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February 5, 2026
If you are like most people, you want your feet to stay healthy and pain free. However, even with the best intentions, many people unknowingly develop habits that can damage their feet over time.
From improper nail trimming to walking barefoot in public spaces, foot care mistakes are more common than you might think. The good news is that most of these issues can be prevented with proper education and routine care.
Below, our team of experienced chiropodists at Feet First Clinic outlines the top five most common foot care mistakes and how to avoid them. We specialize in preventive foot care and the treatment of both common and complex conditions, offering services such as routine care, assessments, and custom orthotics.
1. Cutting Your Toenails Incorrectly
Toenail trimming may seem simple, but doing it improperly can lead to painful ingrown toenails and infections. Cutting nails too short, rounding the edges, or cutting into the cuticle increases the risk of the nail growing into the surrounding skin.
To reduce this risk, soften your nails by soaking them in warm water before trimming. Always cut straight across and avoid cutting too close to the skin. If you develop a painful or infected ingrown toenail, it is important to seek professional care promptly.
Another common mistake when it comes to ingrown toenails: trying to treat them yourself or at a salon. Some of the worst ingrown toenails we've seen at the clinic are due to botched DIY attempts. If your toenail is ingrown, especially if it's irritated, it's recommended that you book an appointment immediately with a chiropodist; they're trained to treat ingrown toenails properly and prevent them from getting worse. A chiropodist will also trim your toenails so that they grow back properly and straight.
2. Walking Barefoot in Damp Areas
Many people walk barefoot in public locker rooms and showers. Although this may not seem like a huge issue to some people, doing this can seriously harm your feet. It's recommended to wear some sort of protective footwear while you’re walking in moist areas.
Some examples of reliable footwear include:
Sandals
Flip-flops (just for those public spaces)
Water shoes
Shower shoes
Doing this is important for preventing issues like toenail fungus. This will cause your nails to become yellow, thick and foul-smelling; they may even fall off! Men tend to have a higher chance of developing foot fungus, along with elderly people and individuals that suffer from athlete’s foot. Once fungus gets underneath the toenail, it becomes very difficult to treat; at-home treatment is typically ineffective. This is because the toenail blocks anti-fungal medication from penetrating and reaching the fungus. That's why it's important to see a chiropodist at the first sign of toenail fungus. They can debride the toenail to make it easier for anti-fungal medication to penetrate to the fungus living in the nailbed.
Walking barefoot in public places can also cause warts. Warts are a contagious virus that spreads when bare skin comes into contact with an infected surface. The wart-causing virus especially thrives in warm, damp places, like locker room floors and the puddles on pool decks. Left untreated, warts can multiply and spread to other people. Sometimes you can treat warts in the early stages with over-the-counter treatments. However, if those are ineffective, it's recommended to see a chiropodist to eradicate your warts once and for all. Unlike family doctors and dermatologists, chiropodists can debride the dead skin and callus that forms over the wart, which helps the treatment penetrate through the wart tissue and treat the warts faster.
3. Ignoring Early Signs of Foot Problems
Many people dismiss early symptoms such as redness, thickened nails, calluses, or mild discomfort. Unfortunately, delaying treatment often allows minor issues to develop into more serious foot conditions.
Addressing concerns early can prevent pain, reduce complications, and keep your feet healthy long term.
4. Wearing Poorly Fitting Footwear
Did you know that between 63% to 72% of the population are wearing shoes that don't fit correctly? Shoes that are too tight, too loose, or lacking proper support can contribute to problems such as blisters, corns, bunions, and heel pain. While style may be important, proper fit and support should always be the priority.
Well fitted footwear helps support proper foot function and reduces strain on the feet, ankles, knees, and lower back. It's also important to make sure your shoes accommodate your foot type and gait pattern. If you don't know your foot type, you can get a biomechanical assessment with a chiropodist to find out.
5. Skipping Preventive Foot Care
Many people only think about foot care when pain develops. Regular foot assessments, proper hygiene, and preventive treatment are essential for maintaining healthy feet, especially for individuals with diabetes or circulation concerns.
Routine visits to a chiropodist can help identify potential problems early and keep your feet comfortable and functional. Something as simple as a medical pedicure can go a long way.
November 13, 2025
Toenail fungus is a common foot problem that affects people of all ages, but the risk increases significantly as we grow older. Understanding the connection between age and toenail fungus can help you take steps to protect your foot health and maintain strong, healthy nails throughout your life.
Why Does Toenail Fungus Become More Common with Age?
Several factors make older adults more susceptible to toenail fungal infections:
1. Reduced Immune Function
As we age, our immune system naturally weakens, making it harder for the body to fight off infections, including fungal infections.
2. Slower Nail Growth
Toenails grow more slowly with age, which means fungi have more time to settle and multiply before the nail is naturally shed.
3. Poor Circulation
Aging often comes with reduced blood flow, especially to the extremities. Poor circulation means fewer nutrients and immune cells reach the toenails, impairing the body’s ability to fight infections. Poor circulation also disrupts the toenail growth and moisturization process. This makes toenails more dry and brittle, which makes it easer for fungal infections to penetrate the toenail and set up shop.
4. More Exposure and Wear
Years of nail trauma, tight footwear, or minor injuries can create entry points for fungi.
5. Other Health Conditions
Older adults are more likely to have conditions like diabetes or vascular disease that increase the risk of fungal infections.
Common Symptoms of Toenail Fungus
Thickened nails
Discoloration (yellow, brown, or white spots)
Brittleness or crumbling of the nail edges
Distorted nail shape
Unpleasant odor in some cases
Separation of the nail from the nail bed (onycholysis)
Prevention Tips for Older Adults
Maintain Good Foot Hygiene
Wash feet daily and dry thoroughly, especially between toes.
Keep nails clean and trimmed straight across.
Avoid nail salons. Improperly sanitized tools and foot baths can result in the spread of fungus from other patrons. Instead, opt for a medical pedicure at a foot clinic by a chiropodist.
Wear Proper Footwear
Choose breathable shoes with enough room to avoid pressure on nails.
Avoid walking barefoot in communal areas such as pools or locker rooms.
Manage Underlying Health Conditions
Control diabetes, circulatory problems, and other health issues with your healthcare provider.
Regular Foot Inspections
Check your feet and nails regularly for changes or signs of infection.
You can also get routine medical pedicures by a chiropodist. A chiropodist will monitor your foot health and notice the first signs of any infection.
Consult a Specialist Early
At the first sign of nail changes or discomfort, see a foot care professional for diagnosis and treatment.
Treatment Options for Toenail Fungus
Treatment may include topical antifungal creams, oral medications, laser therapy, or in severe cases, removal of the affected nail. Early intervention improves the chances of successful treatment.
Treating toenail fungus with over-the-counter medication is often ineffective because the toenail blocks medication from penetrating the nail bed. Instead, it's recommended to see a chiropodist at the first signs of a fungal infection. The chiropodist can debride the toenail, which allows prescription antifungal medication to penetrate the nail bed and attack the fungus.
October 16, 2025
Diabetes is a chronic condition that affects many parts of the body, including your feet and toenails. Proper foot care is especially important for people with diabetes because they are at a higher risk of developing complications that can impact mobility and overall health. Understanding how diabetes affects toenails can help you prevent problems and maintain healthy feet.
Why Diabetes Impacts Toenail Health
People with diabetes often experience poor circulation and nerve damage (neuropathy) in their feet. These issues make it harder for wounds and infections to heal and can reduce sensation, so small injuries or infections may go unnoticed. Toenails can also become more vulnerable to damage, infections, and deformities.
Common Toenail Problems in People with Diabetes
1. Fungal Infections
Diabetes can weaken the immune system, making it easier for fungal infections like athlete’s foot or toenail fungus to develop. Fungal toenails may become thickened, discolored, brittle, and painful.
In addition, good circulation is required for the natural moisturization processes in the toenails and feet. Diabetes disrupts blood flow to the feet, which means they can't properly moisturize themselves. This dries out the toenails and causes them to become brittle. It also dries out the skin, which can cause small cracks and abrasions. Fungus can then more easily penetrate through brittle cracked toenails and abrasions. Once it does, it's harder for your body to fight the infection due to diabetes' affect on the immune system.
2. Ingrown Toenails
Reduced sensation means small cuts or ingrown toenails might not be felt immediately, increasing the risk of infection. Ingrown toenails can cause redness, swelling, and pain if left untreated.
3. Toenail Discoloration and Deformities
Poor circulation and infections may cause toenails to change color, thicken, or become deformed. This is because circulation is required to facilitate the toenail growth process. When this process is disrupted, it causes nail cells to build up on top of each other rather than beside each other, which causes thickening and an irregular toenail shape. This can make nail trimming difficult and increase the risk of injury.
4. Delayed Healing
Any cuts or injuries around the toenails heal more slowly in people with diabetes, increasing the chance of complications like ulcers or infections.
Tips for Preventing Toenail Problems with Diabetes
Practice Good Foot Hygiene
Wash your feet daily with warm water and mild soap.
Dry your feet thoroughly, especially between the toes.
Keep Toenails Trimmed and Clean
Cut nails straight across to prevent ingrown toenails.
Avoid cutting nails too short or rounding the corners.
Wear Proper Footwear
Choose shoes with a wide toe box and good support.
Avoid tight or narrow shoes that can cause pressure and injury.
Regular Foot and Toenail Checks
Inspect your feet daily for cuts, blisters, redness, or swelling.
Have a healthcare professional, like a chiropodist, examine your feet regularly.
Manage Blood Sugar Levels
Keeping blood glucose under control supports overall foot health and healing.
When to See a Foot Specialist
It is recommended that people with diabetes include a chiropodist in their healthcare team and see them on a routine, ongoing basis for diabetic foot care. When it comes to diabetes, prevention is the best treatment.
If you notice any signs of infection, persistent pain, changes in nail appearance, or wounds that don’t heal, it’s essential to seek professional care promptly. Early intervention can prevent serious complications, including foot ulcers and infections that may lead to amputation.
April 10, 2025
Curved toenails can indicate various underlying toenail conditions, each with unique causes and additional characteristics. They also don’t always look the same. Toenail curvature issues can range from having a severe Ram’s Horn toenail, accompanied by other symptoms like thickening and discoloration, or small pincer nails that pierce your skin. Let’s learn about curved toenail causes, and most importantly, how a chiropodist or podiatrist can treat curved toenails at a foot clinic so complications don’t arise.
Why Do Toenails Curve?
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To understand the best ways of preventing curved toenails, it’s important to learn how healthy toenails grow. They should naturally grow forward in a slightly arched but mostly flat shape, following the contour of the toe. This process begins in the nail matrix, the tissue under the skin at the base of the nail, where specialized cells produce layers of keratin—the protein that makes up the nail.
As new cells form, older cells are pushed outward, harden, and form the visible nail plate. Ideally, the nail grows evenly and straight across, guided by both the shape of the matrix and the direction of mechanical forces applied to the toe, like walking or wearing shoes. The nail bed beneath provides support and helps keep the nail anchored and flat as it grows. A balance between nail thickness, width, and surrounding skin tension is key to maintaining this typical shape.
Toenails start to curve when something disrupts this balance.
Repetitive Trauma from Ill-Fitting Footwear
One common reason is uneven pressure and toe crowding. Tight footwear or repetitive trauma can push the nail’s edges downward or inward over time. That’s why one of the best ways of preventing curved toenails, or virtually all foot conditions for that matter, is purchasing and wearing only shoes that fit properly, allow your toes to splay comfortably, and have ample cushioning, arch support and shock absorption. It’s better to have a small selection of solid, high-quality shoes that support foot health than several pairs of low-quality, poorly designed shoes that cramp your toes.
https://www.youtube.com/shorts/rwNLRZ-MN_M
Genetics
Genetics also play a role in abnormal toenail growth; some people naturally have a more curved nail matrix or a narrower nail bed, both of which can encourage curling. If keratin production is uneven—say, one side of the nail grows faster than the other—the nail can begin to twist or curve as it extends.
Underlying Health Conditions
Inflammatory conditions, infections, poor circulation, or chronic diseases like diabetes can also interfere with normal nail growth by altering cell turnover in the matrix or causing changes to the skin and tissue around the nail. As a result, curved toenails are often not just a cosmetic issue—they can signal deeper structural or health-related concerns.
Curved Toenail Causes
Whether your curled toenails are the result of a sinister condition or simply a genetic growth pattern you’ve inherited, preventing them from getting worse is key. No matter the cause, proper trimming (straight across with simple nail clippers) and wearing shoes that fit well are two of the best things you can do from home to prevent painful complications and live life as comfortably as possible. Below you’ll find some of the most common causes of curved toenails:
Ingrown Toenails (Onychocryptosis)
Ingrown toenails are tricky as they look deceptively mild. But complications, like painful infections, can arise if you ignore them. They develop when the edge of a curved toenail grows into the surrounding skin, causing swelling, redness, and sensitivity. They can look curved, but they also look like a small “extra nail” on the edge of the main nail. It most commonly affects the big toe, and naturally curved toenails (involuted nails) are more likely to become ingrown because their growth pattern is already unusual.
Trimming the nails too short or rounding the edges can also encourage the skin to fold over the nail edge, allowing it to grow inward instead of outward. Repeated pressure or trauma from sports, stubbing the toe, or restrictive footwear (in the toe box, like narrow, pointed high heels) can also disrupt normal growth and set the stage for an ingrown nail to form.
https://www.youtube.com/shorts/B5a3yIgokh8
Pincer Nails (Trumpet Nails)
Classified by podiatrists and chiropodists as “the most painful type of ingrown toenail,” pincer nails, or trumpet nails, occur when the sides of the toenail curve inward toward each other, sometimes so dramatically that the edges look like they want to meet underneath the toe!
This shape creates a pinching effect on the nail bed and surrounding tissue. While some people are born with a naturally curved nail structure that gradually tightens over time, others develop this condition due to external pressures. Long-term use of tight shoes, particularly those with narrow toe boxes, is a major contributing factor. Certain systemic conditions, such as autoimmune disorders or circulatory problems, may also affect the nail matrix and contribute to this unusual curvature. Additionally, aging can play a role, as nail shape and growth patterns tend to change over time.
Onychogryphosis (Ram’s Horn Nails)
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Onychogryphosis is a condition where the toenail becomes dramatically thickened and begins to grow in a distorted, curved, or spiraled shape that resembles a ram’s horn. It often affects the big toe and progresses gradually over time. The nail’s irregular growth is usually the result of uneven cell production in the nail matrix, where one side grows faster than the other.
The most common causes include repetitive trauma (like years of wearing ill-fitted shoes), long-standing fungal infections, or neglect of nail trimming. It’s more frequently seen in older adults or individuals with limited mobility who may struggle with basic foot care. Certain systemic conditions, including psoriasis and vascular disorders, may also interfere with healthy nail growth and lead to this thickened, curved form.
Curved Toenail Pain Relief and Solutions: Nail Disorder Treatment
Toenail curvature can cause pain and nagging discomfort that disrupts your daily life. Remember, the nail should not be growing this way, and it’s up to you to take the first step towards finding a solution. Chiropodists and podiatrists offer several effective treatments to address curved toenails, tailored to the severity and underlying causes. Below are some common treatments available at foot clinics:
Proper Fitting Footwear
Wearing shoes that are the correct length 0with a wide toe box is crucial for preventing and alleviating discomfort associated with curved toenails. Footwear that allows ample space for the toes reduces pressure on the toenails, minimizing the risk of them growing into the surrounding skin. Properly fitting shoes not only aid in preventing the development or worsening of curved toenails, but also provide some pain relief for existing conditions that need accommodation. Ensuring that shoes complement the natural shape of the foot without squeezing or compressing the toes is a simple yet effective measure in maintaining toenail health.
Medical Pedicures
Medical pedicures are performed by trained chiropodists or podiatrists and focus on the health and hygiene of the feet and nails. Unlike cosmetic pedicures, these procedures address underlying issues and focus more on nail maintenance and health than aesthetic appearances (although the nails always look clean and fresh afterwards!). During a medical pedicure, the specialist will carefully trim and reshape the toenails using sterilized instruments, reducing the risk of further complications.
They are a common treatment for people with diabetes who cannot cut and clean their nails properly without assistance, and who need an extra set of eyes and expertise to spot abnormalities.
OnyFix Nail Correction System
The OnyFix system is a non-invasive, highly innovative, and pain-free treatment designed to correct curved toenails—especially ingrown toenails. It involves applying a specialized composite material to the nail, which hardens and acts as a brace, guiding the nail to grow in its natural shape without exerting direct force. This method is suitable for various nail shapes and is particularly beneficial for patients seeking an alternative to surgical interventions. The Onyfix system allows individuals to continue their daily activities without restrictions, including swimming and wearing nail polish.
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Nail Avulsion Surgery
In severe cases, such as with ram's horn toenail, surgical intervention may be recommended. This procedure involves the partial or complete removal of the affected toenail under local anesthesia. By removing the deformed nail, the underlying tissue can heal properly, and a healthier nail may regrow. Alternatively, a solution called phenol may be used to prevent nail regrowth.
April 3, 2025
Healthy toenails need healthy circulation, but when blood flow is compromised, they can become brittle, discoloured, or grow slowly. Additional toenail conditions can also develop. Poor circulation and toenail problems are closely linked, especially for those with health problems like diabetes or peripheral artery disease. Understanding why poor blood flow affects toenails can help you take the right steps to protect your foot health and prevent complications.
https://www.youtube.com/shorts/3JAUqiqJfus
The Importance of Blood Circulation
In order to understand the link between poor circulation and toenail issues, we have to start by understanding what blood flow is and what it does. The circulatory system, comprising the heart, blood vessels, and blood, serves as the body's transportation network. Its primary function is to deliver oxygen and essential nutrients to cells while removing waste products like carbon dioxide.
The heart pumps oxygen-rich blood through arteries, which branch into smaller arterioles and capillaries, reaching every tissue and organ. This process ensures that each cell receives the necessary components for energy production, growth, and repair.
Efficient blood circulation is vital for overall health. Oxygen transported by red blood cells is crucial for cellular respiration, the process by which cells generate energy. Nutrients absorbed from digested food are distributed via the bloodstream to support various bodily functions.
Key nutrients delivered by the bloodstream include:
Glucose: A simple sugar derived from carbohydrates in our diet, glucose serves as the primary energy source for cells, fueling various physiological processes.
Amino Acids: These are the building blocks of proteins, obtained from the digestion of dietary proteins. Amino acids are crucial for tissue growth, repair, and the synthesis of enzymes and hormones.
Fatty Acids and Lipids: Essential components of cell membranes and energy storage molecules, fatty acids and lipids are transported to cells for incorporation into cellular structures and for energy production.
Vitamins and Minerals: These micronutrients support a range of cellular functions, including maintaining bone health and facilitating nerve transmission.
Hormones: Although not nutrients in the traditional sense, hormones are vital signaling molecules transported by the circulatory system to regulate various physiological activities, such as metabolism, growth, and mood.
Impaired circulation can slow down healing processes—even for seemingly innocent and minor problems like cuts and scrapes. Likewise, organs and tissues deprived of adequate circulation can suffer damage over time, increasing the risk of conditions such as peripheral artery disease, stroke, and heart attacks.
Toenail Health and Circulation: The Connection
The circulatory system delivers oxygen and essential nutrients to the nail beds, supporting the growth and maintenance of strong, clear nails. When blood flow is compromised, the nails may not receive adequate nourishment, leading to various issues such as brittleness, discoloration, and slowed growth. In some cases, poor circulation can cause nails to develop ridges, indicating underlying vascular problems.
Reduced blood flow can also increase the risk of infections like toenail fungus (onychomycosis). A weakened circulatory system impairs the body's ability to combat pathogens, making the toenail environment more susceptible to fungal overgrowth. This often results in yellowed, thickened nails that you can’t treat without the help of a chiropodist or podiatrist. They must remove the infected portion of the nail so they can apply the correct medicine.
Poor blood flow on its own may not cause a problem with your foot health, but it can contribute to the following toenail conditions:
Slow or halted nail growth: Inadequate blood flow deprives the nail matrix of essential nutrients and oxygen, resulting in reduced or ceased toenail growth. This can be very frustrating if your toenail falls off or cracks and you’re waiting for it to grow back, leaving your feet vulnerable.
Brittle and discolored nails: Insufficient circulation can cause nails to become brittle and change color, often appearing yellowed or darkened.
Thickened nails: Poor blood flow may contribute to the thickening of toenails, often via toenail fungus, making them difficult to trim and maintain. Poor blood flow also affects the nail growth process, which can cause nail cells to pile on top of each other and lead to thicker toenails.
Ingrown toenails: While not directly caused by poor circulation, individuals with compromised blood flow, such as those with diabetes, are at higher risk for complications from ingrown toenails, including infections and delayed healing.
Diabetes, Toenail Health and Circulation
Diabetes can lead to two significant complications affecting foot health: diabetic neuropathy and peripheral artery disease (PAD). Diabetic neuropathy results from prolonged high blood sugar levels damaging the nerves, particularly in the legs and feet, causing numbness, tingling, or a loss of sensation.
This diminished sensitivity means that innocent injuries, such as cuts or blisters, may go unnoticed, increasing the risk of infections and complications like ulcers, or in severe cases, life threatening problems like gangrene, which require amputation. This is also the case for seemingly minor problems with the toenails. Simultaneously, PAD causes blood vessels to narrow and harden, reducing blood flow to the extremities. This impaired circulation hampers the delivery of oxygen and essential nutrients needed for healing, making the feet and toenails even more susceptible.
Regular foot inspections and nail care with a chiropodist or podiatrist, maintaining proper hygiene, and promptly addressing any abnormalities are crucial steps for diabetics to prevent toenail-related complications stemming from poor blood flow.
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Foot and Nail Care for Poor Circulation
Maintaining proper foot and nail care is essential for individuals experiencing poor circulation, as reduced blood flow can lead to various complications. Here are some recommended practices and treatments:
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Regular Exercise: Maintaining good circulatory health through regular exercise, a balanced diet, and avoiding smoking is essential for ensuring that the body's systems function as well as possible. One of the best circulation maintenance tips for foot health is working the muscles in the lower extremities. Exercises like toe splays, toe flexes and raises, massage ball rolls, pen pick-ups and seated toe pulls can work wonders. Click here to learn the five best foot exercises to improve blood circulation. They’re particularly helpful in the winter, but are useful all year round.
Regular Self Inspections: Conduct daily checks for cuts, sores, or changes in nail color and texture to detect issues early.
Moisturizing: Keep feet hydrated to prevent cracks and fissures that can lead to infections. Learn how to moisturize properly here.
OnyFix Nail Correction System: For those with ingrown or involuted toenails, the OnyFix system offers a non-invasive, pain-free solution. This innovative treatment involves applying a composite material to the nail, which helps guide it back to its natural shape as it grows, without the need for surgery. It's suitable for various nail shapes.
Medical Pedicures: Unlike traditional cosmetic pedicures, medical pedicures are performed by trained foot care professionals, such as chiropodists or podiatrists, in a sterile environment in a foot clinic. They focus on health, addressing issues like nail trimming, callus reduction, and infection prevention. They are especially helpful for dealing with irregular shaped toenails caused by poor circulation - cutting and maintaining these on your own can be very difficult. For people with diabetes, who are at higher risk for foot complications due to poor circulation and neuropathy, medical pedicures are a common and recommended treatment. These specialized pedicures help prevent complications like infections or ulcers by ensuring meticulous foot care.
Proper Footwear: Wear well-fitting shoes that provide adequate support and reduce pressure points to promote better circulation.
Proper Nail Trimming: Trim nails straight across and avoid cutting them too short to prevent ingrown toenails. And if your toenails are too thick or difficult to cut on your own, book an appointment with a foot specialist.
March 20, 2025
Ram’s horn toenails? Sounds like a serious foot issue! And it is—this condition, medically known as onychogryphosis, causes thickened, curved nails that can become painful and difficult to manage over time. It doesn’t just affect nail appearance; it can lead to discomfort, infection, and mobility issues if left untreated. Fortunately, onychogryphosis treatment options from a chiropodist or podiatrist are available to help you manage comfort and nail health.
What Are Ram’s Horn Toenails?
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Ram’s horn toenails (onychogryphosis), one of the many types of toenail conditions, is classified as a nail disorder or nail disease where the toenail becomes extremely thick, abnormally curved, and overgrown, often resembling the spiraled shape of a ram’s horn. This happens because the nail plate—made of keratin—grows unevenly due to disruptions in the nail matrix, the part of the nail bed responsible for new cell production. Instead of growing outward smoothly, the nail thickens, hardens, and may curl or twist due to uneven pressure and irregular cell turnover. They have a similar appearance to a severe fungal toenail infection.
The texture of a ram’s horn toenail is usually rough, ridged, and extremely hard, making it difficult to trim with standard nail clippers. Over time, the nail can develop a yellowish, brownish, or even grayish hue due to keratin buildup and potential fungal infections. In severe cases, the nail may grow so long and misshapen that it presses into the surrounding skin, causing pain, tenderness, and difficulty wearing shoes or walking comfortably. Because the thickened nail loses its normal flexibility, it can crack or split, increasing the risk of infection.
The appearance of onychogryphosis can also affect confidence and make it difficult to find shoes that accommodate their size and abnormal shape.
Although onychogryphosis most commonly affects the big toe, it can develop on others as well. It tends to progress gradually, meaning that early signs—such as mild thickening or slight discoloration—can go unnoticed until the nail has significantly changed in shape and texture.
Causes of Ram’s Horn Toenails
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These toenails do not generally form spontaneously without an underlying cause or risk factor. Let’s take a look at what generally causes this nail disorder.
Risk Factors for Ram’s Horn Toenails:
Trauma and Ill-Fitting Footwear
Repeated or acute trauma to the toenail can disrupt normal nail growth, leading to thickening and deformation. Continuous pressure and friction, such as from ill-fitting footwear, can cause microtrauma to the nail bed, contributing to the development of onychogryphosis. Essentially, the toenail thickens and starts growing in a different direction to protect itself.
Age
In general, our feet become more vulnerable with age due to several physiological changes that can occur, which can predispose us to onychogryphosis. For instance, reduced peripheral circulation, common in older adults, impairs blood flow to the extremities, leading to diminished oxygen and nutrient delivery to the nails. This alters the nail's natural growth process, causing nails to grow slower and nail cells to pile up on top of each other (rather than growing out). As a result, they thicken and can change shape. Additionally, decreased mobility in the elderly may lead to inadequate foot care, contributing to nail abnormalities.
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Diabetes
Diabetes significantly increases the risk of developing onychogryphosis, particularly due to the effects of diabetic neuropathy. Diabetic peripheral neuropathy reduces sensation in the feet, so individuals may not notice pressure, injuries, or trauma to the toenails, which can lead to deformities like onychogryphosis. Without the ability to feel discomfort, they may unintentionally cause damage to the nail, leading to thickening, curling, and other changes associated with the condition. Additionally, poor circulation caused by diabetes can impede healthy nail growth, making the nails more prone to abnormalities.
Peripheral Vascular Disease (PVD)
As already discussed, poor circulation affects the nail growth process and can lead to nail deformities. In particular, peripheral vascular disease involves the narrowing of peripheral arteries, reducing blood flow to the limbs. The diminished circulation can cause various symptoms, including slow or unusual nail growth. Without proper blood flow, the nails may become thickened and misshapen, potentially progressing to onychogryphosis if left untreated.
Cognitive Impairment
Relating back to age as a risk factor, conditions such as dementia can lead to neglected foot care due to cognitive decline. Individuals with dementia may forget or be unable to perform regular foot hygiene practices, increasing the risk of nail deformities like onychogryphosis. Self neglect, or infrequent cutting of toenails for a significant amount for any reason, is also a risk factor.
High-Friction Sports and Activity
Participating in high-friction sports like running, soccer, or ballet can increase the risk of developing onychogryphosis. Repetitive pressure and friction from constant movement or improper footwear during these activities can cause trauma to the toenail, leading to thickening, curling, and potential deformity. Runners, for example, often experience repeated impact on their toenails, particularly the big toe, which can cause them to become damaged or misshapen over time. Additionally, athletes who wear shoes that are too tight or too loose, which cause friction and rubbing, are more likely to develop toenail issues. As is the case with ill-fitting footwear, over time, the nail thickens and changes growth direction in order to protect itself from the repetitive trauma.
Hyperuricemia
High levels of uric acid in the blood is often associated with gout, but it can also contribute to the development of onychogryphosis. Elevated uric acid can lead to the deposition of urate crystals in joints and tissues, including the nails, which can cause inflammation and damage. This buildup may result in nail thickening, distortion, and a rough appearance. While gout primarily affects joints, the condition’s systemic nature can also have an impact on nail health
Fungal Infections
Also known as onychomycosis, fungal infections cause thickening and nail distortion. These infections often thrive in warm, moist environments and can infiltrate the nail, leading to changes in color, texture, and shape. In diabetic patients, onychomycosis prevalence is notably higher, reaching up to 31.5%, due to factors like elevated blood glucose levels and compromised immune response.
Psoriasis / Psoriatic Arthritis
Psoriasis or psoriatic arthritis can cause nail changes in roughly half of affected individuals. Proper management of psoriasis through medical treatments can help alleviate these nail changes and improve overall nail health.
Treating Ram’s Horn Toenails: Nail Care for Curved Toenails
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Routine Professional Nail Care
It’s very important to visit a Podiatrist or Chiropodist, both types of foot specialists in Ontario, if you have Ram’s horn toenails. This is because it is far too difficult, even dangerous, to manage them yourself. Their thickness, abnormal shape and unsightly appearance and positioning on your foot make it impractical to try cutting them with standard nail clippers, and is not advised.
A chiropodist or podiatrist can tend to your nails properly with specialized tools designed to maintain nail disorders. They can also perform toenail debridement, smooth out nail edges, clean out debris, and apply sprays that help with discoloration.
Other nail care treatment options may vary depending on the severity of the condition. In more extreme cases, surgical interventions such as nail avulsion—removal of the nail plate—may be considered.
If an infection is present, a chiropodist or podiatrist can prescribe the appropriate antifungal or antibacterial treatments to address the underlying cause (you can't treat fungal infections from home).
In addition to the specialized care provided by podiatrists and chiropodists, treatment for Ram’s horn toenails can also include regular monitoring to track any changes in the condition. They may suggest specific at-home care practices, such as gentle cleaning and moisturizing, to support the overall health of the nails and surrounding skin. For individuals with chronic conditions, like diabetes, it is especially important to maintain close contact with a foot care specialist to ensure the toenails remain manageable and complications are avoided. Diabetes patients who neglect their foot health can experience severe ulcer formation.
Onyfix
Onyfix is just one of the many unique ways a foot specialist can help treat curved, curled or Ram's Horn Toenails. It's a non-surgical treatment that involves the placement of a band across the toenail. This band then corrects the nail's growth pattern and shape. It's great for Ram's Horn Toenails because it will help flatten out the toenail on the nail bed and "train" the toenail to grow in the correct direction.
Proper Fitting Footwear
But all the treatment in the world won't matter without eliminating one of the most common causes of curved, curled and abnormal toenails: ill-fitting footwear. As we already discussed, ill-fitting footwear causes repetitive trauma on the nailbed, which disrupts the toenail's growth process. Prioritizing footwear that minimizes pressure and allows for adequate toe room to alleviate discomfort and prevent further nail distortion is key. Opting for shoes with a wide toe box provides ample space for the toes to spread naturally, reducing friction and pressure on the affected nails. Shoes may also require extra depth, and orthopedic footwear may be required for sufficient comfort.
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