June 19, 2023
Toenails serve a critical role in the health of our feet. They are are sensory organs that act like a shield, providing a critical layer of protection. The various parts of the toenail comprise toenail anatomy. These parts work together to protect the underlying tissues of the toe and aid in walking and other activities.
Toenails may look like a singular unit, they're actually pretty complex. In this blog post, we'll dive into the structure and functions of the different parts of our toenail anatomy, providing a deeper understanding of this often-overlooked aspect of foot health.
Nail plate
The nail plate is the hard part of the nail and is comprised of a tough protective protein called alpha-keratin. Keratin adds strength and durability to the nail. The nail plate grows out from the nail matrix. It is translucent, and its colour can vary from white to yellowish-brown, depending on the thickness and the presence of underlying tissues. The end of the nail plate is part of the nail you trim away when clipping your toenails.
Nail bed
The nail bed is the skin under the nail. It nourishes and supports the nail. The nail bed is composed of blood vessels, nerves, and cells called melanocytes, all of which combine to produce the pigment that gives the nail its colour. When the nail bed is damaged, you may notice your toenail appears to change colour. For instance, your nail bed may produce a purple/darkish colour known as a black toenail, which occurs when the nail bed is damaged and pools blood.
Nail matrix
Did you know it takes roughly 18 months for a toenail to grow its entire length? This is thanks to the nail matrix, which helps dictate toenail growth. The nail matrix is the part of the nail bed that produces new nail cells. It is at the base of the nail plate, just beneath the cuticle. The nail matrix contains specialized cells called keratinocytes, which produce the protein that forms the nail plate.
Lunula
The lunula is the crescent-shaped white area at the base of the nail plate. It's the actively-growing component of the nail. The lunula is sometimes called the "half-moon" of the nail due to its curvature and half-ringed shape.
Cuticle
The cuticle is the thin skin layer covering the nail plate's base. It protects new nails from bacteria when they grow from the root, and also helps to keep the nail plate hydrated.
Nail folds
The nail folds are the skin folds surrounding the sides and base of the nail plate. They help to anchor the nail plate in place and provide support and protection to the surrounding tissues. Nail folds direct the nail growth in the correct direction and shape. When the nail folds are damaged, you may experience horizontal grooves across the nail, known as Beau's lines.
Nail groove
The nail groove separates the nail plate and the nail fold. It helps to direct water and debris away from the nail bed.
January 16, 2023
Fact: Your toenails can give you clues about your overall health. That's right, the state of your nails, including toenails, can indicate an underlying health condition. Conversely, healthy nails can be a sign of a healthy lifestyle.
The state of our toenails can differ in a lot of ways. Toenails can splinter, thicken, thin, peel, dry out, break, and pit. Toenail pitting is the focus of this article.
Below, you'll learn about toenail anatomy, the basics of pitting, signs, treatment methods, and preventative measures to keep your nails in good shape.
Toenail anatomy
Before we delve into the details of toenails and pitting, we must understand their anatomy and the part it plays for our feet.
Toenails are the plate-like covers on our toes. Alpha-keratin, a type of protein, comprises toenails. Alpha-keratin is the same protein building block for hair and the outermost layer of our skin (the epidermis). Generally, the toenail is about 0.5 mm thick and slightly curved.
The toenail consists of several distinct components. The toenail includes the nail plate, the cuticle, and the nail folds surrounding the nail's perimeter. The part referred to as the toenail colloquially is the "nail plate."
What's toenail pitting?
Pitting, by definition, is an indentation. Toenail pitting follows the same logic. Pitting of the nail occurs when tiny dents or "pits" form in the nail plate. Toenail pitting is a type of nail abnormality.
Toenail indents can be shallow and only recognizable by touch. Deep toenail pits may be visible due to their concave nature. Within the grooves, some parts of the pitting may be deeper than others, just as there are deeper and shallow parts of a pit.
Nail pitting is generally more common for fingernails, but toenails are also affected.
What causes toenail pitting?
There are several causes for toenail pitting. Toenail pitting reasons range from external trauma to an underlying medical condition. Learn about the various causes of toenail pitting below.
Nail psoriasis
Psoriasis is a chronic inflammatory disease that can cause toenail pitting. Those with nail psoriasis produce too many skin cells, causing nail irregularities. According to Healthline.com, approximately 80% of those with psoriatic arthritis experience nail irregularities or changes.
You may be able to recognize nail psoriasis because of two related symptoms: discolouration and nail bed separation. There are a few groups more likely to develop nail psoriasis. At-risk factors include:
People who are over 40 (though psoriasis may occur at any age)
Males
Genetics
Psoriatic arthritis
According to a study published in the National Library of Medicine, psoriasis can cause toenail pits "remarkably even in size and depth. Their distribution may be haphazard or sometimes arranged in parallel transverse or short longitudinal lines."
Though psoriasis is not curable, you can mask the effects of toenail pitting. You can buff or apply nail polish to hide the indents and improve the aesthetic.
Nail eczema
Eczema is a condition that causes itchy and red skin. The disease can cause nail thickening or pitting when eczema targets the feet.
Habit-tic deformity
Habit-tic deformity on the fingernail.
The habit-tic deformity is a nail condition similar to toenail pitting with several differences. When you constantly pick at your nails, external trauma can create pits in your nail. The habit-tic deformity is most common on the fingernails, specifically the thumbs, but it can also happen on your toenails. For instance, if you sit cross-legged or have your feet at arm's reach, you may develop a habit of picking at your toenails.
The defining features of habit-tic deformity are horizontal ridges across the nail and a slight depression in the middle of the nail plate. The habit-tic deformity is not severe and typically heals if left alone. The condition is known as "washboard nails" because of the horizontal nail ridges.
Reiter's syndrome/reactive arthritis
Those with reactive arthritis may experience toenail pitting. An infection or bacterial infection elsewhere in the body can cause reactive arthritis, also known as Reiter's syndrome. People with a specific type of gene are more likely to develop the condition, as it's believed to be genetic.
How do you fix nail pitting?
Toenail pitting fixes vary. In some cases, like psoriasis, there is no cure. Cosmetic procedures are an option to mask the effects. Removing external trauma can help reverse toenail pitting in cases like a habit-tic deformity.
Additional treatment options include medication applied to the nail itself. Options include steroids, salicylic acid, calcipotriol, cyanoacrylate adhesive (for the habit-tic deformity) and tazarotene.
Is nail pitting serious?
In most cases, nail pitting as a symptom isn't severe. Nail pitting is more often a cosmetic issue than a medical issue. However, the underlying conditions that cause toenail pitting can vary in severity.
October 20, 2022
Toenails aren't always something we pay attention to. They're hidden in our shoes all day long, and when we relax, we can often forget about our feet. But when we notice curled toenails or pincer nails, it's a whole new ball game.
When our toenails curl upward or downward, it can cause a lot of insecurity and self-consciousness. It can be a perplexing condition that occurs alongside other worrisome traits, and they just aren't what healthy toenails should look like.
The slight glimmer of good news is that curled nails don't just occur for no reason. You, your foot care specialist and your family doctor will be able to determine the cause by zeroing in on the additional symptoms. From that point, you can follow a treatment plan to address your curled toenails and your condition.
Here are some common reasons for curled toenails:
Fungal infections
Autoimmune disease
Medications
Diabetic toenail
Genetics
The Connection Between Curled Toenails and Ingrown Toenails
Curled toenails are almost always ingrown, and both conditions arise from the same causes. The growth pattern of an ingrown toenail causes it to curve over time, often curling inward along the sides of the toe (usually the big toe). Eventually, the curled toenail pierces the skin and starts to grow into the skin, causing tenderness, redness, and swelling.
Fungal Infections
Curved toenails can result from fungal infections. Onychomycosis is usually associated with a curling shape in the nails. Other symptoms include dry toenails, a greenish-yellow tint in the nails, thickening and total separation from the nail bed.
Fungal infections resulting in curled toenails usually arise in older people suffering from peripheral vascular disease and diabetes. Having a chronic immunological illness can also be a risk factor.
It's difficult to treat toenail fungus at home, so you should help from a specialist. Patients may take oral prescription anti-fungal pills for 12 weeks. A total nail avulsion performed by a foot specialist may be required in severe cases.
Autoimmune Disease
As we've mentioned, autoimmune conditions can degrade once healthy toenails in addition to curling them.
One example is nail psoriasis, which can completely alter your toenails' structure, colour and texture. Your nails can turn yellow or brown, and tiny red spots may even form. The toenail may also hurt, and grooves and ridges appear. The pain stems from debris formation that alters the direction the nail grows in.
Medications like corticosteroids (injections or potent oral medicines) and tazarotene (for tackling the nail shape) can be particularly useful in treating nail psoriasis.
Medications
The culprit behind your strangely shaped toenails could be drug-induced nail disease. This phenomenon usually causes pain and discomfort in addition to a drastic change in the nail's shape and colour, and nails become more brittle.
Countless drugs can cause curled toenails. Chemotherapy drugs, lithium and antibiotics are just a handful of examples.
Diabetic Toenails
A curved toenail may result from diabetes-related onychogryphosis, or "ram horn," when nails take on a severely curled and thickened appearance. There are also several other variations of diabetic curled toenails.
People with diabetes frequently neglect to cut their toenails because of the shame associated with the complications of their disease, but diabetic nail care should be a top concern.
Diabetic toenails can ultimately lead to irreversible damage like foot ulcerations, skin breakdown and severe infections (even gangrene).
Genetics
Families can pass down certain characteristics that contribute to curled toenails. Factors such as the shape of the nail, the amount of skin surrounding the nail, and even the shape of your toes can be hereditary, making you genetically prone to toenail growth issues. So if you're struggling to understand why you have this recurring problem, it may be a good idea to compare symptoms with your close family.
Remember, you can combat toenail conditions by taking the proper precautions, even when genetics are at play. Be sure to wear properly fitted footwear, take care of your nails, and prevent damage at all costs.
How to Fix Curved Toenails
It's not about fixing the curled toenails; it's about management. Frequently, curled toenails occur alongside another condition, so you may not be able to get rid of them entirely.
Managing your curled toenails involves monitoring them around the clock and the proper nail care. You can figure out a system to help you cope and keep your nails as healthy as possible.
Nail and Foot Care
If you aren't sure how to properly cut curled toenails, don't try to do it yourself. Instead, seek help from a trusted chiropodist or partake in medical pedicures. If you do it yourself without the right knowledge, you are putting yourself at risk of developing an ingrown toenail.
Generally, it's crucial to keep your nails short and clean regularly. You should also use a file to keep your toenail edges smooth and use moisturizers for the cuticles.
Since pincer nails are usually ingrown, you'll want to take extra care and prevent painful, recurring ingrown nails. Wear shoes that fit correctly and leave ample space in the toe box. While everybody should adhere to these guidelines, those struggling with curled toenails must be extra vigilant.
OnyFix
OnyFix is a new, revolutionary, and pain-free way to treat ingrown and curled toenails. Performed by a chiropodist, the non-invasive procedure corrects the natural growth pattern of your toenails, so the experience isn't just a quick fix.
Chiropodists correct the nail growth path by using a composite material in the shape of a thin band. After applying it to the top of the nail, it ensures the rest of the nail grows in a straight direction. With OnyFix, you can enjoy a future without nail issues and relatively instant pain relief (usually noticeable soon after treatment).
October 6, 2022
It's no mystery when you have a stubbed toe. It usually results from a sudden hit or jam into furniture or another foreign object. Tripping over something or getting your toe stuck can also cause this painful nuisance.
The sudden pain from a stubbed toe can be both alarming and momentarily debilitating. While most stubbed toes come and go, it's important to look for signs of a more serious injury and how you can relieve it.
Stubbed Toe: What to Look Out For
Since stubbed toes are so common, most people assume that they don't cause complications or can't be serious. However, stubbed toes can range in severity. It's even possible to confuse a broken toe for a stubbed toe.
Here are some signs to pay attention to:
If your stubbed toe is turning purple: Internal bleeding under a stubbed toenail can cause bruising and blood pooling, or a subungual hematoma. Typically, a purple or blueish tint in a stubbed toe will go away. But if it doesn't go away within a few days or the colouring spreads, you may have a broken toe.
If you've stubbed your pinky toe: Your pinky toe is more vulnerable than its counterparts since its placement and small size leave it more susceptible to injury. Despite this, you should follow the same steps to healing your pinky toe as any other toes.
Stubbed toe and nail damage: Sometimes, stubbing your toe can lead to a cracked toenail. The sudden impact to the toenail may also be enough to break deep into the nail plate and cause bleeding. It may be painful and difficult to walk for a while as the broken portion of the nail regrows. It's important to pay close attention to an open, externally bleeding toenail as it is vulnerable to infection.
Stubbed toe vs. broken toe: If you notice discolouration and pain that does not subside, deformity, and stiffness, you may have broken your toe.
Swelling and difficulty walking: See a doctor or foot specialist if you notice swelling and an inability to put weight on your foot.
How to Relieve a Stubbed Toe: Stubbed Toe Treatment
To prevent stubbed toes as much as possible, wear orthopedic slippers or other footwear indoors. Going barefoot at home is second nature for many of us, but protective footwear can prevent many minor injuries.
The RICE method is one of the most effective ways to handle sudden minor injuries.
Rest: If the pain from your stubbed toe is lingering, stop physical activity and rest your foot. Many healthcare professionals suggest staying off your toe for at least 48 hours.
Ice: Applying ice to the toe can reduce pain and swelling.
Compression: Light compression also reduces pain and swelling. Try using a medical bandage or gauze.
Elevation: Raising your foot can reduce swelling, pain and throbbing. You can easily elevate your foot by stacking a few pillows on top of each other and placing your foot on top of them while laying down.
You can try nonprescription medication, like Ibuprofen to help relieve throbbing pain. Additionally, if you have a cracked toenail, you can try soaking it in an Epsom salt foot bath.
If you're concerned about the severity of your stubbed toe, you can schedule an appointment with a chiropodist. They may be able to tape your toe, so it heals faster. Furthermore, they can determine if your toe is broken during a thorough foot assessment. If your chiropodist suspects a toe fracture, they may suggest x-rays.
How Long Does a Stubbed Toe Take to Heal?
In many cases, your toe will be momentarily painful but quickly feel better.
If the impact pain is excruciating, use the RICE method. See a foot specialist or your doctor if the pain doesn't subside within several hours.
If you have a toe fracture, the average recovery time is 4-6 weeks.
September 26, 2022
Oh no! You have a cracked toenail. You maybe just stubbed it while you were in a rush, or perhaps you're not wearing shoes with enough room in the toe box.
If you're prone to certain foot conditions, cracked toenails can also be a symptom of something more sinister.
A slight detachment or crack is not a pressing issue. But if you do crack your toenail, you probably have a lot of questions. In this article, we'll answer the following:
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?
A mild case of a cracked toenail is no cause for alarm. A torn or detached nail will eventually grow back, and you will notice progress about 6-8 weeks after your toenail cracked.
But it's important to state the obvious: once the toenail detaches itself completely from the nail bed, you can't simply reattach it. You will have to play the waiting game.
Furthermore, the cause of the cracked toenail may determine how long it will take to grow back fully. 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:
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 nail growth.
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, and it may take up to a year before your nail looks normal again. But luckily, there are ways to manage pain and protect your nail health.
The typical course of action is to wait patiently for the nail to grow back, but you may 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.
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 tend to 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 and nail care.
While you wait for a cracked toenail to grow back fully, avoid getting a cosmetic pedicure. 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.
September 1, 2022
Toenails are our body's shield that protects the skin below it and the tissue around it. Like any defence system, toenails can withstand repeated trauma, but they're not entirely impermeable. Toenails are susceptible to loosening, breaking, splintering, abnormal growth, and cracking. In this article, we'll discuss the latter, specifically how to treat a cracked toenail.
How to spot a cracked toenail
A cracked toenail occurs when there is a breakage in the nail. This can occur either at the base, middle, or tip of the toenail. Thinner toenails are more vulnerable to cracking. You may also notice flaking, which indicates a brittle, weakening surface.
How to treat a cracked toenail
Now that you've spotted a cracked toenail, you can begin treating it so it can return to full health and strength. The steps you'll find below are comprehensive - the steps you ultimately follow to treat a cracked toenail will depend on the severity and the underlying cause. You may be able to skip steps, jump ahead, or have to return to certain treatment methods for a full recovery.
Step 1: Stop to assess the damage
First, you should assess the damage to the nail. This will help influence the treatment needed. There could be varying degrees of damage to your toenail including but not limited to:
A crack extending from the tip of the nail to the nail bed
Complete or partial detachment of the toenail from the toe
Toenail breakage
Toenail discolouration
Pain, tenderness or sensitivity around the affected area
Fungal infection (causing a cracked toenail)
Step 2: Clean the affected area to prevent infection
If your nail bed is partially exposed, clean the nail and its surroundings with soap and water and dry properly. If your nail is still intact but with a small crack, look for any debris or dirt that may have lodged itself in the crevasses.
Step 3: Remove any artificial nail if it begins to separate from the nail bed
Leaving an artificial nail on the nail bed can lead to further tears. It can also get caught or snagged on your sock or shoe and make things worse.
Step 4: Trim and/or file your toenail
File and/or trim your toenail (make sure you're using the best of the best toenail clippers too!) to ensure there are no jagged edges that could get caught on something. This prevents any additional damage to the area.
If there is breakage near the tip of the nail, trim off the detached portion. This should reduce the chance of the nail catching and tearing.
Step 5: Applying dressing to the affected area
Apply a dressing, such as a bandage, toe sleeve, or toe cap, on the toenail to protect the area. This also provides a layer of padding between the toenail and your footwear. Replace the bandage or sleeve if it gets wet and monitor the toenail every few days when swapping a new wrap.
Step 6: Continue (or start) with general foot care
Proper foot care, including washing regularly, trimming toenails, keeping your feet and toes moisturized, and wearing proper footwear, will help encourage toenail growth and limit additional damage to the cracked toenail.
Step 7: Consult a chiropodist
When in doubt, consult a professional. A chiropodist can help you treat a cracked toenail, especially if the toenail is infected. For example, a chiropodist can drain the infection site. Further, if there are complications and no other nailcare treatments work, an expert can perform a procedure where the nail is removed entirely.
Step 8: Let the toenail grow out naturally
If the above isn't relevant, and the cracked toenail is not severe, you can let nature run its course. Simply continue to trim your toenail until the cracked portion grows out. In fact, this is the ideal treatment.
That said, toenail growth can be slow so be patient; toenails can take 12-18 months (1.5 years) to fully grow (granted there are no other underlying issues to the toenail other than trauma), although less time may be required if you don't require full re-growth. If the cracked toenail is closer to the edge, then it may just take months, if not weeks, to gradually grow out to the point where you can begin nail trimming. There are ways to expedite the process like taking a biotin supplement. Read our full article on how to get your toenails to grow faster.
Step 9: Addressing and treating any foot deformities or biomechanical abnormalities
Cracked toenails are often secondary to other issues like trauma. If you have a biomechanical issue that causes excessive pressure, friction or banging on the affected toe, it can slow the healing process and the issue can reoccur. By investing in proper footwear and addressing any biomechanical abnormalities that may cause trauma to the toenail, you'll ensure you are doing your best to prevent any future damage to your toenails.
Step 10: Use nail hardeners
Supplement nail regrowth with a nail hardener. Nail softness makes nails more prone to breaking, which increases the need for nail regrowth.
