Secondary Toenail: What It Is and How to Handle It

Written by Brittany Stuckless on August 15, 2024

Last updated August 22, 2024

Medically reviewed by Peyman Alishahi, D. Ch.

Whether they’re discoloured, cracked, ingrown, curly, or on the verge of falling off, toenail anatomy can be fragile and our nails can do funny things. A less commonly discussed issue is a secondary toenail. Also known as an accessory toenail or petaloid toenail, a secondary toenail is a sneaky little extra nail twin that grows alongside or beneath the pinky toenail. This abnormal toenail growth can be concerning, so it’s natural to have questions.

person standing at the side of the pool showing just feet and legs

Signs You Have a Secondary Toenail

It’s important to know the difference between an ingrown toenail and an accessory toenail.

First, ingrown toenails can grow on any toe, whereas a secondary toenail appears on the fifth, smallest toe.

Ingrown toenails are also far more common, and pierce the skin rather than growing alongside the nail.

Secondary toenails are thin in nature and often don’t cause pain, infection or swelling like ingrown toenails do (although it is possible).

Lastly, ingrown toenails form on the side of the nail unit, whereas secondary toenails grow underneath the proper nail.

female feet laying on top of flowers in front of blue background

What Causes a Secondary Toenail?

A secondary toenail is a rare phenomenon.

It often makes an unexpected appearance after trauma or injury to the nail bed. You may notice your nail growing differently after stubbing or hurting it. Chronic pressure from tight shoes or less-than-perfect nail trimming can also coax this extra nail into existence.

female feet with red painted toenails and hands on top of them

Do You Need Surgery For Secondary Toenails?

Studies show that the treatment of choice for this extra pinky toenail is an excision, especially if it’s infected. A partial or total nail avulsion from Toronto’s Feet First Clinic may be the solution you need, but you’ll have to schedule a proper foot assessment to determine the best course of action.

Treatment of accessory toenails targets the original toenail, not the second one. The second toenail should grow properly after the “main” nail is removed.

Are You Dealing With Abnormal Toenail Growth?

Visit Toronto’s best foot Clinic, Feet First Clinic, for amazing foot care! We have everything you need for healthy toenails under one roof! Call us at (416) 769-3338 or book an appointment here!

About Author: Brittany Stuckless

Brittany holds a Bachelor of Arts in English Language and Literature from Memorial University of Newfoundland. With a diverse background in journalism and marketing, she got her start as a freelance content writer. She currently works as a Marketing Assistant at Real Food for Real Kids in addition to her role as a writer at Feet First Clinic. Previously, Brittany has been a journalist for the Ontario Learning Development Foundation and Immigrant Muse magazine, and an Administrative and Marketing Assistant at Evolve Chiropractic and Physiotherapy. Originally from Newfoundland, she has lived in Toronto since 2014.

Learn more about Brittany Stuckless

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September 26, 2022

Does a Cracked Toenail Grow Back? Explained

Oh no! You have a cracked toenail. Maybe you just stubbed it while you were in a rush, or perhaps you're not wearing shoes with enough room in the toe box and it's finally damaged your nails. These are innocent causes, but if you're prone to certain foot conditions, cracked toenails might become a nuisance. A slight detachment or crack is not a pressing issue. But you probably have these questions: Does a cracked toenail grow back? What are the stages of nail regrowth? Are there cracked toenail remedies and treatments? Does a Cracked Toenail Grow Back? In general, yes! You should notice progress about 6-8 weeks after the initial crack. The cause of the cracked toenail may determine how long it will take to grow back. Losing a toenail due to psoriatic arthritis, a fungal infection, or surgical removal can take anywhere from 6 months to a year to grow back completely. Blunt force trauma, like a severe stubbed toe or toe injury, may take up to two years to grow back. What are the Stages of Nail Regrowth? According to Healthline, toenails take longer to grow than fingernails. Here are the stages of toenail regrowth: Nail growth stems from the toenail's matrix underneath the skin. The matrix is responsible for producing new skin cells that replace old ones, making room for nails to grow. After a trauma-induced cracked toenail, the nail matrix may not be able to create new skin cells for some time. However, the matrix will eventually start replenishing cells at a faster, more normal rate. As we mentioned, you may already notice progress at six weeks. Older cells reaching the surface harden, creating the nail and restructuring your cracked toenail. Cracked Toenail Remedies and Treatment It's frustrating having a cracked toenail, especially a cracked big toenail. Wearing shoes can be painful, but luckily, there are ways to manage pain and protect your nail health. You may also require care from a chiropodist in the interim. Here are some remedies that may help you out: Biotin Research suggests a link between nail health and this B-complex vitamin, specifically for its cell-signaling ability. Foods with healthy fats, like eggs and salmon, contain biotin. You can also take biotin supplements. Read more about great foods for healthy feet. OnyFix Sometimes, nails may grow back ingrown or misshapen. If this happens to you, your chiropodist may recommend Onyfix. This exciting and contemporary treatment acts as a brace for the nail while redirecting nail growth and aligning the shape as it grows. As a bonus, it's completely painless! Regular Nail Care Want to avoid cracked toenails and complications? Keep your toenails strong and clean. This means regular filing, trimming, cleaning, and more. Your cracked toenail won't grow back as smoothly if you neglect nail care, and brittle nails are more susceptible to damage. Furthermore, your cracked toenail is more vulnerable to bacterial growth if you don't take care of it. A great way to ensure your nails stay healthy is by scheduling regular medical pedicures. Avoid getting a cosmetic pedicure while a cracked nail grows back. Don't just assume that because your nail is making progress, it's finished growing. Nail polishes at salons often contain harmful chemicals that weaken your nails, like toluene, formaldehyde and dibutyl phthalate. Learn more about nail pedicure safety.

September 2, 2024

How to Recognize and Treat Ingrown Toenails Safely

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.

August 15, 2024

Secondary Toenail: What It Is and How to Handle It

Whether they're discoloured, cracked, ingrown, curly, or on the verge of falling off, toenail anatomy can be fragile and our nails can do funny things. A less commonly discussed issue is a secondary toenail. Also known as an accessory toenail or petaloid toenail, a secondary toenail is a sneaky little extra nail twin that grows alongside or beneath the pinky toenail. This abnormal toenail growth can be concerning, so it’s natural to have questions. Signs You Have a Secondary Toenail It’s important to know the difference between an ingrown toenail and an accessory toenail. First, ingrown toenails can grow on any toe, whereas a secondary toenail appears on the fifth, smallest toe. Ingrown toenails are also far more common, and pierce the skin rather than growing alongside the nail. Secondary toenails are thin in nature and often don’t cause pain, infection or swelling like ingrown toenails do (although it is possible). Lastly, ingrown toenails form on the side of the nail unit, whereas secondary toenails grow underneath the proper nail. What Causes a Secondary Toenail? A secondary toenail is a rare phenomenon. It often makes an unexpected appearance after trauma or injury to the nail bed. You may notice your nail growing differently after stubbing or hurting it. Chronic pressure from tight shoes or less-than-perfect nail trimming can also coax this extra nail into existence. Do You Need Surgery For Secondary Toenails? Studies show that the treatment of choice for this extra pinky toenail is an excision, especially if it’s infected. A partial or total nail avulsion from Toronto’s Feet First Clinic may be the solution you need, but you’ll have to schedule a proper foot assessment to determine the best course of action. Treatment of accessory toenails targets the original toenail, not the second one. The second toenail should grow properly after the “main” nail is removed.

August 1, 2024

Tips For When Your Toenail Is on The Verge Of Falling Off

A toenail falling off can be uncomfortable and cause concern about damage to the toenail. The goal is to preserve the toenail's state to prevent further damage. Fortunately, if you take a few proactive steps, you can reduce the discomfort and promote healing. Here are our six tips for managing a toenail on the verge of falling off. 1. Keep the toenail area clean and dry Wash the toenail gently and often. We recommend using mild soap and water to keep it clean. Next, pat dry so as not to snag the toenail with a towel. 2. Cut the nail carefully and slowly Use clean, sterilized nail clippers to remove any dangling or loose portions of the toenail. Cut straight across without digging into the surrounding skin. The goal here is to prevent further snagging or tearing down the road. Improperly cutting your nail may also increase your risk of an ingrown toenail. In addition to trimming the toenail straight across, you should trim the toenail slowly. Don't over-cut it. Be patient with toenail growth. (It may take months to a year for a nail to fully grow out.) If in doubt, let our toenail specialists in Toronto trim your toenails for you as part of a medical pedicure. 3. Use a non-stick bandage to protect the area We recommend applying a bandage or non-sticky wrap to your toe. (Adhesive can attach itself to the toenail and be difficult to peel off without grabbing onto it.) A protective layer keeps an otherwise exposed nail bed safe. Replace the bandage regularly and keep the area dry to promote healing. 4. Antiseptic ointment is your friend Use an antiseptic ointment or petroleum jelly on the exposed nail bed to keep it moisturized and prevent infection. This may help soothe any discomfort from the loose toenail. 5. Choose comfortable and roomier footwear You'll want to reduce pressure as much as possible to prevent a loose toenail from falling off. Given that we wear footwear so often, finding shoes with ample fit can help prevent further damage to the toenails. 6. Avoid intense activity Reduce your activity level if it puts excessive pressure or strain on the affected toenail. For instance, running or high-impact sports like soccer could increase the risk of the toenail getting snagged or torn off. Give your toe some rest, and return to physical activity gradually.

July 11, 2024

Why You Shouldn’t Use Fingernail Clippers for Your Toenails

There's always the right tool for the job. Using each tool for its intended purpose is best, or you risk doing more damage than good. That's why fingernail clippers and toenail clippers exist. To understand why, it's important to understand the difference between toenails and fingernails. Toenails are thicker, harder, and grow slower than fingernails because your feet and hands serve different functions. Toenails also have a greater surface area. In this blog post, we explain why you should avoid using fingernail clippers for your toenails and opt for toenail clippers exclusively. Reduce the risk of bacterial or fungal contamination For one, separating your nail tools prevents contamination and possible spread of bacteria and fungus. Given how exposed your hands are every day, you wouldn't want to spread any bacteria to your feet. When in doubt, clean your clippers with 70%—90% isopropyl alcohol. Fingernail clippers may not work on toenails When looking at fingernail vs. toenail clippers, the size difference is stark. Fingernail clippers are smaller, narrower, and curved. Toenail clippers are larger, wider, and straight across, as you should trim your toenails straight across. Cutting them with a curved edge increases your risk of ingrown toenails. If you want more guidance on choosing the tool for your toenails, read our blog post on our top choices for toenail clippers. Limit the risk of cracking and damaging your toenails Using sharp, rigid toenail clippers makes trimming easy and more effective. Using fingernail clippers means you'll need to apply more pressure to cut the nail and risk damaging or even cracking the toenail. If you don’t have the right tools, enough time, or simply the confidence to focus on a nail trim, try a medical pedicure instead. It includes the right nail trimming procedure and includes moisturization, thorough cleaning, and more. Before the nail trim, a chiropodist also examines your feet for other foot conditions. Prevent ingrown toenails You'll also notice the curvature of fingernail vs. toenail clippers. Fingernail clippers are curved and meant to follow the contours of your fingernails. On the other hand, toenails are plateaued and should be cut straight across. Using a curved tool on your toenails puts you at risk of jagged edges, nail splitting, or could be a root cause of ingrown toenails. If you wish, use a nail file to round the edges. This tool is necessary for properly smoothing the edges of the nails. After the trimming, there will likely be some jagged edges, sharp corners, and “spikes.”

June 20, 2024

Toenail Anatomy: Understanding the Structure Beneath Your Toes

At first glance, our toenails look like a single nail, and that's about it. However, beneath the surface is a more complex structure that makes up the nail and the bed below it. This is our toenail anatomy. Toenails and fingernails are made of Keratin. Keratin is a type of protein that gives the nail strength and protection. (There are many types of Keratin. It also comprises hair and your epidermis.) Toenails differ from fingernails in a few ways, namely their thickness and growth rate, as the external forces on your toenails are greater than those on your hands. Today, we explore toenail anatomy and how each component affects foot health. Layers of the toenail Nail plate The nail plate is the easiest part of the toenail anatomy to recognize. It's the nail itself. The colour and texture of the nail plate can vary based on factors like health, genetics, and lifestyle habits. Nail bed Next, we go a bit deeper. The nail bed is beneath the nail plate. Just like sheets and blankets are the nail plate, imagine the nail bed is the mattress or bed frame below. The nail bed is a layer of skin that nourishes the nail as it contains blood vessels and nerves. It is also the growth engine behind the nail plate. If you damage the nail bed, you'll notice nail plate abnormalities or reduced growth rates. Sometimes, a damaged nail bed will cause you to lose a toenail or experience a discoloured toenail. A subungual hematoma occurs within the nail bed and can cause a black toenail. Lunula The lunula, or "half-moon," is the pale, crescent-shaped area visible at the base of the nail. It represents the edge of the nail matrix, where new nail cells are generated. Eventually, nail growth from the lunula extends out to the outer edges of the nail, at which point you'd trim them. Nail matrix The nail matrix is the tissue beneath the cuticle at the base of the nail. It produces new nail cells, pushing older cells forward and resulting in nail growth. Damage to the nail matrix can affect the quality and growth rate of the toenail. Each nail matrix produces 196 layers of cells that combine to make your toenails.

May 13, 2024

Pedicure Safety: Tips for Healthy Summer Feet 2024

Summer foot care and pedicures - can you name a more iconic duo? Showing off a sleek pedi is one of the best ways to enjoy the warm months. But safe pedicures differ greatly from your run-of-the-mill cosmetic pedicure, so it’s important to be on the lookout for the safest way of avoiding pedicure infections. We’ve got 3 pedicure safety tips you should follow before you hit the salon! Top 3 Pedicure Safety Tips Choose clean salons or foot clinics Avoid certain tools Practice aftercare Choose Clean Salons or Foot Clinics Only visit nail salons that demonstrate good practices. Be on the lookout for: An organized workspace. Equipment sanitization protocols. An autoclave with steam sterilization is best. Employees visibly maintaining hygienic standards. Employees using disposable liners in the foot baths, and cleaning and filtering them between uses. Fresh linens (if applicable). Clean floors and surfaces. Clean uniforms on employees. Clear labels on products. Clients wearing protective footwear when walking around. Another good tip is visiting your nail salon when they first open in the morning, when everything is cleanest! Pedicures at Feet First Clinic Foot clinics are where you can get a medical pedicure, which tends to be safer than a cosmetic pedicure. Appointments don’t happen in communal areas, unlike salons, so you’re already in a safer environment with less people spreading contagious fungal infections. And although you’ll be skipping the polish (you can always apply it yourself afterwards!) and foot bath (again, you can do this at home - foot baths at nail salons are not hygienic, especially if the bath has jets), you’ll be enjoying so much more than you can get from many salons. This includes: Guaranteed use of sterilized, safe tools. A thorough cleaning of the entire foot with alcohol. An inspection of your feet from a chiropodist who can recognize foot conditions. Thorough cleaning of dead skin(onychophosis) under the nails. Callus softening or removal. Learn more about what happens during a medical pedicure and the differences between a cosmetic vs. a medical pedicure. Avoid Certain Tools Nail technicians in salons use many tools, but you should kindly request they skip some of them. One of these is the foot rasp or “grater” they use to scrape the bottom of the feet. It can be overly abrasive and damage the skin, leading to irritation and cuts. Strong skin is a barrier for contaminants, and damaged skin welcomes dirt and infections. To protect your feet even more, you can skip tools that don’t appear to be properly sanitized or cleaned between uses, or avoid tools with visible signs of wear and tear. Practice Aftercare After getting your pedicure, it’s up to you to keep on top of proper foot care! Here’s what to do: Avoid tight shoes that crowd the toes. This can cause ingrown toenails. Wash your feet every day with gentle soap before thoroughly drying. If you must cut your own toenails, only trim straight across, avoiding shaping. Moisturize and exfoliate your feet. Wear clean cotton socks and change them frequently.

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Secondary Toenail: What It Is and How to Handle It

Signs You Have a Secondary Toenail

What Causes a Secondary Toenail?

Do You Need Surgery For Secondary Toenails?

Are You Dealing With Abnormal Toenail Growth?

About Author: Brittany Stuckless

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Related Posts

Does a Cracked Toenail Grow Back? Explained

How to Recognize and Treat Ingrown Toenails Safely

Secondary Toenail: What It Is and How to Handle It

Tips For When Your Toenail Is on The Verge Of Falling Off

Why You Shouldn’t Use Fingernail Clippers for Your Toenails

Toenail Anatomy: Understanding the Structure Beneath Your Toes

Pedicure Safety: Tips for Healthy Summer Feet 2024

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