Toenail Anatomy: Understanding the Structure Beneath Your Toes

Written by Erica Halpern on June 20, 2024

Last updated August 7, 2024

Medically reviewed by Connie Christou, D. Ch.

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.

Trust Toronto's toenail experts at Feet First Clinic

Do you have a toenail issue? Look no further. Our dedicated licensed chiropodists in Toronto are ready to help with your foot and nail concerns. Call us at 416-769-3338 or book an appointment online.

About Author: Erica Halpern

Erica is the operations manager at Feet First Clinic. Since 2021, she has been writing, researching and editing website and social media content. She also oversees Feet First Clinic’s daily and strategic operations to ensure the best possible experience for our clients. Her goal is to ensure patients are equipped with the knowledge and solutions they need to help with their pain.

Learn more about Erica Halpern

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February 17, 2022

5 Causes of Black Toenails

It can be quite startling to pull your sock off and spot a black toenail. For some people, it may be only a black dot under the nail, while for others, the entire nail may be dark. But rest assured, as disturbing as it may appear, a black spot on your nail is usually not serious. Read on to discover five causes of black toenails, and what you can do to treat and prevent them. 1. Singular Injury Ouch! A trauma, such as stubbing your toe or dropping a heavy object on it, can cause a black nail. This happens because the force of the object breaks the blood vessels under the nail, causing a pooling of blood that appears dark. The toe may also be sore and sensitive to touch. While this type of black toenail can resolve on its own, you may need to see a chiropodist to have the blood drained. You should see the dark section of the nail growing out within a couple of months. In some cases the nail can come off, but don't worry: another nail will be growing behind it to take its place. In some cases, the new nail can be thickened because the trauma has traumatized the nail from where it grows. 2. Repeated Injury Have you increased your running distance as part of your New Year’s resolution? What feels great for your body may not always be so great for your toes. When you run longer distances, your toes can get squished up against or repeatedly hit the inside of your shoes, especially if you are not wearing the right running shoes. Over time, this causes bruises and blood blisters to form under the nail, giving your toenails a black colouring. Your dark nail should grow out in six to nine months, but make sure you are wearing properly fitting shoes while it does. If your nail begins to lift off or falls off all together, ask one of our Chiropodists to assess your toes and see if the thickening can be prevented or treated. Sometimes if your nail(s) is constantly getting hit by footwear (usually seen on the 5th toe), then the nail can become thickened. Unfortunately, the nail won't recover from this as constant micro-traumas can also permanently damage the nail bed from where the nail grows. https://www.youtube.com/watch?v=I65eFhvnPhw 3. Fungal Infection While most fungal infections under the toenail are a white or yellowish colour, dirt and other fragments can get under the nail, causing it to have a dark appearance. Feet are especially susceptible to fungal infections because socks and shoes create a warm and moist environment — a fungus’s dream! Over-the-counter treatments are typically ineffective against fungal toenails since they don’t penetrate the actual fungus living within the toenail. That’s why, if your black nail is caused by a fungus, a chiropodist’s visit is needed to get proper and effective anti-fungal treatment. 4. Underlying Conditions If you are noticing a black spot under your toenail, it could be a symptom of an illness in another part of your body. For instance, diabetes can cause black toenails due to the decreased circulation and increased thickening of the toenails associated with the disease. Other illnesses that can cause darkened nails include kidney disease, anemia and heart disease. If you notice a black toenail and are currently living with one of these conditions, or think you might be, speak to your family doctor. 5. Melanoma This is one of the rarer causes of black toenails, but it is more common in people of Asian descent and people with brown or Black skin. This form of skin cancer is highly aggressive, and causes dark, irregular looking patches on the skin. It is possible for melanoma to form on the skin, under the nail, or where the nail grows from, giving the appearance of a black toenail. One of the main differences between this and blood within the nail is that a melanoma doesn't grow out. However, it is always wise to check with your Chiropodist or family doctor as soon as possible. What Should I Do If I Get a Black Toenail? Black toenails are surprisingly common, and normally, nothing to worry about. To prevent the usual causes of black spots on your toenails, remember to wear well-fitted shoes, keep your nails cut short and feet dry. In rare circumstances, black dots under your nail can be a sign of something serious. If your black toenail is not improving or you are concerned, make an appointment to speak to a chiropodist.

June 7, 2019

3 Toenail Problems That We Can Help you With

You’ve pulled off your sock and noticed that something is wrong with your big toe. Maybe it’s swollen and sends a sharp twinge up your foot with each step, or maybe the nail has changed from its normal clear shade into a completely different colour. There’s no need to panic. Read this brief list of common toenail problems, and what steps you should take to resolve them. Ingrown Toenails An ingrown toenail is when the side of the toenail cuts into the nailbed and causes the area to become swollen and painful. Sometimes the weight of a bedsheet or a sock will be too much to handle. Common causes of ingrown toenails are inadequate footwear, ill-fitting socks and cutting the nails too short. For an at-home treatment, you can soak your foot in warm water with Epsom salt to reduce inflammation. Keep the affected area clean and place antibiotic cream over it to fight off infection. When appropriate, wear open-toed sandals to avoid putting pressure on the area. These steps could be enough to resolve the issue. If you have diabetes or circulation problems, you should contact licensed chiropodists in Toronto to take care of your ingrown immediately because the area will be vulnerable to infection. Ignoring the toenail problem or trying to fix it on your own could put your health at risk. At Feet First Clinic, you can get your nail treated safely. Common signs of this problem are hardened brittle nails, build-up beneath the surface, and discoloration (usually white or yellow). You can catch a toenail fungal infection from walking around barefoot in public areas with lots of moisture like swimming pools, locker rooms and gym showers. People who are elderly, who have diabetes or who have weakened immune systems will be more susceptible to fungal nail infection. You should schedule a nail fungus treatment appointment with a chiropodist when you spot any of the symptoms. Since there are different types of fungi, you will want to get a professional opinion before you try to get rid of your own. Bruised Toenails When shoes are too small, the toes hit the edge of the toe box over and over again, resulting in black toenails that never seem to go away. Make sure that there is enough space for your toes to wiggle in the toe box. If you’re a runner or jogger, you’ll also notice that you get black toenails whenever you’re stepping up your training for endurance goals like half-marathons and full marathons. The repetitive friction from running will hurt your toenails. When you notice a black toenail, soak your feet in a bath of warm water and Epsom salt. If your shoes don’t fit, get a new pair that offers enough room and support. The best way to heal a bruised toenail is to give it time to recover. If the nail falls off, try to keep the area clean and see your doctor right away. Whatever you do, do not remove the nail on your own. Sometimes you can’t fix a toenail problem on your own. Trying to DIY your treatment could accidentally cause more damage and expose yourself to harmful bacteria. When Epsom salt soaks and rest can’t fix the issue, seeking help from a professional is your best bet for a cure.

October 24, 2024

How to Prevent Toenail Fungus: Tips from a Foot Specialist

There are two common fungal infections that can target your feet. For your skin, it’s athlete’s foot (tinea pedis), and for your nails, it’s fungal toenail (onychomycosis). Fun fact: Onychomycosis is the name for nail anatomy changes caused by contagious fungus, while dystrophic is the term for any other abnormalities that affect how your nails look or grow. Today’s blog will focus solely on toenail fungus. You’ll learn what it is and how to treat it, as well as some top fungal toenail prevention tips recommended by our Toronto chiropodists. Toenail Fungus Symptoms Sometimes toenail fungus is mild and barely noticeable. But fungal toenail can present more severely if you’re immunocompromised, such as if you have diabetes, or a senior. Keep an eye out for these common symptoms: Drastic changes in the nail’s appearance: it can look much thicker, have a yellowish, brown colour, and be very brittle and prone to cracks, despite thickening. Unpleasant odour coming from the nail: the smell is often reported to be sour or like cheese. The nail starts lifting off the nail bed: this is because debris starts to accumulate and lifts the nail up so it can’t reattach. Pain, swelling and bleeding in severe cases. Toenail Fungus Prevention: Foot Specialist Advice The most important fact to remember about fungal toenail is that it’s contagious. Since fungal infections spread easily in damp, shared spaces like pools, gyms, and shower rooms, the best defense is keeping your feet clean and protected! Here are some top, Toronto-chiropodist-recommended tips to remember: Follow a strict, yet fun and relaxing, foot hygiene routine. It’s a part of self care, after all! Wear breathable footwear. Opt for shoes made from materials that allow airflow to keep your feet dry. Change socks daily. Fresh socks prevent moisture buildup, which fungi love. Avoid going barefoot in public places. Use flip-flops or shower shoes to protect your feet in shared spaces. Keep your toenails trimmed and clean. Regular maintenance helps prevent infections from taking hold. Get a professional medical pedicure if you don’t have time to focus on nail care. How to Treat Toenail Fungus Once fungus has gotten a hold of your nails, it’s time to think about treatment and eradicating the problem. Unfortunately, you can’t do much to treat toenail fungus yourself at home, and you often need a chiropodist’s help. Luckily, treatments are easy to follow and non-invasive. Here’s what a foot specialist can do: Perform nail debridement to remove infected parts of the nail. Use prescription-strength topical antifungal medicine on the nail (it penetrates the actual fungus) Educate you on products you can use going forward to prevent re-infection, like the best moisture-wicking socks, shoes, foot creams, deodorants and more.

September 19, 2024

Foot Care for Runners: Preventing Injuries and Maximizing Performance

Whether you're an experienced marathoner or an occasional runner, healthy, happy feet are core to your running success. After all, our feet are the unsung heroes that carry us through kilometres of training and races. Without proper care, our feet and body can only take us so far before we develop aches and injuries. Proactively caring for your feet can help prevent injuries and boost your performance. In this blog post, we dive into our top foot care tips for runners to keep your feet in tip-top shape. Choose the right shoes It all starts with the right pair of running shoes. Everyone's feet are different, so there's no one-size-fits-all. Make sure your shoes fit well—there should be about a finger's width of space between your longest toe and the end of the shoe. The best way to find your ideal shoe is to visit a specialty running store (like our Toronto foot clinic!) where they can analyze your gait and recommend a shoe that suits your running style and foot type. https://youtube.com/shorts/TnDaLrqYTac?si=9ITp7rfI5t9SIeK9 Replace your shoes regularly Another one of our top foot care tips for runners is to replace your running shoes when they wear out. Running shoes don't last forever. Generally, they should be replaced every 450-800km. Worn-out shoes lose their shock absorption, grip, and support, which can lead to injuries. Look for signs like flattened soles or uneven tread to know when it's time for a new pair. You may also notice wrinkles among the various areas of cushioning. Incorporate foot-strengthening exercises Strong feet are less prone to injury. Simple exercises like toe curls, heel raises, and foot stretches can help build strength and flexibility. Try using a resistance band to stretch your feet and calves, and don't forget to roll a tennis ball under your foot to relieve tension and keep things limber. You may also find a lacrosse ball effective for a more rigid plantar fascia massage. https://youtube.com/shorts/gOwgyrmU6hM?si=CGKDpITzbsXnte2g Pay attention to your running form Sometimes, foot pain can be traced back to improper running form. Ensure you're landing with your feet underneath your hips rather than over-striding, which can put unnecessary stress on your feet. If you're unsure about your form, consider working with a coach or getting a gait analysis to pinpoint any issues. Stretch and foam roll Stretching isn't just for your legs and back; your feet need love, too. Incorporate foot stretches into your routine, focusing on the Achilles tendon, calves, and the bottom of your feet. For example, do a calf stretch by standing on a step and letting your heels drop below the level of the step. Foam rolling can also help, particularly if you're experiencing tightness in your plantar fascia or Achilles tendon. Keep your shoes dry Blisters and fungal infections love a moist environment. Make sure your feet are dry before putting on socks and running shoes. Choose moisture-wicking socks designed to remove moisture from your skin to help keep things dry. This can prevent blisters and reduce the risk of fungal infections. Consider using foot powder or antiperspirant if you're prone to sweaty feet. For additional moisture prevention, buy two of the same pairs of running shoes and cycle them in and out. Longer durations between uses allow the cushioning to decompress and give your shoes more time to dry thoroughly. https://youtube.com/shorts/I65eFhvnPhw?si=TADkBaNfQoyspzuZ Listen to your body Our final foot care tip for runners is to always listen to your body. If you're experiencing persistent foot pain, don't push through it. Ignoring pain can lead to more serious injuries later. Rest, assess, and seek professional advice if needed. Remember, rest days are just as important as training days. They give your feet and body the time they need to recover and adapt to the stress of running.

September 5, 2024

How to Treat and Prevent Athlete’s Foot: Tips from Chiropodists

Athlete's foot is a fungus that infects the skin on your feet. Many people get it, and it can cause a lot of problems. Your feet may itch, turn red, and peel when you have it. This fungus grows best in places that are warm and damp. The good news is that you can treat and stop athlete's foot if you know what to do. Here are some tips from chiropodists (foot specialists) to help you keep your feet healthy and free from fungus. Treatment strategies See a Chiropodist Because of all the moisture buildup on our feet, fungal infections can grow out of control very quickly; they're stubborn and persistent, and once the infection gets under the toenail, it becomes very difficult to treat. In addition, over-the-counter anti-fungal medications are not very effective unless the infection is in the very early stages. That's why it's important to see a chiropodist as soon as you notice any symptoms. A chiropodist will debride and clean up any fungal growth on the skin and prescribe a topical anti-fungal medication to help nip the athlete's foot in the bud before it spreads to the toenails. Oral anti-fungal medications, while effective, are often not recommended due to their side effects. Often, topical prescription anti-fungal medication and persistence are the best way to go. Maintain a rigid hygiene routine Your feet and body will thank you if you keep the infected area clean and dry. Wash your feet daily with soap and water and dry them well between your toes. Fungus grows best in damp places, so ensure your feet are dry before putting on socks and shoes. If you're particularly prone to sweaty feet, you can also try an anti-bacterial foot deodorant like Gehwol's Foot Deodorant spray. This can help prevent Athlete's foot, and even treat it in its very early stages. Avoid scratching Scratching the infected spot can cause other bacterial infections. To soothe the itch, try using antifungal creams or powders. If the infection gets worse or spreads, talk to a doctor. Change socks regularly Choose cotton or merino wool socks that let your feet breathe and wick away sweat. Wear fresh socks every day and change them after physical activity or when they get wet. This helps reduce moisture build-up, which can worsen the fungal infection. Prevention Tips Avoid walking barefoot in public Athlete's foot, along with other fungal infections, are contagious and spread when skin comes into contact with an infected surface. Therefore, always make sure you are wearing some kind of protective footwear in public spaces - like flip flops or slippers - in locker rooms, communal showers, pool decks and gymnasiums. Stick to a foot care routine Clean your feet and dry them well between your toes. Also make sure you cut and clean your toenails often, as fungi can hide under the toenails. Just make sure you don't cut them too short, or you can get an ingrown toenail. Put on the right shoes Pick shoes that let air flow through them. Avoid (if possible) wearing the same shoes all day, every day, and ensure they're dry before putting them on. Use flip-flops or water-safe sandals in public spots like pools or gym showers to avoid touching infected surfaces. Clean Your Shoes Fungal spores can hang around in shoes, which will feed the infection. To combat this, spray your shoes and socks with antifungal and antibacterial products, such as hypochlorous acid, zinc oxide or zinc incoleate, and dry them out before you put them on again. You can use Gehwol Foot & Shoe Deodorant Spray in your shoes, or dust Gehwol Foot Powder into your socks. These products contain zinc oxide and zinc ricinoleate, respectively, which are great for maintaining a healthy environment in your shoes. You can find these products at our Toronto foot clinic. Keep personal items to yourself Don't let others use your towels, socks, or shoes, and vice versa. Fungal infections are contagious and spread through touching or sharing personal items with people who have a fungal infection.

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 22, 2024

5 Common Foot Problems and How to Prevent Them

When it comes to foot problem prevention, being proactive is key to maintaining healthy feet and avoiding a future of discomfort. Understanding common foot issues and taking steps to prevent them can help reduce the risk of complications down the road. In this article, we’ll explore five of the most common foot conditions and provide essential foot care tips to help you keep your feet in top shape. Plantar Fasciitis One in ten people will experience plantar fasciitis in their lifetime, making it one of the most common foot issues. Plantar fasciitis at the start, can cause minor discomfort in the arch of the foot or even in the heel. It usually starts when you just get out of bed. It calms down through the day and then the soreness starts at the end of the day. That discomfort, if not properly treated and investigated, can increase and then start to cause stronger and sharper pain. Sometimes this pain can last through the day to a point where you might find it difficult to walk. The main cause is inflammation- constant pulling and tugging on the thick, inelastic fascia itself (midfoot pain). Or, where it inserts from (the heel pain). Pressure can be from the arch pressing down on the fascia: It can also be a tight muscle, like the calf muscle pulling up behind the heel and forcing the fascia to pull away from the heel It can also be a combination of a tight muscle and pulling of the fascia. In rare occasions plantar fasciitis is caused by a nerve entrapment. Prevention Preventing plantar fasciitis is mainly down to figuring out what was the cause in the first place. It might be a biomechanical issue with the feet. It could be due to the shoes that you might be wearing- at home, at work or just around town. In some cases it is due to a muscle imbalance. So figuring out the cause is the first step in treating and then preventing further plantar fascia pain in the future. One of the cornerstone treatments in preventing plantar fasciitis involves prioritizing arch support! It is a good idea to wear supportive shoes with good arch support and shock absorption, especially if you spend long periods standing or walking. Custom or over-the-counter orthotic inserts can also provide extra arch support and cushioning to distribute pressure more evenly across your feet. If you have a muscle imbalance then regular, targeted stretching of your calves and feet is also a healthy foot practice that can prevent foot ailments like plantar fasciitis. Stretching the calves is especially helpful as it reduces strain on the plantar fascia. Check out the best exercises for plantar fasciitis. You can do your exercise routine before bed and when you wake up to prevent this painful condition from affecting your mornings. Some patients have found rolling a tennis ball/ golf ball under their foot can be helpful to break up the inflammation to the area. Or rolling a wrapped frozen water bottle (no longer than 4 mins, then remove, wait to warm then walk) reduces inflammation build up Athlete’s Foot Athlete's foot can affect up to 15% of the global population! It's a fungal infection that usually occurs on the skin between the toes. However it can also start and spread to the arches and then to the boarder of the foot. It can be itchy, red scaly looking and sometimes crack. Inbetween the toes the skin can look more damp than normal. Prevention Athletes foot is prevented if you reduce the causes. It enjoys dark, moist environments with an ample food supply. So your feet can be a perfect place for this to thrive. It can be contagious but also you can be more prone to catching it. So, -if your feet are kept in a constant moist environment. - you go to public pools and walk around barefooted. - if you put your socks on right after having a bath or shower... All these issues increase the risk of catching Athletes foot and allowing it to spread. Prevention is linked to good foot hygiene. Therefore, make sure you wear slippers or flip-flops in public areas such as locker rooms or pools, and avoid walking barefoot in these places. You should also make sure your feet stay clean and dry, as fungus thrives in moist environments. Opt for moisture-wicking socks, foot deodorants and breathable shoes. And never put on your shoes while your feet are damp! If you are daily in the same shoes then try to use 2 pairs of shoes. Use one one day and one pair another day to allow the shoes to dry out. Change the insoles regularly. Morton’s Neuroma Some experts believe that one in three people will experience a Morton’s neuroma at some point. It is characterized by a thickening of the tissue around the nerves inbetween the balls of toes (typically between the 3rd and 4th balls of the toes), and causes pain and discomfort in the ball of your foot. You can get neuromas in other parts of the foot, but between the 3rd and 4th ball of the toes is called a Mortons neuroma Prevention Prevention is the best treatment for a Mortons Neuroma. Preventing the rubbing and thickening of the nerves is a priority. Unfortunately as the nerve thickens there is a chance that it will not go back to normal. Preventing a neuroma is simply by wearing wider footwear in the toebox. You can tell if it is your shoes just by removing the shoes and your soreness should subside. Remember that work shoes, normal outdoor shoes and even slippers can all have an affect on compressing the toes together. Having a heeled shoe puts more pressure upon the balls of your foot- so reducing arch height is also helpful (and if you must wear high heels, make sure they're the healthy kind!). Custom orthotics can provide a way to splay the balls of the foot so even if the neuroma has thickened, it can reduce the pressure the balls of the foot are placing upon the nerves. Ingrown Toenails Our toenails can be a bit troublesome sometimes —they crack, curl, get too thick, and sometimes even surprise us with strange colours! But one of the most common toenail conditions is ingrown toenails. Two out of every ten people visiting a healthcare provider for a foot issue end up complaining about this painful nuisance. Ingrown toenails can occur when a spike of nail is pressing into the skin. It can also happen if you have pincer like nails (involuted) and those nails press into the skin. If you have wider nails, the skin on the side of your toe can be more prone to go into the nail. If the toes are kept in a damp environment then the skin and nails will be soft and more easily press into one another Prevention Prevention comes with finding the cause and preferable no home treatment (in many cases it can make it worse). Apart from scratching your socks, placing a "V" into the nail doesn't do anything. Poor nail care is usually the main culprit especially cutting down the sides of the nail. It is better to allow the nail to grow past the skin line and then cut to the contour of the nail. Cutting straight across can leave angles and cutting down the sides can leave spikes of nail. If your nails are curled around or thickened then professional footcare can help thin down the nail and offer treatments for the curved nail. Reducing dampness can reduce ingrown toenails. Wider footwear (and non tight socks) can reduce the risk of compressing the skin into the nail. In some cases it can be hard to cut your nails effectively, if this is the case then having a medical pedicure from a professional is usually a good preventative option. Calluses Almost everyone will get at least a small foot callus in their lifetime and is a common foot issue. They are thickened areas of skin that develop due to repeated friction or pressure. Initially they can be pain free but as time continues then the callus can build up and adds pressure that that area. This adds more callus and now a cycle starts. Eventually too much pressure and the skin starts to break down and dry blood can appear within the skin. Prevention Callus is best treated by prevention- finding out why the hard skin is there in the first place. So a footcare professional will look at your feet and assess where the hard skin is and then find the cause- where is that pressure coming from. They will then reduce down the hard skin, to break that pressure cycle, then offer advice on how to prevent the hard skin coming back- or reducing its build up. In many cases this is due to poor fitting footwear or a mechanical issue with the foot. Preventing callus build up can be done once a week with a plastic footfile when the foot is dry. Pumice stones are used when the foot is wet. But it is usually a good idea to check the cause by a footcare professional as sometimes too much file or pumice use can make the area sore, affect the good skin surrounding the callus or even make the area worse as you might go too deep. Dry skin is prevented where you moisturize your feet regularly (but not inbetween your toes). It will also help the callus not crack but it won't prevent the callus build up- as that is caused through pressure.

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.

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Toenail Anatomy: Understanding the Structure Beneath Your Toes

Layers of the toenail

Nail plate

Nail bed

Lunula

Nail matrix

Trust Toronto's toenail experts at Feet First Clinic

About Author: Erica Halpern

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