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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.
January 30, 2025
Toenail conditions can cover a wide range of problems, each with its own set of symptoms. Typical causes and risk factors include wearing ill-fitting shoes over long periods, contracting contagious fungi, infections, cutting your toenails incorrectly, having poor circulation and more. Today we’ll talk about the 5 most common toenail conditions and what you can do to address each one. Nailed it!
5 Common Toenail Conditions
Ingrown toenails
Toenail fungus
Cracked/stubbed toenails
Discoloured toenails
Onycholysis
Risk Factors for Common Toenail Problems
Improper nail trimming, such as cutting nails too short or rounding edges.
Wearing tight or ill-fitting footwear that puts pressure on the toes.
Frequent exposure to damp or moist environments - this leads to fungal infections, which can spread and worsen without treatment.
Walking barefoot in communal areas, which increases exposure to fungi and bacteria.
Trauma to the toes, such as stubbing or dropping heavy objects.
Poor foot hygiene, leading to debris buildup and a more favourable environment for bacteria and fungi.
Genetics, including naturally curved nails or a family history of nail issues.
Poor circulation, which disrupts the natural toenail growth process and can lead to an array of toenail deformities and misshapen toenails.
Medical conditions like diabetes or peripheral vascular disease, which impair circulation and healing. It's extremely important to attend regular appointments with a chiropodist or podiatrist if you have diabetes as even deceptively minor issues, like cracked toenails or ingrown toenails, can turn into diabetic ulcers when ignored.
Psoriasis or other skin conditions affecting the nails.
Weak or brittle nails caused by aging, poor nutrition, or overuse of harsh chemicals (too many cosmetic pedicures).
Repetitive pressure on nails from activities like running or wearing high heels.
1. Ingrown Toenails
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Ingrown toenails are one of the most common toenail problems, with some studies suggesting they affect 20% of patients who seek medical care for foot-related issues. They occur when the edges or corners of a toenail grow into the soft skin surrounding it. This leads to inflammation, swelling, and pain. The big toes are particularly prone to this condition due to their size and the pressure they endure during daily activities.
Nails grow from the nail matrix, a layer of tissue beneath the cuticle that produces keratin, the protein that forms the nail. Healthy nails grow straight outward, following the curve of the toe. However, if the nail is cut incorrectly, exposed to excessive pressure and toe crowding in shoes, or grows irregularly due to genetics, its edges can deviate and pierce the surrounding skin.
Once the nail edge enters the skin, the body identifies it as a foreign object. This triggers an inflammatory response, where blood flow to the area increases, causing redness, swelling, and pain. If bacteria enter the wound, infection may develop, leading to pus and further discomfort.
Treatment for ingrown toenails depends on the severity of the condition and the individual’s needs. For mild cases, conservative care such as warm water soaks, antibiotic ointments, and proper nail trimming can help alleviate discomfort and prevent infection. Professional treatments offer more targeted solutions.
OnyFix is a non-invasive option that uses a specialized band applied to the nail, gently guiding its growth to prevent future ingrown edges without the need for surgery. Medical pedicures, performed by a chiropodist or podiatrist, safely address ingrown nails by trimming and reshaping them with sterilized tools while maintaining overall nail health. For severe or recurrent cases, surgical interventions such as partial or total nail avulsion may be necessary to remove the problematic portion of the nail and ensure long-term relief. Consulting a foot care specialist is key to determining the most effective treatment plan.
https://www.youtube.com/shorts/ZsFQqCkVf40
2. Toenail Fungus
Fungal toenails occur when fungi infect the nail bed, causing changes in the nail's colour, texture, and thickness. The fungi thrive in warm, moist environments, which makes the toes a prime target, especially in people who wear tight shoes, sweat excessively, or walk barefoot in public areas. Over time, the nail may become discoloured (yellow, brown, or white), thickened, and brittle, and it may even begin to separate from the nail bed.
Fungal infections can be persistent and difficult to treat due to the fact they’re essentially stuck under the nail. This means professional intervention from a chiropodist or podiatrist is necessary. They can apply topical antifungals after performing nail debridement (removing a part of the infection) so they have access to the nail.
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3. Cracked / Stubbed Toenails
Cracked and stubbed toenails often coexist. They occur when the nail becomes brittle and breaks, often due to factors like dehydration, excessive moisture, or external pressure from tight shoes. The nail’s keratin structure weakens, leading to splits or fractures. Stubbed toenails, on the other hand, happen when the toe is forcefully struck, causing immediate pain and potential damage to the nail, which includes cracking.
You can usually let your cracked toenails grow out naturally. If the nail is cracked due to sudden trauma and there is no other culprit at play, this will take about 6 to 8 weeks to start, and sometimes over a year to completely regrow properly. A chiropodist or podiatrist might be able to provide a remedy to encourage faster growth, and suggest the best footwear for your feet to avoid toe crowding and further nail damage.
In the case of complications or a more sinister underlying problem, a foot specialist may partially or fully remove the nail (avulsion) or apply dressing to the area to prevent infection.
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4. Discoloured Toenails
Discoloured toenails are more of a symptom than a problem. When the nail changes colour, it often reflects a problem with the nail, tissue beneath it, or your general health. Fungal infections, for example, commonly cause yellow or brown discoloration, as the fungi damage the nail and its growth. Trauma can also lead to discolouration, often presenting as a dark bruise (purple or black) due to blood pooling under the nail.
Nail Discolouration Causes and Colours:
Yellow: Fungal infections, thickening, aging.
Black: Trauma or bruising beneath the nail, potentially accompanied by blood pooling.
White spots: Trauma, fungus, allergies — generally harmless.
Bluish/Pale: Circulation issues, anemia, or other health conditions.
Treatment is difficult to discern as many factors may be causing discolouration. The best course of action is scheduling a foot assessment or nail care appointment with a chiropodist or podiatrist at a foot clinic.
5. Onycholysis
This is a term for when your nail starts to separate from the nail bed. It often coexists with toenail fungus, psoriasis or trauma/toe injuries. Depending on the cause, you may need a full course of fungal toenail treatment at a foot clinic, or you may need to ask a specialist what’s causing the problem before they curate a treatment plan. As mentioned before, the detached portion of your nail will usually grow back on its own if it's separated because of trauma.
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Prevention Tips for Common Toenail Problems
Trim nails straight across and avoid cutting them too short.
Wear properly fitting footwear that allows adequate toe room.
Maintain good foot hygiene, including regular washing and drying of feet.
Avoid walking barefoot in communal areas to reduce the risk of fungal infections.
Keep feet dry, especially in winter, and use moisture-wicking socks to prevent fungal growth.
Protect toes from trauma by wearing protective footwear in hazardous environments.
Moisturize nails and cuticles regularly to prevent brittleness and cracking.
Avoid harsh chemicals, including acetone-based nail polish removers.
Monitor nails for discoloration, thickening, or unusual texture changes.
Seek professional care from a chiropodist or podiatrist if you suspect you have a fungal infection. You can’t treat these at home.
Seek professional care from a chiropodist or podiatrist if you notice persistent pain, redness, or swelling.
Schedule foot assessments and regular medical pedicures with a chiropodist or podiatrist so they can keep an eye on your feet — four eyes are better than two!
August 15, 2024
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
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
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
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.
