, avoiding cutting nails when wet, inspecting toenails regularly, cleaning nails, washing and drying feet, moisturizing feet, filing nails, wearing thick socks |
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What You'll Learn
- Toenail trauma from tight-fitting shoes, stubbing your toe, or dropping something heavy on your foot
- Ingrown toenails that expand sideways into the skin, causing pain and inflammation
- Fungal infections that cause thickening, yellowing, and loss of flexibility in the nail
- Genetic factors such as double toenail syndrome or nail patella syndrome
- Foot care practices like trimming nails, washing and moisturising feet, and wearing appropriate socks and shoes
Toenail trauma from tight-fitting shoes, stubbing your toe, or dropping something heavy on your foot
Toenail trauma can be caused by tight-fitting shoes, stubbing your toe, or dropping something heavy on your foot. Repeated trauma to toenails can lead to deformities. Deformities may resemble fungal infections, with thickened or discoloured nails that lift away from the nail bed. Bleeding under the toenail occurs when the toenail repeatedly makes contact with the shoe, causing a shearing force that separates the toenail from the nail bed. This often happens when shoes are too tight or toenails are too long. It can also occur when a heavy object strikes the toenail.
Toenail injuries can be very painful, especially if the toenail breaks deep in the nail plate. Intense pain may worsen over hours or days. If the injury is severe enough to bleed, it may be challenging to walk for several weeks. The toenail may fall off immediately after the injury or weeks later. A subungual hematoma is a spot of blood under the toenail that can cause intense, painful pressure. Hematomas often cause the toenail to fall off and can take six to nine months to disappear.
If the skin is broken, keeping the toe clean and covered is essential to prevent infection. Applying a numbing cream or spray can help with pain management. In the case of severe injury, a doctor may recommend surgery or physical therapy. To prevent toenail trauma, it is important to wear properly sized shoes. Silicone or gel toe caps can also help protect the toenails and prevent toenail loss.
Toenails that grow upward are another possible outcome of toenail trauma. This condition is characterised by thin and fragile nails that look concave or "scooped out." Upward-growing toenails tend to rip more often, increasing the risk of infection. Maintaining good foot and toenail hygiene is crucial. Trimming toenails straight across and leaving them a little long can help prevent the nails from growing inward. Inspecting toenails at least once a week, using a nail cleaner, and washing and drying the feet thoroughly are essential hygiene practices.
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Ingrown toenails that expand sideways into the skin, causing pain and inflammation
An ingrown toenail is a common condition that develops when the corner or side of a toenail grows sideways into the soft skin around the nail bed. This can cause pain, inflammation, swelling, and sometimes infection. Ingrown toenails typically affect the big toe, but they can occur on any toe, including the pinky toe.
There are several factors that can contribute to the development of ingrown toenails. One of the most common causes is cutting the toenails incorrectly, such as cutting them too short or rounding the corners instead of trimming straight across. This can encourage the nail to grow into the surrounding skin. Tight footwear, such as socks, stockings, or shoes that are too tight or narrow, can also increase the risk of ingrown toenails by placing pressure on the toes and directing the nail's growth into the tissue. Additionally, certain nail care habits, such as tapering the corners of the nails during pedicures, can also contribute to the formation of ingrown toenails.
The symptoms of an ingrown toenail include pain, redness, swelling, and tenderness around the affected toe. In some cases, the toenail may pierce the skin, increasing the risk of infection. If left untreated, the condition can worsen, leading to more severe pain and difficulty in walking or performing daily activities.
Home treatments for ingrown toenails include gently lifting the edge of the nail and placing a small piece of cotton or dental floss underneath to separate the nail from the skin. Keeping the toe clean and dry, soaking it in warm water, and using antibiotic cream and pain relievers can also help manage the condition. However, if the pain worsens or signs of infection develop, it is important to seek medical attention.
In more severe cases of ingrown toenails, professional treatment or surgery may be required. Partial nail removal involves numbing the toe and removing the portion of the nail that is growing into the skin, while total nail removal, or matrixectomy, is performed when the ingrown nail is caused by thickening and involves removing the entire nail. These procedures are effective in treating and preventing ingrown toenails, but proper post-operative care, such as keeping the foot raised and wearing special footwear, is crucial for optimal healing.
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Fungal infections that cause thickening, yellowing, and loss of flexibility in the nail
Toenails growing upward could be hereditary or the result of external factors such as ill-fitting shoes or profuse foot sweating. However, it may also be due to medical conditions such as onychogryphosis, a thickening of the nails due to injury or infection.
Fungal infections are a common cause of nail abnormalities, and they can lead to thickening, yellowing, and loss of flexibility in the nail. Here are some key points about fungal infections:
Symptoms
Fungal nail infections usually start mildly and worsen over time. Initially, you may notice a white or yellow spot under your nail, which gradually spreads and can turn the entire nail white, yellow, green, or black. The nail may thicken and become challenging to trim. It may also start to curl, loosen from the nail bed, or become brittle and crumble. In some cases, the infection may cause a bad smell or pain when pressure is applied to the area, making it difficult to walk.
Causes
Fungal nail infections are caused by fungi that thrive in dark, warm, and moist environments, such as the feet. The fungus enters through a crack in the nail or the surrounding skin and multiplies. Walking barefoot in places like communal showers, swimming pools, and locker rooms can increase the risk of contracting a fungal nail infection, as these are environments where fungi spread easily.
Treatment
Fungal nail infections typically require treatment and are unlikely to resolve without intervention. While treatments are effective, they can take a long time and may cause side effects. Antifungal medications, either applied topically or taken orally, are commonly used to treat fungal nail infections. In severe cases, a doctor may recommend removing the nail to allow a new, healthy nail to grow.
Prevention
To prevent fungal nail infections, it is important to maintain good foot and toenail hygiene. Keep your feet clean and dry, and wear shoes in communal areas to reduce the risk of contracting or spreading the infection.
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Genetic factors such as double toenail syndrome or nail patella syndrome
Unusual nail growth, such as toenails growing upward, could be due to genetic factors. One such genetic factor is nail patella syndrome (NPS), a rare multisystemic disease with a classic clinical tetrad of fingernail dysplasia, hypoplasia or absence of the patella, presence of iliac horns, and elbow deformities. It occurs in about 1 in 50,000 people and is caused by mutations in the LMX1B gene, which provides instructions for producing a protein that attaches to specific regions of DNA and regulates the activity of other genes. NPS is inherited in an autosomal dominant pattern, meaning that only one copy of the altered gene in each cell is needed to cause the disorder.
Nail abnormalities are seen in almost all individuals with NPS, with fingernails being more commonly affected than toenails, and thumbnails usually showing the most severe symptoms. The nails may be absent, underdeveloped, discoloured, split, ridged, or pitted, and the areas at the base of the nails (lunulae) may be triangular instead of the usual crescent shape. In addition to nail abnormalities, individuals with NPS often have skeletal abnormalities involving the knees, elbows, and hips, and are prone to developing kidney disease and increased pressure within the eyes (glaucoma) at an early age.
Another genetic factor that may contribute to unusual pinky toenail growth is double toenail syndrome, also known as the accessory nail of the fifth toe or petaloid toenail. This condition is characterised by the presence of a minuscule sixth toenail in the outer corner of the smallest toe, protruding outwards and averaging 2-7 mm in length. It is considered common but underreported, with a prevalence of 51-79% in certain parts of China. The additional nail can cause discomfort or pain, particularly when it protrudes vertically from the nail bed, and can be treated with surgical or chemical matricectomy or segmental excision.
In summary, genetic factors such as nail patella syndrome and double toenail syndrome can contribute to unusual pinky toenail growth. NPS is a rare genetic disorder characterised by nail abnormalities and skeletal issues, while double toenail syndrome is a common but underreported condition characterised by the presence of an additional toenail on the smallest toe, which can cause discomfort or pain.
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Foot care practices like trimming nails, washing and moisturising feet, and wearing appropriate socks and shoes
Toenails that grow upward are often due to the natural growth pattern of the nail. However, there are several other factors that can cause this, including ill-fitting shoes, profuse foot sweat, and more complex medical conditions. To address this issue and practice good foot care, it is important to incorporate the following practices into your routine:
Trimming Nails
Toenails should be trimmed regularly and properly. Use a strong, sharp nail clipper to cut each toenail straight across, following the natural curve of the nail. Avoid cutting the nails too short or inward to prevent ingrown toenails. It is also important to leave a small amount of nail protruding from the edge of the toe to prevent the nail from growing inward. Additionally, inspect your toenails at least once a week for any dirt or debris, and use a nail cleaner to carefully remove any buildup.
Washing and Moisturising Feet
Wash your feet daily with warm water and antibacterial soap, ensuring that you clean between your toes. Dry your feet thoroughly after washing, as damp feet can lead to fungal infections such as athlete's foot. Moisturise your feet regularly, especially if you have dry skin, to maintain skin health and prevent cracking.
Wearing Appropriate Socks and Shoes
Choose socks that are clean, absorbent, and made from breathable materials such as cotton or wool. Moisture-wicking socks are also recommended to help keep your feet dry and prevent fungal infections. Change your socks daily or more frequently if you experience excessive sweating. Regarding shoes, select well-fitting, protective footwear made from breathable materials like leather, canvas, or mesh. Avoid wearing nylon or plastic shoes, as these materials can trap moisture and promote the growth of fungi. It is also important to rotate your shoes, allowing them to air out for at least 24 hours between wears, to prevent the buildup of bacteria and fungi.
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Frequently asked questions
Toenails that grow upwards could be due to genetics, shoes that are too tight, or profuse foot sweating. In some cases, it could be indicative of a more complex medical issue such as onychogryphosis or nail patella syndrome (NPS).
Pinky toenails are prone to nail trauma due to their small size. This can be caused by tight-fitting shoes, stubbing your toe, dropping something heavy on your toes, or accidents. Nail trauma can cause the nail to turn black and fall off, and in severe cases, can result in permanent damage to the nail bed and abnormal nail growth.
Yes, fungal infections are a common cause of unusual-looking toenails. They are characterised by thicker nails that take on a yellowish appearance, lose their flexibility, and become crumbly. Fungal infections can be treated with over-the-counter remedies, or more intensive treatments like laser therapy or permanent nail removal.
Yes, subungual melanoma can occur under the nail plate, causing dark discolouration that does not grow out with the nail. Other nail tumours can also grow beneath the nail plate, and it is important to consult a doctor or podiatrist if you notice any unusual growths or lumps.
