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April 10, 2025
Curved toenails can indicate various underlying toenail conditions, each with unique causes and additional characteristics. They also don’t always look the same. Toenail curvature issues can range from having a severe Ram’s Horn toenail, accompanied by other symptoms like thickening and discoloration, or small pincer nails that pierce your skin. Let’s learn about curved toenail causes, and most importantly, how a chiropodist or podiatrist can treat curved toenails at a foot clinic so complications don’t arise.
Why Do Toenails Curve?
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To understand the best ways of preventing curved toenails, it’s important to learn how healthy toenails grow. They should naturally grow forward in a slightly arched but mostly flat shape, following the contour of the toe. This process begins in the nail matrix, the tissue under the skin at the base of the nail, where specialized cells produce layers of keratin—the protein that makes up the nail.
As new cells form, older cells are pushed outward, harden, and form the visible nail plate. Ideally, the nail grows evenly and straight across, guided by both the shape of the matrix and the direction of mechanical forces applied to the toe, like walking or wearing shoes. The nail bed beneath provides support and helps keep the nail anchored and flat as it grows. A balance between nail thickness, width, and surrounding skin tension is key to maintaining this typical shape.
Toenails start to curve when something disrupts this balance.
Repetitive Trauma from Ill-Fitting Footwear
One common reason is uneven pressure and toe crowding. Tight footwear or repetitive trauma can push the nail’s edges downward or inward over time. That’s why one of the best ways of preventing curved toenails, or virtually all foot conditions for that matter, is purchasing and wearing only shoes that fit properly, allow your toes to splay comfortably, and have ample cushioning, arch support and shock absorption. It’s better to have a small selection of solid, high-quality shoes that support foot health than several pairs of low-quality, poorly designed shoes that cramp your toes.
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Genetics
Genetics also play a role in abnormal toenail growth; some people naturally have a more curved nail matrix or a narrower nail bed, both of which can encourage curling. If keratin production is uneven—say, one side of the nail grows faster than the other—the nail can begin to twist or curve as it extends.
Underlying Health Conditions
Inflammatory conditions, infections, poor circulation, or chronic diseases like diabetes can also interfere with normal nail growth by altering cell turnover in the matrix or causing changes to the skin and tissue around the nail. As a result, curved toenails are often not just a cosmetic issue—they can signal deeper structural or health-related concerns.
Curved Toenail Causes
Whether your curled toenails are the result of a sinister condition or simply a genetic growth pattern you’ve inherited, preventing them from getting worse is key. No matter the cause, proper trimming (straight across with simple nail clippers) and wearing shoes that fit well are two of the best things you can do from home to prevent painful complications and live life as comfortably as possible. Below you’ll find some of the most common causes of curved toenails:
Ingrown Toenails (Onychocryptosis)
Ingrown toenails are tricky as they look deceptively mild. But complications, like painful infections, can arise if you ignore them. They develop when the edge of a curved toenail grows into the surrounding skin, causing swelling, redness, and sensitivity. They can look curved, but they also look like a small “extra nail” on the edge of the main nail. It most commonly affects the big toe, and naturally curved toenails (involuted nails) are more likely to become ingrown because their growth pattern is already unusual.
Trimming the nails too short or rounding the edges can also encourage the skin to fold over the nail edge, allowing it to grow inward instead of outward. Repeated pressure or trauma from sports, stubbing the toe, or restrictive footwear (in the toe box, like narrow, pointed high heels) can also disrupt normal growth and set the stage for an ingrown nail to form.
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Pincer Nails (Trumpet Nails)
Classified by podiatrists and chiropodists as “the most painful type of ingrown toenail,” pincer nails, or trumpet nails, occur when the sides of the toenail curve inward toward each other, sometimes so dramatically that the edges look like they want to meet underneath the toe!
This shape creates a pinching effect on the nail bed and surrounding tissue. While some people are born with a naturally curved nail structure that gradually tightens over time, others develop this condition due to external pressures. Long-term use of tight shoes, particularly those with narrow toe boxes, is a major contributing factor. Certain systemic conditions, such as autoimmune disorders or circulatory problems, may also affect the nail matrix and contribute to this unusual curvature. Additionally, aging can play a role, as nail shape and growth patterns tend to change over time.
Onychogryphosis (Ram’s Horn Nails)
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Onychogryphosis is a condition where the toenail becomes dramatically thickened and begins to grow in a distorted, curved, or spiraled shape that resembles a ram’s horn. It often affects the big toe and progresses gradually over time. The nail’s irregular growth is usually the result of uneven cell production in the nail matrix, where one side grows faster than the other.
The most common causes include repetitive trauma (like years of wearing ill-fitted shoes), long-standing fungal infections, or neglect of nail trimming. It’s more frequently seen in older adults or individuals with limited mobility who may struggle with basic foot care. Certain systemic conditions, including psoriasis and vascular disorders, may also interfere with healthy nail growth and lead to this thickened, curved form.
Curved Toenail Pain Relief and Solutions: Nail Disorder Treatment
Toenail curvature can cause pain and nagging discomfort that disrupts your daily life. Remember, the nail should not be growing this way, and it’s up to you to take the first step towards finding a solution. Chiropodists and podiatrists offer several effective treatments to address curved toenails, tailored to the severity and underlying causes. Below are some common treatments available at foot clinics:
Proper Fitting Footwear
Wearing shoes that are the correct length 0with a wide toe box is crucial for preventing and alleviating discomfort associated with curved toenails. Footwear that allows ample space for the toes reduces pressure on the toenails, minimizing the risk of them growing into the surrounding skin. Properly fitting shoes not only aid in preventing the development or worsening of curved toenails, but also provide some pain relief for existing conditions that need accommodation. Ensuring that shoes complement the natural shape of the foot without squeezing or compressing the toes is a simple yet effective measure in maintaining toenail health.
Medical Pedicures
Medical pedicures are performed by trained chiropodists or podiatrists and focus on the health and hygiene of the feet and nails. Unlike cosmetic pedicures, these procedures address underlying issues and focus more on nail maintenance and health than aesthetic appearances (although the nails always look clean and fresh afterwards!). During a medical pedicure, the specialist will carefully trim and reshape the toenails using sterilized instruments, reducing the risk of further complications.
They are a common treatment for people with diabetes who cannot cut and clean their nails properly without assistance, and who need an extra set of eyes and expertise to spot abnormalities.
OnyFix Nail Correction System
The OnyFix system is a non-invasive, highly innovative, and pain-free treatment designed to correct curved toenails—especially ingrown toenails. It involves applying a specialized composite material to the nail, which hardens and acts as a brace, guiding the nail to grow in its natural shape without exerting direct force. This method is suitable for various nail shapes and is particularly beneficial for patients seeking an alternative to surgical interventions. The Onyfix system allows individuals to continue their daily activities without restrictions, including swimming and wearing nail polish.
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Nail Avulsion Surgery
In severe cases, such as with ram's horn toenail, surgical intervention may be recommended. This procedure involves the partial or complete removal of the affected toenail under local anesthesia. By removing the deformed nail, the underlying tissue can heal properly, and a healthier nail may regrow. Alternatively, a solution called phenol may be used to prevent nail regrowth.
April 3, 2025
Healthy toenails need healthy circulation, but when blood flow is compromised, they can become brittle, discoloured, or grow slowly. Additional toenail conditions can also develop. Poor circulation and toenail problems are closely linked, especially for those with health problems like diabetes or peripheral artery disease. Understanding why poor blood flow affects toenails can help you take the right steps to protect your foot health and prevent complications.
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The Importance of Blood Circulation
In order to understand the link between poor circulation and toenail issues, we have to start by understanding what blood flow is and what it does. The circulatory system, comprising the heart, blood vessels, and blood, serves as the body's transportation network. Its primary function is to deliver oxygen and essential nutrients to cells while removing waste products like carbon dioxide.
The heart pumps oxygen-rich blood through arteries, which branch into smaller arterioles and capillaries, reaching every tissue and organ. This process ensures that each cell receives the necessary components for energy production, growth, and repair.
Efficient blood circulation is vital for overall health. Oxygen transported by red blood cells is crucial for cellular respiration, the process by which cells generate energy. Nutrients absorbed from digested food are distributed via the bloodstream to support various bodily functions.
Key nutrients delivered by the bloodstream include:
Glucose: A simple sugar derived from carbohydrates in our diet, glucose serves as the primary energy source for cells, fueling various physiological processes.
Amino Acids: These are the building blocks of proteins, obtained from the digestion of dietary proteins. Amino acids are crucial for tissue growth, repair, and the synthesis of enzymes and hormones.
Fatty Acids and Lipids: Essential components of cell membranes and energy storage molecules, fatty acids and lipids are transported to cells for incorporation into cellular structures and for energy production.
Vitamins and Minerals: These micronutrients support a range of cellular functions, including maintaining bone health and facilitating nerve transmission.
Hormones: Although not nutrients in the traditional sense, hormones are vital signaling molecules transported by the circulatory system to regulate various physiological activities, such as metabolism, growth, and mood.
Impaired circulation can slow down healing processes—even for seemingly innocent and minor problems like cuts and scrapes. Likewise, organs and tissues deprived of adequate circulation can suffer damage over time, increasing the risk of conditions such as peripheral artery disease, stroke, and heart attacks.
Toenail Health and Circulation: The Connection
The circulatory system delivers oxygen and essential nutrients to the nail beds, supporting the growth and maintenance of strong, clear nails. When blood flow is compromised, the nails may not receive adequate nourishment, leading to various issues such as brittleness, discoloration, and slowed growth. In some cases, poor circulation can cause nails to develop ridges, indicating underlying vascular problems.
Reduced blood flow can also increase the risk of infections like toenail fungus (onychomycosis). A weakened circulatory system impairs the body's ability to combat pathogens, making the toenail environment more susceptible to fungal overgrowth. This often results in yellowed, thickened nails that you can’t treat without the help of a chiropodist or podiatrist. They must remove the infected portion of the nail so they can apply the correct medicine.
Poor blood flow on its own may not cause a problem with your foot health, but it can contribute to the following toenail conditions:
Slow or halted nail growth: Inadequate blood flow deprives the nail matrix of essential nutrients and oxygen, resulting in reduced or ceased toenail growth. This can be very frustrating if your toenail falls off or cracks and you’re waiting for it to grow back, leaving your feet vulnerable.
Brittle and discolored nails: Insufficient circulation can cause nails to become brittle and change color, often appearing yellowed or darkened.
Thickened nails: Poor blood flow may contribute to the thickening of toenails, often via toenail fungus, making them difficult to trim and maintain. Poor blood flow also affects the nail growth process, which can cause nail cells to pile on top of each other and lead to thicker toenails.
Ingrown toenails: While not directly caused by poor circulation, individuals with compromised blood flow, such as those with diabetes, are at higher risk for complications from ingrown toenails, including infections and delayed healing.
Diabetes, Toenail Health and Circulation
Diabetes can lead to two significant complications affecting foot health: diabetic neuropathy and peripheral artery disease (PAD). Diabetic neuropathy results from prolonged high blood sugar levels damaging the nerves, particularly in the legs and feet, causing numbness, tingling, or a loss of sensation.
This diminished sensitivity means that innocent injuries, such as cuts or blisters, may go unnoticed, increasing the risk of infections and complications like ulcers, or in severe cases, life threatening problems like gangrene, which require amputation. This is also the case for seemingly minor problems with the toenails. Simultaneously, PAD causes blood vessels to narrow and harden, reducing blood flow to the extremities. This impaired circulation hampers the delivery of oxygen and essential nutrients needed for healing, making the feet and toenails even more susceptible.
Regular foot inspections and nail care with a chiropodist or podiatrist, maintaining proper hygiene, and promptly addressing any abnormalities are crucial steps for diabetics to prevent toenail-related complications stemming from poor blood flow.
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Foot and Nail Care for Poor Circulation
Maintaining proper foot and nail care is essential for individuals experiencing poor circulation, as reduced blood flow can lead to various complications. Here are some recommended practices and treatments:
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Regular Exercise: Maintaining good circulatory health through regular exercise, a balanced diet, and avoiding smoking is essential for ensuring that the body's systems function as well as possible. One of the best circulation maintenance tips for foot health is working the muscles in the lower extremities. Exercises like toe splays, toe flexes and raises, massage ball rolls, pen pick-ups and seated toe pulls can work wonders. Click here to learn the five best foot exercises to improve blood circulation. They’re particularly helpful in the winter, but are useful all year round.
Regular Self Inspections: Conduct daily checks for cuts, sores, or changes in nail color and texture to detect issues early.
Moisturizing: Keep feet hydrated to prevent cracks and fissures that can lead to infections. Learn how to moisturize properly here.
OnyFix Nail Correction System: For those with ingrown or involuted toenails, the OnyFix system offers a non-invasive, pain-free solution. This innovative treatment involves applying a composite material to the nail, which helps guide it back to its natural shape as it grows, without the need for surgery. It's suitable for various nail shapes.
Medical Pedicures: Unlike traditional cosmetic pedicures, medical pedicures are performed by trained foot care professionals, such as chiropodists or podiatrists, in a sterile environment in a foot clinic. They focus on health, addressing issues like nail trimming, callus reduction, and infection prevention. They are especially helpful for dealing with irregular shaped toenails caused by poor circulation - cutting and maintaining these on your own can be very difficult. For people with diabetes, who are at higher risk for foot complications due to poor circulation and neuropathy, medical pedicures are a common and recommended treatment. These specialized pedicures help prevent complications like infections or ulcers by ensuring meticulous foot care.
Proper Footwear: Wear well-fitting shoes that provide adequate support and reduce pressure points to promote better circulation.
Proper Nail Trimming: Trim nails straight across and avoid cutting them too short to prevent ingrown toenails. And if your toenails are too thick or difficult to cut on your own, book an appointment with a foot specialist.
March 20, 2025
Ram’s horn toenails? Sounds like a serious foot issue! And it is—this condition, medically known as onychogryphosis, causes thickened, curved nails that can become painful and difficult to manage over time. It doesn’t just affect nail appearance; it can lead to discomfort, infection, and mobility issues if left untreated. Fortunately, onychogryphosis treatment options from a chiropodist or podiatrist are available to help you manage comfort and nail health.
What Are Ram’s Horn Toenails?
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Ram’s horn toenails (onychogryphosis), one of the many types of toenail conditions, is classified as a nail disorder or nail disease where the toenail becomes extremely thick, abnormally curved, and overgrown, often resembling the spiraled shape of a ram’s horn. This happens because the nail plate—made of keratin—grows unevenly due to disruptions in the nail matrix, the part of the nail bed responsible for new cell production. Instead of growing outward smoothly, the nail thickens, hardens, and may curl or twist due to uneven pressure and irregular cell turnover. They have a similar appearance to a severe fungal toenail infection.
The texture of a ram’s horn toenail is usually rough, ridged, and extremely hard, making it difficult to trim with standard nail clippers. Over time, the nail can develop a yellowish, brownish, or even grayish hue due to keratin buildup and potential fungal infections. In severe cases, the nail may grow so long and misshapen that it presses into the surrounding skin, causing pain, tenderness, and difficulty wearing shoes or walking comfortably. Because the thickened nail loses its normal flexibility, it can crack or split, increasing the risk of infection.
The appearance of onychogryphosis can also affect confidence and make it difficult to find shoes that accommodate their size and abnormal shape.
Although onychogryphosis most commonly affects the big toe, it can develop on others as well. It tends to progress gradually, meaning that early signs—such as mild thickening or slight discoloration—can go unnoticed until the nail has significantly changed in shape and texture.
Causes of Ram’s Horn Toenails
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These toenails do not generally form spontaneously without an underlying cause or risk factor. Let’s take a look at what generally causes this nail disorder.
Risk Factors for Ram’s Horn Toenails:
Trauma and Ill-Fitting Footwear
Repeated or acute trauma to the toenail can disrupt normal nail growth, leading to thickening and deformation. Continuous pressure and friction, such as from ill-fitting footwear, can cause microtrauma to the nail bed, contributing to the development of onychogryphosis. Essentially, the toenail thickens and starts growing in a different direction to protect itself.
Age
In general, our feet become more vulnerable with age due to several physiological changes that can occur, which can predispose us to onychogryphosis. For instance, reduced peripheral circulation, common in older adults, impairs blood flow to the extremities, leading to diminished oxygen and nutrient delivery to the nails. This alters the nail's natural growth process, causing nails to grow slower and nail cells to pile up on top of each other (rather than growing out). As a result, they thicken and can change shape. Additionally, decreased mobility in the elderly may lead to inadequate foot care, contributing to nail abnormalities.
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Diabetes
Diabetes significantly increases the risk of developing onychogryphosis, particularly due to the effects of diabetic neuropathy. Diabetic peripheral neuropathy reduces sensation in the feet, so individuals may not notice pressure, injuries, or trauma to the toenails, which can lead to deformities like onychogryphosis. Without the ability to feel discomfort, they may unintentionally cause damage to the nail, leading to thickening, curling, and other changes associated with the condition. Additionally, poor circulation caused by diabetes can impede healthy nail growth, making the nails more prone to abnormalities.
Peripheral Vascular Disease (PVD)
As already discussed, poor circulation affects the nail growth process and can lead to nail deformities. In particular, peripheral vascular disease involves the narrowing of peripheral arteries, reducing blood flow to the limbs. The diminished circulation can cause various symptoms, including slow or unusual nail growth. Without proper blood flow, the nails may become thickened and misshapen, potentially progressing to onychogryphosis if left untreated.
Cognitive Impairment
Relating back to age as a risk factor, conditions such as dementia can lead to neglected foot care due to cognitive decline. Individuals with dementia may forget or be unable to perform regular foot hygiene practices, increasing the risk of nail deformities like onychogryphosis. Self neglect, or infrequent cutting of toenails for a significant amount for any reason, is also a risk factor.
High-Friction Sports and Activity
Participating in high-friction sports like running, soccer, or ballet can increase the risk of developing onychogryphosis. Repetitive pressure and friction from constant movement or improper footwear during these activities can cause trauma to the toenail, leading to thickening, curling, and potential deformity. Runners, for example, often experience repeated impact on their toenails, particularly the big toe, which can cause them to become damaged or misshapen over time. Additionally, athletes who wear shoes that are too tight or too loose, which cause friction and rubbing, are more likely to develop toenail issues. As is the case with ill-fitting footwear, over time, the nail thickens and changes growth direction in order to protect itself from the repetitive trauma.
Hyperuricemia
High levels of uric acid in the blood is often associated with gout, but it can also contribute to the development of onychogryphosis. Elevated uric acid can lead to the deposition of urate crystals in joints and tissues, including the nails, which can cause inflammation and damage. This buildup may result in nail thickening, distortion, and a rough appearance. While gout primarily affects joints, the condition’s systemic nature can also have an impact on nail health
Fungal Infections
Also known as onychomycosis, fungal infections cause thickening and nail distortion. These infections often thrive in warm, moist environments and can infiltrate the nail, leading to changes in color, texture, and shape. In diabetic patients, onychomycosis prevalence is notably higher, reaching up to 31.5%, due to factors like elevated blood glucose levels and compromised immune response.
Psoriasis / Psoriatic Arthritis
Psoriasis or psoriatic arthritis can cause nail changes in roughly half of affected individuals. Proper management of psoriasis through medical treatments can help alleviate these nail changes and improve overall nail health.
Treating Ram’s Horn Toenails: Nail Care for Curved Toenails
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Routine Professional Nail Care
It’s very important to visit a Podiatrist or Chiropodist, both types of foot specialists in Ontario, if you have Ram’s horn toenails. This is because it is far too difficult, even dangerous, to manage them yourself. Their thickness, abnormal shape and unsightly appearance and positioning on your foot make it impractical to try cutting them with standard nail clippers, and is not advised.
A chiropodist or podiatrist can tend to your nails properly with specialized tools designed to maintain nail disorders. They can also perform toenail debridement, smooth out nail edges, clean out debris, and apply sprays that help with discoloration.
Other nail care treatment options may vary depending on the severity of the condition. In more extreme cases, surgical interventions such as nail avulsion—removal of the nail plate—may be considered.
If an infection is present, a chiropodist or podiatrist can prescribe the appropriate antifungal or antibacterial treatments to address the underlying cause (you can't treat fungal infections from home).
In addition to the specialized care provided by podiatrists and chiropodists, treatment for Ram’s horn toenails can also include regular monitoring to track any changes in the condition. They may suggest specific at-home care practices, such as gentle cleaning and moisturizing, to support the overall health of the nails and surrounding skin. For individuals with chronic conditions, like diabetes, it is especially important to maintain close contact with a foot care specialist to ensure the toenails remain manageable and complications are avoided. Diabetes patients who neglect their foot health can experience severe ulcer formation.
Onyfix
Onyfix is just one of the many unique ways a foot specialist can help treat curved, curled or Ram's Horn Toenails. It's a non-surgical treatment that involves the placement of a band across the toenail. This band then corrects the nail's growth pattern and shape. It's great for Ram's Horn Toenails because it will help flatten out the toenail on the nail bed and "train" the toenail to grow in the correct direction.
Proper Fitting Footwear
But all the treatment in the world won't matter without eliminating one of the most common causes of curved, curled and abnormal toenails: ill-fitting footwear. As we already discussed, ill-fitting footwear causes repetitive trauma on the nailbed, which disrupts the toenail's growth process. Prioritizing footwear that minimizes pressure and allows for adequate toe room to alleviate discomfort and prevent further nail distortion is key. Opting for shoes with a wide toe box provides ample space for the toes to spread naturally, reducing friction and pressure on the affected nails. Shoes may also require extra depth, and orthopedic footwear may be required for sufficient comfort.
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February 20, 2025
Toenails are more than just a cosmetic feature; they’re protective shields that provide insight into overall toenail health, general health and well-being. Their shape, texture, and condition can indicate underlying issues, simple genetic traits, or the effects of lifestyle habits. In this article, we will explore the various types of toenails based on shape, thickness, texture, as well as medical and foot conditions.
How do Toenails Grow?
Nails grow from a specialized area of skin called the nail matrix, located beneath the cuticle at the base of the nail. This matrix contains rapidly dividing cells that produce keratin, a tough protein that forms the structure of the nail. As new cells are generated, older cells are pushed forward, gradually hardening through a process called keratinization.
The visible part of the nail, known as the nail plate, rests on the nail bed, which supplies it with nutrients and oxygen through a network of capillaries. The lunula, the pale crescent-shaped area at the base of the nail, is the visible portion of the matrix, where active growth occurs. Healthy nail growth depends on factors like blood circulation, nutrition, and overall health, with fingernails typically growing faster than toenails.
You can learn more about toenail anatomy here.
Toenail Shapes
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Toenails can naturally grow in different shapes due to genetic factors, footwear, medical conditions, and nail care routines. Below are some common toenails types (and some not-so-common types as well).
1. Normal (Flat or Slightly Curved) Toenails
Healthy toenails are typically flat or slightly curved, with a smooth surface and a light pinkish hue. They are neither too thick nor too brittle and grow evenly without splitting or cracking. If your toenails are entirely white with no pinkish hue, it may indicate anemia.
2. Curled Toenails
Some people naturally have curled toenails, where the edges curve gently. This shape is common and generally poses no issues unless the curvature is extreme, leading to a higher risk of ingrown toenails. Toenails that are excessively curled are called involuted toenails. It’s important to note you should never purposely try to round the sides of your toenails with toenail clippers — always cut straight across.
3. Square Toenails
Square toenails are straight across with sharp (but not too sharp!) or slightly rounded corners. This shape is often preferred for reducing the risk of ingrown nails, as it prevents the nail from growing into the surrounding skin. When you trim your nails, or get them trimmed by a specialist like a podiatrist or chiropodist during a medical pedicure, the end result should resemble a square shape on all nails.
4. Spoon-Shaped (Koilonychia) Toenails
Koilonychia is a term for spoon-shaped toenails that curve inward, creating a concave appearance. They can be a tell-tale way to discern the difference between healthy toenails vs. unhealthy toenails. This condition may be a sign of iron deficiency, anemia, autoimmune disease, lupus and poor blood flow to the hands and feet. Regular health check-ups and iron-rich diets can help prevent or manage this issue.
5. Clubbed Toenails
Clubbed toenails are thickened and rounded, often appearing swollen and accompanied by broadening of the tip of the toes. This can be a sign of chronic respiratory or cardiovascular conditions. If toenails appear clubbed, a medical evaluation is recommended.
Toenail Thickness & Texture
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The thickness and texture of toenails can reveal a lot about their health.
1. Thickened Toenails
Thickened toenails are often due to fungal infections. Thick nails infected with fungus require professional care from a Chiropodist or Podiatrist for proper maintenance and treatment because the infection is trapped and buried beneath the thickening — you won’t be able to treat it at home successfully. More on fungal infections later!
2. Brittle Toenails
Brittle toenails tend to split or crack easily and may be caused by dehydration, prolonged exposure to moisture, or certain medical conditions like hypothyroidism. Moisturizing and maintaining proper hydration can help prevent brittleness.
3. Toenails with Ridges
Vertical ridges on the toenails are common with aging and are usually harmless. Horizontal ridges (Beau’s lines) that look like indented grooves may indicate trauma, illnesses like viral infections or heart disease, severe stress and more. If Beau’s lines appear one day, you should talk to your family doctor. Subtle bands or stripes running along the nail can also be a signal you need to eat more protein.
4. Pitted Toenails
Pitted toenails have small indentations or depressions in the nail surface. This condition is often associated with psoriasis, eczema, or alopecia areata. Treating the underlying condition can help improve nail health.
The Most Common Toenail Conditions
Beyond shape and texture, toenails can be affected by various conditions that may cause discomfort or indicate a medical issue.
1. Ingrown Toenails
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Ingrown toenails occur when the edge or corner of a toenail (usually the big toe) grows into the surrounding skin, causing pain, redness, and swelling. Ill-fitting shoes are a common cause; when shoes are too tight, they squeeze the toes together, increasing pressure on the sides of the toenail toenail, which disrupts the natural toenail growth pattern and forces it into the skin. High heels or narrow-toed shoes are particularly problematic because they alter the natural position of the foot and toe alignment, leading to more friction and pressure on the nail. This can result in the nail digging into the surrounding tissue, exacerbating the risk of infection and discomfort.
Additionally, improper trimming of toenails (e.g., cutting them too short or in a rounded shape) can also contribute to ingrown toenails, especially when combined with tight footwear.
Sometimes, there may be a genetic component to ingrown toenails. Certain nail shapes and growth patterns are hereditary (i.e.: involuted toenails) and can make a person more prone to developing ingrown toenails.
Chronic ingrown toenails may lead to infection, so it’s a good idea to visit a foot clinic at the first sign of discomfort. A Chiropodist can safely treat the ingrown toenail - often without surgery. OnyFix is also a great, modern option that’s completely non-invasive and stimulates a normal nail growth pattern. Both of these services are performed by foot care professionals.
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2. Fungal Toenails (Onychomycosis)
Fungal infections can cause toenails to become thick, yellowish, and crumbly. This condition is common in people who frequently visit places where fungal infections breed, like moist, shared locker rooms and showers, public pools, nail salons and more. You can also get fungal toenail if you’re prone to athlete’s foot (which can then spread to the toenails). Older people, as well as people who wear shoes that trap foot sweat (and exacerbate it) are also more at risk. Keeping your nails clean and away from contagious areas is a key prevention tip.
Antifungal treatments and maintaining good foot hygiene can help control fungal infections, but it’s important to see a foot specialist to properly treat it. It is difficult to treat fungal infections on your own (unless it's in the very early stages) because the infection occurs beneath the nail, making it hard for topical treatments to penetrate deeply enough to eliminate the fungi. The nail acts as a natural barrier, trapping the infection in the nail bed and protecting the fungus from over-the-counter creams or home remedies. Sometimes our nails being so protective can be a double-edged sword!
A Chiropodist or Podiatrist can perform nail debridement (removing infected parts of the nail to allow proper treatment) before applying a prescription-strength topical antifungal medication.
3. Discoloured Toenails
Toenails can change colour due to various reasons. Here are some common discolourations that stray from the natural pink hue, and why it happens:
Yellow or brown nails: Often a sign of fungal infection and accompanied by nail thickening. This can also be caused by wearing nail polish; the chemicals are absorbed by the structure of the nail, causing yellow staining.
White spots: Can indicate several issues. They can happen due to minor trauma, kidney issues, yeast infections, cirrhosis, or they may signal something more innocent, like nutritional deficiency— often zinc. If your toenails are entirely white with no pinkish hue, it could possibly be anemia.
Black, red or purple: Generally caused by trauma (subungual hematoma). The dark colour is essentially bruising underneath the nail. People often notice a black toenail after stubbing it or dropping a hard object on it. Trauma can also cause toenail damage, like cracked toenails.
4. Detached Toenails (Onycholysis)
Sometimes your toenail can start to fall off, which can be alarming. Onycholysis occurs when the nail separates from the nail bed, often due to trauma, fungal infections, or psoriasis. Treatment depends on the underlying cause.
5. Ram’s Horn Toenails (Onychogryphosis)
This condition results in extremely thick and curved toenails that resemble a horn. It is more common in elderly individuals or those with poor circulation. Regular trimming and professional care from a chiropodist or podiatrist are essential for management.
December 5, 2024
Seasonal changes can significantly impact diabetic foot health. In the summer, heat and sweating can create challenges, while cold temperatures and wet weather during the winter present other risks. That's why diabetic winter foot care is so important. Today we'll talk about:
You'll learn all about:
The connection between diabetes and foot health
The importance of diabetic foot care in the winter
Our Foot Specialists' top tips for diabetic winter foot care
The Connection Between Diabetes and Foot Health
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Approximately 800 million adults worldwide have diabetes. It isn’t often immediately recognized as a foot condition on its own, but a serious issue called diabetic foot (a broad term encompassing a wide range of problems) can occur. As a result, foot care should be a top health priority for people with diabetes.
Reduced Blood Flow
People with Diabetes are at risk of developing neuropathy. There are four types, with peripheral symmetric neuropathy (which affects the feet and hands) being the most relevant for diabetes patients.
This condition develops when elevated glucose levels lead to a series of metabolic and vascular changes that impair nerve function. Over time, excess glucose triggers oxidative stress and inflammation, damaging the small blood vessels (microvasculature) that supply the nerves. Without adequate blood flow, nerves are deprived of oxygen and essential nutrients, resulting in their gradual deterioration.
Reduced Sensation
This damage primarily affects sensory nerves, which are responsible for transmitting pain, temperature, and pressure signals to the brain. This progressive loss of sensation makes it difficult for individuals to detect injuries or changes in their feet, such as cuts, blisters, or pressure points. These minor skin issues can turn to diabetic ulcers (open sores or wounds) when ignored.
Reduced Immune Function
Diabetes can also contribute to ulcer formation due to its impact on the immune system. High blood sugar levels over time impair the function of white blood cells, which are essential for fighting infections and promoting wound healing. When blood glucose levels are consistently elevated, it reduces the ability of these immune cells to properly respond to bacteria or other pathogens. This makes it more difficult for the body to prevent wounds that may develop on the feet - including minor cuts, blisters, pressure sores or even calluses - from getting infected. As a result, these small injuries are more likely to become infected, and ultimately lead to diabetic ulcers.
The impaired immune function, combined with poor circulation and reduced sensation, creates a perfect environment for these infections and ulcers to progress, further delaying healing and increasing the risk of severe complications, such as deep tissue infections or gangrene.
Why is Diabetic Foot Care Important in the Winter?
Cold and wet weather can impact everyone's feet, but winter can have a more severe effect on people with diabetes.
Cold Weather and Diabetes: Risk Factors
Low temperatures: Cold air can reduce circulation by constricting blood vessels, particularly in the lower extremities, making it even more difficult for already-compromised vessels to supply the feet with sufficient oxygen and nutrients. This further impairs the body’s ability to heal wounds.
Wet conditions: Snow, rain and sleet getting into your shoes and socks is a recipe for disaster for diabetics. You can develop blisters, sores and infections (which are all ulcer risks) when you let moisture build for too long.
Dry skin: On the other hand, it is also not ideal for your skin to be too dry. By nature, cold air is very dry. Indoor heating makes the air even dryer by extracting humidity. The lack of moisture in the air dries out the skin - including the skin on our feet. This makes calluses form faster and can lead to issues like cracked heels. And since diabetes impairs the body's ability to heal dry skin and cracked heels, the cracks can easily split open, get infected and turn into a diabetic ulcer.
Winter Foot Care for Diabetics
Podiatrists and chiropodists strongly advise individuals with diabetes to take extra care of their feet during the winter months due to the increased risks posed by the elements. If you have diabetes, keep reading to learn the best tips for winter foot care - all recommended by the foot specialists at our Toronto foot clinic.
Practice Skin Care
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Moisturizing your feet regularly is one of the most important steps to combat dry, cracked skin. However, our foot specialists also caution against using harsh creams full of chemicals and fragrances - especially if you have diabetes. Opt for medically respected products with natural ingredients, like Gehwol’s Lipidro and Dermal Therapy Heel Care, that replenish the natural amount of moisture in the skin while also healing cracks.
Only moisturize your feet after thoroughly cleaning and drying. Check out this ultimate guide to moisturizing your feet to master four easy steps. While you're at it, check out the best foot hygiene routine.
Perform Foot Stretches and Exercises
Movement is one of the most effective ways to manage diabetic foot concerns and counteract the impact of cold weather on blood flow. Low-impact cardio exercises such as swimming and walking can assist people in managing blood flow and sensation loss, respectively. Removing the elements of competition and high strain exertion found in other sports, and focusing solely on safety and motion, is a great way to encourage activity.
There are also targeted, low-impact and easy-to-perform foot stretches and exercises designed for people with diabetes. The goal is to stimulate blood circulation as much as possible while still considering any physical limitations. Below are three light exercises you can try from home, and while they may be hard to perform at first, practice makes perfect!
Toe Curls: Sit with your back straight, feet planted, and use a towel to scrunch your toes and pull it toward you, repeating five times per foot.
Figure Eights: Lift one foot while keeping the heel on the floor, move your foot in a "figure eight" motion, repeating five to 10 times per foot in each direction.
Single Leg Lifts: Stand with feet shoulder-width apart, hands on hips, and lift your left foot straight out in front, keeping your leg straight and foot flexed, repeating five times per foot.
To learn more about these exercises, check out the best stretches and exercises for diabetes.
Practice Moisture Control
Keep your feet reasonably dry as much as possible. This may mean changing your socks and shoes several times per day, and thoroughly drying your feet with a towel intermittently. While this can be annoying and easy to forget during the busy winter season, it’s important to stay on top of this with snow, sleet and rain posing an extra risk.
It’s important to not go overboard with too much direct heat penetrating your feet. While cozying up by the fire is safe on occasion, excessive heat can cause even more damage to the nerves. This is due to reduced sensation in diabetic individuals, which makes it harder to notice high heat and burns.
Below are the best ways to manage excessive moisture during the winter:
Wear moisture-wicking socks.
Change socks regularly, especially if they get wet.
Use foot powders and deodorants.
Choose breathable, well-ventilated shoes.
Choose shoes made with waterproof fabrics, like GORE-TEX. This fabric uses a membrane with pores small enough to block water but large enough to allow sweat vapor to escape. This creates a waterproof yet breathable barrier, keeping feet dry and comfortable.
Dry feet thoroughly with a towel after washing, especially between toes.
Avoid tight shoes that trap moisture.
Consider insoles with moisture-absorbing qualities.
Keep feet clean and dry before bed.
Perform Foot Inspections
At-home foot inspections are a good diabetic foot care measure in the winter (and in general) because they help identify potential issues like cuts, blisters, or signs of infection early, when they're easier to treat.
Check for cuts, blisters, or sores: Examine the entire surface of your feet for any visible signs of injury and skin perforation.
Look for changes in skin color or temperature: Check for any redness, swelling, or areas that feel unusually warm or cold.
Check your toenails and between toes: Look for ingrown toenails, cracked toenails and fungal infections,
Try Diabetic Socks
Compression stockings are a great way to enhance blood flow to the legs and feet, but they are not recommended for people with diabetes since they can do the opposite and restrict blood flow too much in the arteries. Instead, ask a podiatrist or chiropodist about diabetic socks and if they might work for you. They have several benefits, which are especially useful in the winter, including:
Antimicrobial treatment which prevents bacterial and fungal growth.
Slightly cushioned footbed for extra comfort and protection.
Loose, non-binding top band which rests comfortably around the ankles or calves, allowing more circulation.
Moisture-wicking and stretchy material.
Smooth toe area to prevent blisters and other skin irritation.
Choose the Right Footwear
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For diabetes patients, wearing proper footwear in the winter is essential for maintaining foot health.
Orthopedic shoes are an excellent choice, as they offer extra cushioning, arch support, depth, elasticity, adjustable straps and ample room to reduce pressure points and prevent blisters or sores.
High-quality winter footwear can also be effective, provided it offers warmth, water resistance, and moisture control properties to keep feet dry and comfortable. Here is what you should pay attention to:
Waterproof materials: As you already know, materials like GORE-TEX help maintain dryness by utilizing a membrane with microscopic pores. These pores are small enough to block water molecules, but large enough to allow vapor from sweat to escape. This technology effectively prevents external moisture, like snow or rain, from penetrating the footwear, keeping feet dry. The breathability of GORE-TEX also ensures that perspiration from the feet can escape, which prevents a buildup of moisture inside the shoe. This combination of waterproofing and breathability is essential for preventing cold and damp feet
Adequate insulation: This is crucial for maintaining warmth in winter footwear as insulation helps lock in warm air and retain body heat. Look for insulated winter shoes and boots that also let you maintain moisture control. And remember to let your feet air out after sweating in your boots all day to avoid excessive dampness.
Non-slip soles: For better traction on icy or slippery surfaces to avoid falls.
Cushioning and arch support: To provide comfort and reduce strain on the feet, especially when walking for extended periods.
Roomy toe box: To avoid friction and pressure on the toes, preventing blisters or sores.
Breathable lining: To allow moisture to escape and keep feet dry, reducing the risk of infections.
Adjustable closures: To ensure a secure fit without restricting circulation, particularly important for those with swelling or neuropathy.
In addition, custom orthotics can provide personalized support, improving foot alignment and alleviating pressure, further reducing the risk of diabetic foot complications.
Visit a Foot Specialist
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Our top tip for managing diabetic feet in winter? Book an appointment with a foot care provider, like a podiatrist or chiropodist, at a foot clinic.
At Feet First Clinic, our chiropodists are trained to:
Offer comprehensive education on how cold weather can affect diabetic feet.
Provide skin and nail care.
Provide wound care.
Offer custom orthotics services: assessments, casting, fittings and follow-up guidance.
Thoroughly inspect your feet and pinpoint potential issues (this can be difficult to fully achieve at home, since diabetes also affects eyesight).
Help you understand what winter boots or shoes you should wear, which you can then browse for at our store. A member of our staff can guide you through our options with a complimentary shoe fitting.
Discuss the benefits of products like diabetic socks, orthopedic slippers, moisturizers, and more, which you can then purchase at our store.
Contact our Toronto foot clinic to learn how a foot assessment can be your first step toward healthier, happier feet this winter!
September 2, 2024
Ingrown toenails can be more than just a foot problem. Quite frankly, they're annoying. They can also lead to significant discomfort and even serious complications if not addressed properly. Many people don’t even fully understand what they are or what “ingrown” really looks like, so recognizing ingrown toenails early is crucial! This will allow for prompt, effective and safe ingrown toenail treatment, which will reduce your risk of infection and help you avoid more invasive procedures.
Recognizing Ingrown Toenails
So, how can you tell if you’re dealing with an ingrown toenail? The first symptoms include pain and tenderness along the side edge of your toenail (the exact location is the called the paronychium, or the soft tissue border around the nail), typically on the big toe. Why the big toe? It is larger and more vulnerable! It withstands the most damaging effects from poor foot care habits (more on that later).
You might also notice swelling, redness, and warmth in the affected area. If the condition progresses, pus may develop, indicating an ingrown toenail infection. Catching these signs early is key to avoiding further issues.
Visually, it may look curved or embedded, or simply like a tiny, strange nail growth attached to the main nail. You may also see skin growing over the nail.
Ingrown Toenails Causes
Ingrown toenails result from seemingly innocent routines that over time, damage your foot health.
These include improper nail trimming — cutting nails too short or rounding the edges (many people do this for aesthetics but it's a big no-no!) which encourages the nail to grow into the skin. Tight shoes that squeeze the toes together (your feet may be wider than you think), as well as injuries to the toenail, are also common culprits. In some cases, genetics may play a role: some people's natural nail shape and growth pattern may make them more predisposed to developing ingrown toenails, like involuted or pincer toenails.
Knowing these causes gives you the upper hand in preventing ingrown toenails before they start.
Preventing Ingrown Toenails
Wherever possible, prevention is always better than cure.
By trimming your nails straight across, wearing shoes that fit properly, and keeping your feet clean, you can significantly reduce the risk of developing ingrown toenails and a corresponding infection.
If you’re unsure how to cut your toenails properly, especially if you have conditions like diabetic neuropathy, seeking help from a chiropodist for a medical pedicure can be a smart choice. People with diabetes need to be extra vigilant about foot care, as their condition can make them more susceptible to complications from ingrown toenails. Click here to see how a deceptively minor laceration can turn into an ulcer.
Regularly checking your feet, especially if you’re prone to ingrown toenails, is also an essential part of care.
Treating Ingrown Toenails
For mild cases in the early stages, soaking your foot in warm water for 15 minutes 2 times a day can soften the skin and reduce swelling. After, you can wedge a wet piece of cotton under the corner of the toenail to help lift the ingrown portion while it heals. But beware—safe ingrown toenail treatment at home requires careful handling to avoid making things worse. And whatever you do, do not attempt to cut the toenail or dig the ingrown portion out.
If there's no improvement in 3 days, or if you're experiencing any pain or irritation, seeking professional ingrown toenails treatment from a Toronto chiropodist is a better idea. For safe ingrown toenail treatment, always see a chiropodist - do not go to a salon. If you try to treat your ingrown toenail at home (or at a salon), you can get an infection and make things worse. Plus, when you do ultimately see the chiropodist, the chiropodist will have to cut the toenail even shorter than they normally would in order to fix the DIY job. This lengthens the healing process.
If the pain is severe and you’re waiting for your chiropody appointment, try the following tips for ingrown toenail relief:
Soaking your feet in warm (not hot) water with Epson salts: The salt is a natural disinfectant and will help clean the wound so that it doesn't get infected and become further irritated.
If there are signs of infection (i.e.: bleeding, discharge), wear a band-aid over the ingrown toenail when you're wearing shoes and socks to prevent bacteria from getting stuck in the wound.
Try over-the-counter pain relievers like Tylenol or Ibuprofen
These can offer temporary comfort before you can address the root cause and follow proper treatment guidelines.
Safe Ingrown Toenail Removal
Safe ingrown toenail removal with a licensed chiropodist is always the best way to go. Most ingrown toenails do not need to be surgically removed: a chiropodist can typically safely remove it non-surgically with sterilized tools in a sanitized, safe environment. They can also cut the toenail in a way to prevent it from coming back.
In severe cases (like if you attempted to fix your own ingrown toenail and it got infected, or your ingrown toenail keeps coming back), safe ingrown toenail treatment may involve a minor surgical procedure from a chiropodist called a total or partial nail avulsion.
