Why Do I Have Toenail Problems & How Do I Treat It?

Overview of toenail problems

Your toenails aren’t just there for the fun of it. They serve a purpose, and that’s to protect your toes. Toenails are made from keratin. Keratin is a protein substance that makes up your hair, skin, and fingernails. Keratin is responsible for the resilience and toughness of these body parts.

Your toenails may be affected by your level of physical activity, the friction that you subject them to when you wear shoes, heat, and moisture. Some health conditions can also affect the health of your toenails.

Itching, discoloration, and pain, are some symptoms of toenail problems.

Causes and symptoms of toenail problems

Many toenail problems can cause a range of symptoms from pain to changes in the appearance of the nail.

Let’s examine some of the common toenail problems, their causes, and how we can identify them.

Toenail fungus

Nail fungus is a common condition. It is also known as onychomycosis. Studies have shown that up to ten percent of people have this condition. The risk of having toenail fungus increases as a person gets older. Half of the people over the age of 70 develop toenail fungus.

The first symptom may be a yellow or white spot under your toenail tip. As the fungus penetrates your nail, the toenail gets discolored and also thickens.

The edge of your toenail may also get jagged and crumble, and then spread to other nails. The surrounding skin may also get affected.

Causes of toenail fungus include a foot fungal infection, walking barefoot on a location where someone else with an infection had, like locker rooms or saunas.

Fungi grow well in damp and dark environments, so, the risk is high for people with wet feet (people whose feet are wet for long periods). This happens when we wear sweaty boots or shoes daily, or when we work in wet conditions.

The risk of this toenail problem is also high for diabetic patients.

Symptoms of toenail fungus include:

• A discolored toenail, usually yellow or white
• Thickened toenails
• Toenails are misshapen
• Crumbly or brittle toenails
• Foul-smelling toenails

Ingrown toenail

They are a very common condition. Ingrown toenails are also very painful. A person is diagnosed with ingrown toenail when a side or corner of their toenail grows into the flesh.

Ingrown toenails may be caused by:

• Cutting your toenails too short
• Making a curved cut on your toenails instead of cutting straight across
• Injury to the toenails
• Having unusually curved or large toenails

Symptoms of an ingrown toenail include:

• Pain and redness along the side of the nail
• Swelling around the toenail
• Drainage of pus from the toenail

Toenail trauma

Many factors may contribute to toenail trauma. These include:

• Picking at nails
• Stubbing your toe
• Wearing shoes that don’t fit (very tight shoes)
• Hitting your foot on something heavy

Some activities like ballet dancing or running can also traumatize your toenail, just as a badly done pedicure.

When you injure your toenail, blood collects under it, a condition known as subungual hematoma. Other forms of damage include complete nail separation, partial separation of the toenail, or injury to the underlying bone.

Symptoms include:

• Throbbing or pain
• Torn or split nail
• Dark purple or a red spot under the nail
• Bleeding
• Discoloration
• Lifting of the nail away from the skin

Clubbed nails

These are changes around or under the toenails that create a widened or club-like appearance on your toes.

Clubbing is most often caused by an underlying medical condition, such it is usually caused by an underlying condition, including cancer, gastrointestinal disorders, lung disease, and heart disease. It may also be hereditary in some people.

Clubbing of the nails develops gradually, sometimes taking weeks, or even years, depending on the underlying cause.

Symptoms of clubbed nails include:

• Rounding and widening of the toenails
• Toenails curve downwards
• Angles between the cuticles and nails are more pronounced
• Nailbeds are softened
• Floating nails
• Tips of the toes bulge

Discoloration of the nail plates

Most people are not worried about their discolored toenails. It is worth noting that discolored toenails are the least worrisome of toenail problems.

The color of your toenails is susceptible to changes from the substances they make contact with. Shoe dyes, nail polish, and other products that contain dye can cause a strain on your nails.

Cancer medications, antibiotics, drugs used in the treatment of autoimmune disorders, among others, may cause discoloration of your toenail plates.

Discoloration doesn’t cause any pain and usually improves or even stops completely when you stop taking the medication that’s causing it.

It is worth noting that there is a medical condition that causes the complete whitening of your nail plates.

The only symptoms of discolored nails plates are the discoloration of the nail plates.

Nail-patella syndrome

It is a rare condition affecting at least 1 in 50,000 people. It causes changes in the kneecaps, nails, elbows, and hip bone. The major symptom of Nail-patella syndrome is missing or underdeveloped toe and fingernails. The main cause is a genetic mutation.

Symptoms include:

• Poorly developed toenails or fingernails
• Missing toenails or fingernails
• Discolored nails
• Split or ridged toenails or fingernails
• Small, missing, or deformed kneecaps
• Pains in the elbow and knee
• Deformed or underdeveloped elbows
• Iliac horns (bony growths on the hip bones).

Leukonychia  

This condition describes a whitening of the nail plates. It is divided into two, based on the extent to which the teeth whitens:

• Leukonychia striate – white streaks on the nail
• Leukonychia partialis – partial whitening of the nail
• Leukonychia totalis – total whitening of the nail

White streaks on the nails are caused by problems with keratin production on the nails. Whitening may be caused by injury to the nails or some underlying medical conditions.

Leukonychia may also be caused by inherited gene mutations, chemotherapy, and metal poisoning. Sometimes, the underlying cause may not be known.

Symptoms include:

• Partial and complete whitening of the nails
• White streaks on the nails

The presence of black or redlines on the nails may indicate serious infections and medical conditions, such as cancer. Consult your doctor the moment you notice these changes.

How are toenail problems treated?

The treatment of toenail problems depends on the condition and the cause.

Treatment of toenail fungus

Treatment of fungal infections may be very difficult in some cases. There’s usually a need for prescription of antifungal pills. Sometimes, the affected nail may have to be removed.

A fungal nail infection takes several months to resolve. You may prevent fungal toenail problems by:

• Ensuring that your feet and are clean and dry at all times.
• Not walking barefoot in pools, showers, or locker rooms.
• Avoid sharing nail clippers
• Choose licensed saloons, and ensure that their instruments are sterilized before use.
• Manage your blood sugar levels properly if you are diabetic.

Treatment for ingrown toenail

Your doctor may have to lift the nail or carry out a partial/complete removal of the nail, although this depends on the severity of your symptoms. You could also prevent an ingrown toenail by wearing shoes that fit properly and trimming your nails straight across.

Toenail trauma treatment

It depends on the trauma (the type), and the extent of the injury. It may be treated with medication or surgery.

Other toenail problems, such as leukonychia or clubbed nails may be resolved by treating the underlying condition.

See your doctor if…

You notice abnormal changes or signs of infection on your toenails, like pus draining, redness, or severe pain. If you have black or red lines down your nails, you should also see your doctor.

Final words

Daily, your toenails are subjected to wear and tear, making it a common problem. Caring for your toenails with excellent hygiene and good-fitting footwear can keep your nails healthy and strong.