Dr. Schoene

Importance of Caring for Your Toenails

Taking care of your nails is important for maintaining overall foot health and preventing a host of common toenail problems. Healthy toenails not only improve comfort and appearance but also prevent potential complications that can arise from neglect. Regular care helps avoid conditions such as ingrown toenails, fungal infections, and nail deformities, which can lead to pain, infection, and other complications. This article explores common toenail conditions and how to treat and prevent them at home.

Toenail Conditions

Here are some common toenail conditions. 

Ingrown Toenails

Ingrown toenails occur when the edge of your toenail grows into the surrounding skin. This mostly affects the big toe but can occur on any toe. Symptoms include:

  • Sharp or throbbing pain along the edge of the toenail. 
  • Redness and swelling.
  • Infection, such as pus, increased pain, and warmth around the toe.
  • Red or irritated skin around the toenail.

You may get ingrown toenails from cutting your toenails too short or rounding the edges, which encourages the nail to grow into the surrounding skin. Other causes include wearing shoes that are too tight or suffering an injury to the toe. Genetics may also play a role — you may be more prone to ingrown toenails because of the shape or structure of your nails.

Fungal Infections 

Fungal infections, also known as onychomycosis, are common. Fungi such as dermatophytes, yeasts, and molds that thrive in warm, moist environments cause these infections. Symptoms include: 

  • Color changes, such as nails turning white, yellow, brown, or black.
  • Thick and brittle nails.
  • Crumbling edges. 
  • Unpleasant odor.
  • White or yellowish debris under the nail.

Fungi thrive in warm and moist environments such as sweaty shoes, communal showers, and swimming pools. Injury to the toenail or surrounding skin can make it easier for fungi to invade and cause an infection. Not keeping feet clean and dry can increase the risk of fungal infections. Pre-existing nail conditions that damage the nail’s structure or underlying health conditions such as diabetes can also make you more vulnerable to infection.

Nail Trauma 

Nail trauma is any injury or damage to the toenail or the surrounding area. Nail trauma can lead to various symptoms and complications, such as:

  • Pain at the site of the injury.
  • Bruising or a dark spot under the nail.
  • Swelling around the toenail or toe.
  • Redness and warmth. 
  • Lifting, splitting, or loss of the nail. 
  • Potential infection.

Dropping a heavy object on the toe or stubbing the toe can cause nail trauma. Activities that involve repetitive pressure or friction, such as running or sports, are also factors, while wearing tight shoes that apply constant pressure on the toenails can also cause trauma.

Psoriasis 

Psoriasis is an autoimmune condition that causes the rapid buildup of skin cells, leading to thick, scaly patches on the skin which can extend to the toenails. Symptoms include: 

  • Pitting, depressions, or indentations on the nail’s surface. 
  • Changing color, such as nails turning yellow, brown, or white. 
  • Thickening, distorted, or irregularly shaped nails.
  • Lifting from the nail bed.
  • Crumbling or brittle nails.

Psoriasis often runs in families. Stress, infections, injuries to the skin, and certain medications can trigger or worsen psoriasis. Conditions such as obesity or metabolic syndrome can also contribute to the condition. 

Treatment Options

Here are the treatment options for each condition.

Ingrown Toenails 

Treatment may include:

  • Self-care: Soak the foot in warm, soapy water to reduce swelling and soften the skin. Carefully lift the edge of the nail away from the skin to alleviate pressure. 
  • Antiseptic: Use an over-the-counter antiseptic ointment to prevent infection and reduce inflammation. 
  • Nail removal: For persistent or severe cases, we may perform a minor procedure under local anesthesia to remove part or all of the affected nail.
  • Antibiotics: We may prescribe antibiotics for an infected nail.
  • Nail surgery: In chronic cases, we may recommend a surgical procedure to permanently alter the nail’s growth pattern and prevent recurrence.

Fungal Infections 

Treatments may include:

  • Topical treatments: Apply products such as terbinafine or clotrimazole directly to the affected nail. We may prescribe stronger topical antifungals, such as ciclopirox or efinaconazole for more severe infections. 
  • Oral medications: We may prescribe oral antifungals such as terbinafine, itraconazole, or fluconazole to target the infection from within. 
  • Laser therapy: Laser therapy uses targeted light to destroy the fungi without damaging the surrounding tissue. 
  • Nail removal: In severe cases, partial or complete removal of the affected nail may be necessary so we can apply antifungal agents directly to the nail bed.

Nail Trauma 

Treatments may include:

  • Self-care: Resting and elevating the foot can help reduce pain and swelling. Applying an ice pack can help manage pain and swelling. 
  • Medication: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and inflammation. 
  • Medical treatment: This may include drainage if there is significant bleeding under the nail.
  • Nail removal:We may consider removing the nail partially or completely, under local anesthesia.
  • Antibiotics: We may prescribe antibiotics to clear an infection.

Psoriasis 

Treatments may include:

  • Topical treatments: Corticosteroid creams or ointments can help reduce inflammation and scaling. Other options include coal tar preparations and Vitamin D analogs.
  • Oral medication: We may prescribe oral medications such as methotrexate, cyclosporine, or acitretin. We may also recommend biologic drugs, administered by injection or infusion, to target specific parts of the immune system to control psoriasis. 
  • Light therapy: Phototherapy can help reduce psoriasis symptoms by slowing the rapid growth of skin cells.
  • Nail care: Regularly trim toenails straight across to avoid injury and reduce discomfort.

At-Home Foot Care

Here are some tips for at-home nail care:

  • Regular trimming: Trim toenails straight across to prevent ingrown nails.
  • Proper hygiene: Clean and dry your feet daily to prevent infections and fungal growth. 
  • Moisturize: Apply moisturizer to keep the skin soft. Avoid applying lotion between the toes to reduce the risk of fungal infections.
  • Protective footwear: Wear shoes that fit properly, with plenty of room in the toe box. Avoid high heels or tight shoes, and consider using orthotic insoles or arch supports if you have specific foot issues or need additional support.

Book Your Appointment Today

If you’re experiencing any issues with your toenails or need guidance on proper toenail care, our podiatrists at Gurnee Podiatry & Sports Medicine Associates are here to help. Book your appointment today to receive expert care and advice tailored to your needs. Taking proactive steps toward foot health can prevent complications and improve your overall well-being.