Table of ContentsView AllTable of ContentsIngrown ToenailToenail FungusToenail TraumaClubbed NailsDiscoloration of the Nail PlatesNail-Patella SyndromeLeukonychiaOnycholysisFemale Toenail IssuesWhen to See a DoctorFAQ
Table of ContentsView All
View All
Table of Contents
Ingrown Toenail
Toenail Fungus
Toenail Trauma
Clubbed Nails
Discoloration of the Nail Plates
Nail-Patella Syndrome
Leukonychia
Onycholysis
Female Toenail Issues
When to See a Doctor
FAQ
Your toenails can become irritated for many reasons, like wearing shoes that are too tight, cutting your toenails too short, or even being exposed to high heat and moisture in your environment.
Sometimes, toenail irritation is due to a common toenail problem, such asfungal infections, ingrown toenails, and trauma (injuries). You may notice toenail symptoms such as:
This article provides an overview of the most common toenail problems, as well as their symptoms, causes, andtreatment options. It also includes several toenail problems that are specific to females.
1:59Click Play to Learn More About Damaged Toenails
1:59
Click Play to Learn More About Damaged Toenails
Common Types of Nail Disease: How to Spot and Treat Each
Ilia Anatolev / Getty Images
An ingrown toenail occurs when the edge of the toenail, usually on the big toe, grows into the skin next to it (called the lateral nail fold or medial nail fold).
Ingrown Toenail Symptoms
An ingrown toenail causes pain and swelling at the side of the toe. It may getinfected, which can trigger:
Note that the ingrown part of the nail is usually unseen because it’s below the skin.
Causes of an Ingrown Toenail
Factors that increase your chance of developing an ingrown toenail include:
Ingrown Toenail Causes, Symptoms, Treatment
Treating an Ingrown Toenail at Home
You cantreat most ingrown toenailsat home unless you:
In those cases, you should see a healthcare provider such as apodiatrist(foot specialist).
The first step forat-home careis to soak your foot in an Epsom salt solution using room-temperature water. Then massage the side of your nail gently to decrease inflammation.
Be sure to not cut your toenail. Consider wearing open shoes like sandals until the problem resolves.
In addition, you may have to take a closer look at the fit and shape of your shoes and socks to see if they’re causing the problem. They may be too tight. The health of your feet, not fashion, should guide your shopping.
Medical Treatments for Ingrown Toe Nails
If you have a recurring ingrown toenail, suspect you have an infection, or at-home treatments are unsuccessful, see your healthcare provider or podiatrist for treatment. An infected ingrown toenail will typically clear up withantibiotics.
In some cases, an ingrown toenail may require a simple surgery known as a partial nail avulsion. The simple, in-office procedure removes part of the nail plate.
First, your healthcare provider will inject a local anesthetic into the toe. Once the area is completely numb, the ingrown part of the nail is removed.
Can You Safely Remove Your Ingrown Toenail at Home?
daizuoxin / Getty Images
Toenail fungus, oronychomycosis, is a slow-growing infection of the nail and skin beneath it. Fungal infections usually occur underneath the nail and begin at the tip of the nail, where you trim it.
Toenail Fungus Symptoms
The most common symptoms of toenail fungal infections include:
Less often, an infection can appear as a white, powdery discoloration on top of the nail.
Yellow Nail Syndrome: What to Know
Causes of Fungal Infections
Toenail fungus can affect anyone, but it becomes more prevalent with age, certain diseases (e.g.,diabetes, circulation problems), and asuppressed immune system.
Other risk factors include:
Toenail Fungus and Treatments
Treating Toenail Fungus
Treatment at a foot specialist (podiatrist)’s office will likely involve something calleddebridement(trimming away thickened areas). This can relieve pain from the thick nail pressing against your shoes.
Debridement may also make topical treatments more effective.
You can buy a lot ofover-the-counter (OTC) treatments for toenail fungus. However, since the fungus resides deep in the nail and underneath it, these medications have limited success in treating toenail fungus. This is especially true if it has spread significantly throughout the nail.
Tough ToenailsToenails have to be tough enough to handle stresses like rubbing against shoes and being stubbed. A protein calledkeratinmakes them so strong.
Tough Toenails
Toenails have to be tough enough to handle stresses like rubbing against shoes and being stubbed. A protein calledkeratinmakes them so strong.
Photosvit / Getty Images
Trauma to the toenail can be chronic (long-lasting) or from an acute (short-term) injury.
Toenail Trauma Symptoms
Toenails grow from an area below the skin known as the matrix, which is connected to the blood vessel and nerve-rich nail bed beneath it.
Injury to the matrix can result in a number of possible toenail changes, including bruising beneath the toenail, thickening, and nail loss.
Structure and Growth of Fingernails and Toenails
1:38Click Play to Learn More About Bruised Toenails
1:38
Click Play to Learn More About Bruised Toenails
Causes of Toenail Trauma
Toenail trauma may happen because of repetitive rubbing against a shoe when walking or running. It may be that your new shoes are too tight or loose, which can lead to more friction against your toe.
Trauma can also be the result of a sudden injury, such as stubbing your toe or dropping an object on it.
If trauma makes any part of the nail become loose or separated from the nail bed, it can lead to a secondary bacterial or fungal infection. This can cause dark discoloration of the toenail.
Acute trauma may also result in afracture (break) of the bonebeneath the nail, which is in close proximity.
Loose or Discolored Nails
Treating Toenail Trauma
Depending on the injury, treatment for toenail trauma can include home care or a trip to see a healthcare provider.
For most minor toenail injuries, you can:
For a large tear, trim off the detached part or cover it with an adhesive bandage until it grows out enough to protect the sensitive skin underneath.
See a healthcare provider if you suspect your toenail is infected. Symptoms include:
Sometimes, a healthcare provider will drill a hole in or surgically remove a damaged toenail. This is done to relieve pressure from swelling.
When the new nail grows in, it probably will be thickened or disfigured due to the damaged matrix.
Be especially cautious about toenail injuries if you have diabetes, a weak immune system, orperipheral artery disease. Those conditions can cause reduced sensation in the feet, which means you may not notice an injury or infection. Leaving it untreated can lead to infections and other serious problems.
Foot Care When You Have Diabetes
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet dermnetnz.org 2023
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet dermnetnz.org 2023
Nail clubbingis a condition that can affect the fingers or toes, in which the digits form a bulge at the end and the nail turns downward. Clubbed nails are not a standalone disease, and they are rarely idiopathic (without an underlying cause). Clubbed nails are almost always a sign of an underlying illness.
Clubbed Nails Symptoms
Clubbed nails are typically painless, but can result in the following symptoms:
Clubbed nails may develop slowly, sometimes over the course of years. But they can also develop within a few weeks.
Causes of Clubbed Nails
Other causes of clubbed nails include:
Treating Clubbed Nails
For example, if the underlying condition is lung cancer, treatment may involve surgery, chemotherapy, radiation therapy, or a combination of these treatments. Or, if the cause is celiac disease, the clubbed nails should reverse once agluten-free dietis started.
Discoloration of the nail plates, known asmelanonychia, is the brownish or black discoloration of the nail plate. The condition occurs when pigment cells (melanocytes) deposit brown-colored pigment (melanin) into the nail plate.
Symptoms of Melanonychia
Melanonychia can present in three different ways:
Aside from nail discoloration, melanonychia isn’t associated with other symptoms. However, there may be other symptoms present that are related to the underlying cause.
Causes of Melanonychia
Although melanocytes are normally present in the nail bed, they usually stay dormant unless trauma, infection, or inflammation triggers them to manifest in the nail plate.
Potential causes of melanonychia include:
Treating Melanonychia
There is no specific treatment for melanonychia itself. Treatment depends on the underlying cause, and the discoloration of the nail plate usually resolves once the underlying cause is addressed.
Treatment may involve correcting a nutritional deficiency, resolving an infection with antibiotic or anti-fungal medication, withdrawing from an offending drug, or another condition-dependent treatment.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet and © Raimo Suhonen dermnetnz.org 2023
Reproduced with permission from © DermNet and © Raimo Suhonen dermnetnz.org 2023
Nail-patella syndrome, also called Turner-Kieser syndrome, is a rare genetic disorder that causes changes in the nails, elbows, kneecaps, and hip bones.The disorder affects multiple body systems, placing the affected person at an increased risk of developing numerous chronic conditions, including kidney disease and glaucoma.
Symptoms of Nail-Patella Syndrome
Symptoms of nail-patella syndrome typically appear at birth or in early childhood and may include:
Nail-patella syndrome is a systemic disorder, meaning that it affects multiple body systems. In addition to symptoms affecting the fingers, toes, and nails, people with nail-patella syndrome may have:
Furthermore, people with nail-patella syndrome have an increased risk of developing kidney disease, glaucoma, arthritis, nerve problems, and a number of other issues.
Causes of Nail-Patella Syndrome
This disorder is inherited in an autosomal dominant manner, meaning that a child can be born with it if just one of their parents carries the mutated LMX1B gene.
Treating Nail-Patella Syndrome
There is no cure for nail-patella syndrome. Treatment involves detecting symptoms early and managing them individually.
While people with nail-patella syndrome are able to live a normal lifespan, they will need to be routinely monitored forkidney diseaseand hypertension in order to prevent kidney damage and other potentially life-threatening problems.
Reproduced with permission from © DermNet and © Dr Richard Ashton dermnetnz.org 2023
Leukonychiais a common nail condition in which the nails develop white discoloration. It is linked to a wide array of underlying causes, from simple manicuring habits to congenital conditions and other serious disorders. Most of the time, though, it is not something to be alarmed about.
Symptoms of Leukonychia
The main symptom of leukonychia is white discoloration of the nail, typically presenting as small cloud-like white spots or lines in the nail that may change in number and pattern as the nail grows.
Leukonychia can present in four different ways:
Aside from the white discoloration, leukonychia doesn’t cause other symptoms. In fact, the discoloration is often so minimal that the leukonychia goes unnoticed.
Causes of Leukonychia
The white discoloration in leukonychia occurs when blood vessels under the nail bed become compressed. It is not a standalone condition, but rather a sign that an underlying condition is present.
One of the most frequent causes of leukonychia is the use of irritating nail products, such as nail polish and remover, fake nails, and nail glue.
Other potential causes of leukonychia include:
Treating Leukonychia
Otherwise, treatment depends on the underlying condition. Once that is addressed, leukonychia should resolve on its own.
Onycholysisis a common nail disorder in which the nail plate separates from the nail bed, usually causing white or yellow discoloration at the top of the nail that can progress toward the cuticle.
Symptoms of Onycholysis
The separation of the nail plate from the nail bed typically happens gradually and is painless. As it progresses, the outside edge of the nail becomes discolored with opaque white to yellow or green, and the discoloration can affect the entire length of the nail.
In some cases, the skin beneath the nail can thicken, causing the nail to have a deformed shape or form pits or indentations. Also, the end of the nail may become course or bend over.Onycholysis may also cause throbbing pain.
Causes of Onycholysis
The most common cause of onycholysis is trauma. An acute trauma, such as an object falling on the nail can lead to onycholysis. Chronic trauma, like repeatedly tapping your nails against a hard surface, can also cause it.
Other possible causes of onycholysis include:
Treating Onycholysis
Once a nail detaches from the nail bed, it will not reattach. Onycholysis only goes away once a new nail grows in, which can take four to six months to completely regrow.
If an underlying condition is involved, the nail separation should stop occurring once the underlying condition is addressed. Until then, it can help to trim the nail close to where it separated from the nail bed, and wear comfortable, loose-fitting shoes that do not irritate the affected toe.
What Are the Most Common Toenail Issues Affecting Females?
Some females may be more likely to develop certain nail disorders due to the use of nail cosmetics, complications from nail grooming, and the aging process.
Toenail issues that commonly affect females include:
Females who wear acrylic nails are more prone to developing onycholysis, as the glue used to attach the acrylic nail to the nail plate is stronger than the natural bond between the nail plate and the nail bed. Thus, as the acrylic nail is removed it can easily lift the nail plate from the nail bed along with the acrylic nail.
Furthermore, acrylic nails reduce the nail’s natural ability to evaporate water from the nail. This leads to excessive moisture beneath the nail, which increases the risk of onycholysis. The use of sharp tools to clean beneath the nail plate during the nail grooming process can easily lead to the nail plate’s separation as well.
Brittle Nails
Brittle nailsare a common nail problem in females, particularly over 50 years of age. With brittle nails, the nails cansplit, flake, crumble, become soft, and lose elasticity, increasing the risk of nail infections and inflammatory nail disorders. It can also lead the nail to catch on clothes, bed sheets, and other objects.
The use of harsh nail grooming products, such as nail polish remover, increases the risk of brittle nails.Females who take roles that require them to repeatedly wet and dry their hands, such as homemakers, hairdressers, and nurses, are also more prone to developing brittle nails.
Ingrown Toenails
Females who wear narrow, pointed, or high-heeled shoes are particularly at-risk for ingrown toenails (onychocryptosis) due to the pressure and repeated micro-trauma these shoes place on the toes. The big toe is especially prone to developing an ingrown toenail.
Paronychia
When to See a Healthcare Provider
If you are experiencing an issue with your toenail that continues to worsen despite self-care efforts, give your healthcare provider a call. Depending on the symptoms you describe, your provider may suggest an in-person visit to evaluate your symptoms.
You should also see your healthcare provider for any of the following:
Reach out to your healthcare provider if you have diabetes and are experiencingsigns of infection. If you are experiencing any new or unsettling symptoms, don’t hesitate to contact your healthcare provider.
Summary
Toenail fungus, ingrown toenails, and toenail trauma are three of the most common toenail problems. Each one can be traced to various causes, which in turn leads to varying treatment options.
You may be able to treat your toenail problem at home. However, certain problems warrant medical attention. You may need oral medication or a procedure like a debridement or toenail removal.
Frequently Asked Questions
Some evidence suggests that certain people may have a genetic predisposition to nail fungal infections. Recurrent cases may also occur in people who have weakened immune systems or diabetes, due to compromised blood flow to the feet.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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