Go to navigation Go to content
Phone: 630-834-3668
Prairie Path Foot & Ankle Clinic

Conditions of the Toenail

From ingrown nails to fungus to nails that fall off - you will learn why these conditions happen and what can be done about them!  Our toenails take a lot and we aren't happy when they hurt or don't look good.  As with anything, prevention is key, but if any toenail condition has started or been bothersome for a while, there are things that can be done to make you happier with your toenails once again --- or at least not notice or worry about them anymore!

Ingrown Toenails 

Ingrown toenails can be caused by a great many things.  Some people have curved toenails in their gene pool and are predisposed to problems right from the start.  Other people may not have ever had an issue until they had an injury or until they had a baby or until they started "getting older."  It seems that over time our nails can curve in more and sometimes they even thicken more over time.  In addition, our toes can swell or become injured and a nail that never was an issue before can suddenly get aggravated.  In some, an ingrown toenail may be a "once and done" experience and still others can have issues for years! 

Things you can do on your own: If your toenail feels ingrown and has minimal to no redness and no drainage, you can start with simply soaking the toe in luke warm water with antibacterial handsoap, twice per day.  Resist the temptation to 'dig out' the nail on your own, as this increases the chances that small piece will be left deep under the cuticle and continue to cause pain and increase your risk of infection.  When cutting the nails, cut only straight across.

When to phone for help: If the toenail is red, draining, or constantly painful seek attention right away!  Infection from ingrown toenails should not be taken lightly as it can cause terrible complications later.  Depending on the severity of the ingrown toenail, the solution may be simple, but at Prairie Path Foot & Ankle Clinic we strive to minimize pain even when the treatment is more involved.  Seeing a podiatrist first is to your benefit, as traditional urgent care and ER facilities are not fully equipped to manage the ingrown toenail on their own and will likely refer you to a podiatrist after your visit.

Fungal Toenails

Fungal toenails, a condition called onychomycosis varies in severity but is a very difficult condition to treat.  The toenails grow approximately 1mm per month, so for an entire new nail to grow can take upwards of a year in some people!  The slow growth rate complicates treatment because the infected portion of nail is typically damaged in a way that makes it easier to be re-infected with the fungus.  Treatment of fungal toenails comes in many forms and you can read more here about the options available to you at PPFAC.  The first step involves a nail biopsy, which is a painless procedure to acquire a small piece of nail to be sent off and examined for the presence of fungus.  Yeasts and other factors can cause nails to appear fungal when they may not truly be fungal, which is why biopsy is a key step to diagnosing fungal toenails.  If it is found that a nails is thick or discolored due to factors NOT related to fungus, there are still treatment options available to improve the appearance and health of the nails.

Black Toenails/Loose Toenails

Toenails that appear black and are loose are most often caused by trauma.  If you notice that you chronically lose toenails, you may be an intense athlete and/or training for a long running event.  If this isn't the case, there may be more you can do to prevent this from happening time and time again.  Shoes that do not have mesh over the top of the forefoot (ie. leather shoes) do not allow much motion of the big toe and this can cause increased pressure on the toenail that leads to bleeding under the toenail.  If the bleeding is extensive enough, the nail can become loose or fall off.  Some bone spurs can cause pressure to a nail from underneath and cause chronic black toenails or loose falling off nails.

A more serious reason for black discoloration to the nail is if there is an underlying skin lesion or cancer on the skin under the nail.  The way to tell the difference between discoloration from trauma and that due to an underlying skin lesion is to monitor the spot/area of discoloration for changes.  Over the course of a couple of months, it should be noted that the spot or area of discoloration moves as the toenail grows out.  If the lesion has not moved over the course of 3 months, it is safest to have it evaluated by a podiatrist.  If there is high suspicion that the lesion is malignant, a simple in office procedure can be performed to get definitive information.

Other Conditions

Once the results of a nail biopsy are available, they may show that fungus is not the culprit!  Other reasons for nails to appear discolored, thick, brittle and to be painful include other medical conditions (such as psoriasis), use of some prescriptions and even trauma to the toenails.  In some instances, people recall dropping something on that "one nail" that is now thick and brown.  In other instances, microtrauma from a foot deformity (like hammertoes) can slowly damage the growth cells of the nails and cause abnormal nail cell production which appears as thick, white or yellow discolored nails.

No matter the cause of your thick, painful or unsightly nails, there are treatments to improve the condition of your nails.  It is important to always remember that the sooner an issue is addressed, the better the outcome will be.  If you remove your nail polish and/or start to notice a chalky or yellow discoloration to the nails, treating this early prevents allowing a nail fungus (or other nail condition) from worsening to a point where treatment isn't likely to offer as much improvement. 

Make an appointment today if you are worried about the appearance or pain of your toenails!