Toenail Problems

Toenail problems are actually quite common and treatments are available. If you notice any abnormality in your toenails such that you experience signs of infection, such as redness, severe pain, or drainage of pus, please contact Dr. Neitzel for an evaluation. Your toenails can reveal a lot about your overall health and can provide the first sign of systemic disease.

What are some common toenail problems?

The most common toenail problems include

  • Toenail Fungus 
  • Ingrown Toenail
  • Toenail Trauma
  • Clubbed Nails
  • Thick Toenails

Toenail Fungus

Toenail fungus is a common condition that can affect anyone of any age.  Fungal infections can grow in toenails because they thrive in warm, moist environments.

What are the symptoms of toenail fungus?

You may have toenail fungus if one or more of your toenails become

  • Discolored, usually white or yellow
  • Thickened or misshapen
  • Brittle or crumbly
  • Foul-smelling

Can toenail fungus spread to other toes?

Yes, toenail fungus can spread to other toenails and even spread to the surrounding skin.

What causes toenail fungus?

Toenail fungus  can be caused by

  • Athlete’s foot spreading to the toenail bed
  • Fungal infection on your foot 
  • Weakened immune system
  • Smoking
  • Constricted footwear
  • Walking barefoot where someone else with an infection has walked, such as saunas and locker rooms
  • Wearing the same sweaty shoes and socks every day
  • Working in wet conditions

What is the treatment for toenail fungus?

Toenail fungus can be difficult to treat and may take several months before fungal nail infection goes away. Treatment options may include prescription creams or ointments, oral medications, removal of the toenail to treat the nail bed underneath, or laser therapy.

How can you prevent toenail fungus?

There are several things you can do to prevent toenail fungus including

  • Keeping your feet clean and dry
  • Avoiding walking barefoot in saunas, locker rooms, pools, and public showers
  • Avoid sharing nail clippers
  • Choosing nail salons that are licensed and sterilize their instruments

Patients with diabetes should properly manage their blood sugar levels, as they are at high risk for toenail fungus.

Ingrown Toenail

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toes aren’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress into an infection.

What causes ingrown toenails?

Causes of ingrown toenails include:

Heredity. In many people, the tendency for ingrown toenails is inherited.

Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.

Improper Trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail. Avoid repeated cutting of the nail, as it can cause the condition to worsen over time.

Improperly Sized Footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.

Nail Conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.

When should you see a podiatrist for ingrown toenails?

You should see a podiatrist for ingrown toenails if your symptoms fail to improve, if you suspect you have an infection, or if you have a medical condition that puts your feet at high risks, such as diabetes, nerve damage in the foot, or poor circulation.

What is the treatment for ingrown toenails?

If you have ingrown toenails, Dr. Neitzel will examine the toe and select treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, Dr. Neitzel will remove part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If Dr. Neitzel has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

How can you prevent ingrown toenails?

Many cases of ingrown toenails may be prevented by:

Trimming Nails Properly – Cut toenails in a fairly straight line, and don’t cut them too short. You should be able to get your fingernail under the sides and end of the nail.

Wearing Well-Fitted Shoes – Don’t wear shoes that are short or tight in the toe area. Avoid shoes that are loose, because they too cause pressure on the toes, especially when running or walking briskly.

Toenail Trauma

Trauma to your toenail usually results from some form of injury such as stubbing your toes, dropping something heavy onto your foot, wearing ill-fitting shoes, and picking at your nails. Other traumatic injuries to the toenail may be the result of a poorly done pedicure, or from activities such as running or ballet dancing.

What are the symptoms of toenail trauma?

Any major trauma to the toenail is going to cause some form of pain or throbbing, and perhaps some bleeding or a collection of blood under the toenail. 

Other symptoms may include 

  • Discoloration
  • Thickening of the toenail
  • Nail lifting away from the skin

Some injuries to the toe may even cause a completely or partially separated nail from the nail bed or injury to the underlying bone. 

What is the treatment for toenail trauma?

Typically, the treatment for toenail trauma depends on the type of injury but may include surgery and medication.

Clubbed Toenails

Clubbed toenails refer to changes under and around the toenails that cause the toes to take on a widened, club-like appearance.

What causes clubbed toenails?

Clubbed toenails are often the result of some underlying medical condition, such as heart disease, lung disease, gastrointestinal disorders, and cancer. For some people, it is an inherited trait.

What are the symptoms of clubbed toenails?

Symptoms of clubbed nails may include a

  • WIdening and rounding of the toenails
  • Downward curving of the toenails
  • Pronounced angle between the cuticles and nails
  • Softening of the nail beds
  • Floating appearance of the nails
  • Bulging of the tips of the toes

What is the treatment for clubbed toenails?

Treatment for clubbed nails requires treating the underlying medical condition.

Thick Toenails

There are many causes for thick toenails other than toenail fungus. Thick toenails may also be due to psoriasis or type 1 or 2 diabetes. Sudden or repeated trauma or injury to the toenails due to sports activities (e.g., running, dancing, etc.) can also cause toenails to thicken, as well as ill-fitting shoes.

Psoriasis is an autoimmune disease that causes red, scaly patches on the skin, but it can also cause nail thickness for both the hands and feet. If psoriasis is the cause of your nail thickness, you are likely to develop ridges on the nails, and the nails may loosen and separate from the nail bed.

Additionally, aging can cause your toenails to thicken.

Over time as the toenails get thicker, you might start experiencing some symptoms, such as

  • Nails become brittle and easy to break
  • Nails have a bad odor
  • Nails lift easily from the nail bed
  • Nails become difficult to cut or trim
  • Nails split or crack easily
  • Nails become painful 

As for the appearance, the nails may take on a yellow, green, or brown hue and start looking gnarly or have some scaling on the surface. 

When should you see a doctor for thick toenails?

If thick toenails are left untreated, they can get worse or cause pain. It is, therefore, important to seek medical advice when you notice any discoloration of the nails or thickening. There may be some underlying medical conditions causing these issues that need to be addressed.

What is the treatment for thick toenails?

The treatment for thick toenails usually depends on what is causing the problem. Your doctor will want to look at your medical history and examine your nails to determine the appropriate treatment.

For example, if nail thickening is due to psoriasis, your doctor may prescribe additional medication or recommend topical steroids or injections to help the nails heal.

Contact Us

If you are experiencing any issues with your toenails that appear worrisome to you, don’t hesitate to contact Dr. Neitzel for an evaluation. Give us a call at (360) 286-0404 to schedule an appointment.