Toenail Conditions

The two most common toenail problems are Ingrown Nails, and Nail Fungus.  Both can cause pain and infections in the toes.

Ingrown Toenail

This most often occurs in the big toes, usually on the side next to the 2nd toe, but can occur in all the toenails.  It may an inherited condition, but can also occur after an injury to the toe or to improper trimming of the nail, or to tight fitting shoes. With trauma, such as dropping a heavy object on the toe or stubbing the toe, the skin alongside the nail can become swollen and put pressure against the side of the nail.  This results in pain and may even cause an infection.  Trauma can also cause the cells at the nail root to grow in an abnormal direction, shape, or thickness.  Wearing shoes that are too short or too narrow can cause undue pressure on the toes and result in a painful ingrown toenail.  Ingrown nails may occur in newborns, but is most common in children and teens.  Many adults have problems for years and often try to “dig” the nail out at home.  This can lead to infections and require medical attention.

Fungal Nails

This problem is caused by a fungus (usually the same type that causes athletes foot in the skin, particularly between the toes) infecting the toenail itself.  It will usually start along one corner as a discoloration.  The color may vary from lighter white or yellow, to black or brown.  The nail will begin to thicken and with time can cause pain from pressure on the toe or from shoe wear.  The nails may become so thick that you may no longer be able to trim them with usual nail clippers or scissors.  Fungus can cause the nail to change shape or turn in on the sides, causing infections like an ingrown toenail.  Some people are more prone to nail fungus for hereditary factors, but anyone can experience it.  There is often a history of injury to the toe causing the nail to fall off or lift away from the underlying nail bed.  This allows the fungus to start growing where there is no longer a natural barrier.  Fungus grows best in a warm, dark, and damp environment – such as shoes.  It is more common as you get older, and is more common in persons with diabetes.