Toenail problems can affect people of all ages, but tend to be
more common with advancing age. Causes of nail problems
include trauma, ill-fitting shoes, bunching socks, poor circulation
and infection.
Problems with toenails can be successfully treated by a qualified
foot care nurse. Should more serious foot issues present themselves, foot care nurses are trained to recognize them and will refer you immediately to a foot doctor (Podiatrist) and/or other specialist as is required.
One of the most common problems treated by foot care professionals are ingrown toenails.
The big toe is particularly prone to this painful condition.
Causes may include:
- Incorrect trimming technique
- Trauma (such as stubbing your toe)
- Nails that naturally curve sharply on the sides and dig into the skin
- Wearing tight shoes or poor quality socks
Treatment from a podiatrist depends on the severity of the injury, but may include removing the ingrown nail section using a local anaesthetic.
Suggestions to prevent an ingrown toenail include:
- Trim nails straight across rather than rounding off the edges.
- Wear comfortable, well-fitting shoes and seamless socks that don’t press on the toes
- Regular assessment by a foot care nurse
Symptoms of a nail with fungal infection include discolouration and thickening of the nail, and the separation of the nail from the nail bed. There may also be a white, smelly discharge.
Without early detection and treatment, the nail bed itself can become infected.
Treatment options for fungal infections include:
- Use of antifungal preparations applied topically (directly to the nail) or taken orally
- Professional trimming, shaping and care of the nail by your foot care nurse
The skin lying alongside the nail can become infected with bacteria, typically Staphylococcus aureus. This infection is called paronychia. Symptoms may include pain, redness and swelling around the cuticle and yellow–green discharge. Antibiotics may be used to treat acute cases. Chronic paronychia (where the condition is present for a long time), however, is more difficult to treat. In chronic paronychia, the nail may distort and become discoloured, and the skin may lift at the site of infection. Sometimes, the inflammation spreads from one nail to another. A range of micro-organisms working together are responsible for chronic paronychia.
Treatment options for paronychia include:
- Keeping the feet as dry as possible
- Use of barrier creams, antiseptic lotions and antifungal preparations
- Antibiotic therapy (in acute cases).
A violent toe-stubbing, dropping a heavy object on the toe or some other trauma can injure the nail bed and cause the nail to grow in deformed ways. The nail may be thickened or ridged. It is a normal aging process for nails to thicken. Certain skin conditions may also affect the nails, causing thickening (for example, psoriasis). Deformed or brittle nails can benefit from regular professional attention. Trimming, shaping and nail care from your foot care nurse will improve the health of your nails. For the further diagnose and treatment of more serious nail concerns, your foot care nurse will refer you to a Podiatrist or other foot care professional as is necessary.
- Common toenail problems include ingrown toenail, fungal infections, inflammation of the skin alongside the nail, and nail deformities.
- Toenail problems tend to be more common with advancing age.
Professional care from your foot care nurse will greatly improve the health of your nails and make walking more comfortable.
Symptoms of a nail with fungal infection include discolouration and thickening of the nail, and the separation of the nail from the nail bed. There may also be a white, smelly discharge. Without treatment, the nail bed itself can become infected.
Treatment options for fungal infections include:
- Use of antifungal preparations applied topically (directly to the nail) or taken orally
- Professional trimming, shaping and care of the nail by a foot care nurse.
The skin lying alongside the nail can become infected with bacteria, typically Staphylococcus aureus. This infection is called paronychia. Symptoms may include pain, redness and swelling around the cuticle and yellow–green discharge. Antibiotics may be used to treat acute
cases. Chronic paronychia (where the condition is present for a long time), however, is more difficult to treat. In chronic paronychia, the nail may distort and become discoloured, and the skin may lift at the site of infection. Sometimes, the inflammation spreads from one nail
to another. A range of micro-organisms working together are responsible for chronic paronychia.
- Keeping the feet as dry as possible
- Use of barrier creams, antiseptic lotions and antifungal preparations
- Antibiotic therapy (in acute cases).
A violent toe-stubbing, dropping a heavy object on the toe or some other trauma can injure the nail bed and cause the nail to grow in deformed ways. The nail may be thickened or ridged. It's a normal aging process for nails to thicken. Certain skin conditions may also affect the nails, causing thickening (for example, psoriasis).
Deformed or brittle nails can benefit from regular professional attention. Trimming, shaping and nail care from your foot care nurse can improve the health of your nails. Routine foot assessments enable nurses to recognize more serious nail concerns and refer you to other professional as is necessary.
- Common toenail problems include fungal infections, inflammation of the skin alongside the nail, nail deformities, and ingrown toenails (see Ingrown Toenails at top of page).
- Toenail problems tend to be more common with advancing age.
- Treatment by a foot care professional will greatly improve the health of your nails and make walking more comfortable.
A corn or callus is an area of hard, thickened skin on the foot that is formed in response to pressure or friction. They are part of the body’s defense system to protect the underlying tissues. If the cause of pressure is not relieved, calluses can become painful. If pressure becomes concentrated in a small area, a ‘hard’ corn may develop. A corn has a central core.
Common sites of corn and callus formation are the ball of the foot, under the big toe, the tips and the tops of toes. ‘Soft’ corns may develop between the toes, where the skin is moist from sweat or inadequate drying.
Often the pressure of the corn or callus causes inflammation, which can result in acute pain, swelling and redness.
Corns and calluses may be a sign that you have an underlying foot disorder, such as a joint that is out of alignment. This is why it’s important to get your feet professionally assessed, rather than attempt to treat calluses or corns yourself.
The symptoms of corns and calluses can include:
- Thickened patch of hard skin on the foot.
- Hard, small bump of skin that may have a central core.
- White and rubbery bumps of skin (‘soft’ corns, in between the toes).
- In some cases, the callus pushes into the foot, rather than spreading across the skin surface.
- Pain when pressure or friction is applied to the area.
Anyone can develop corns or calluses, but some groups are particularly at risk, including:
- Elderly people - because ageing skin loses elasticity and fatty tissue.
- People who spend a lot of time standing up - because of the continuous weight-bearing pressure on their feet.
- People with feet that roll inwards (flat feet) - flat feet place excessive pressure on the ball of the foot beneath the big toe, and the inside of the heel.
- A person with foot complaints (such as a hammer toe, bunions or arthritis) - because a bony prominence can rub against the shoe or neighbouring toes.
- People who regularly wear shoes that are narrow, tight, ill-fitting or high-heeled.
Over-the-counter treatments, such as corn plasters, don’t treat the underlying foot disorder. The body protects skin tissues from pressure or friction damage by producing an area of hard skin. So, unless the cause of the pressure or friction is found and removed, calluses and corns will continue to form. These over-the-counter treatments can also damage the healthy surrounding skin, if used incorrectly. Don’t ever attempt to cut away or scrape a callus. If you accidentally cut yourself the humid environment of socks and shoes makes infection of the wound much more likely.
If you have corns or calluses, or think you may be developing them, see a professional for treatment. Treatment may include:
- Investigation and treatment of the possible causes - for example, treatment for bunions.
- Professional reduction of the callus or corn to relieve pain.
- Customized padding on various areas of the foot to temporarily redistribute pressure, for example, you may need to wear little foam wedges between your toes.
- If needed, permanent inserts to wear inside your shoes (orthoses) to offer long term pressure relief.
- Advice on appropriate footwear.
- Advice on appropriate foot care, such as applying moisturizer daily.
- A Foot Care Professional (Foot Care Nurse/Chiropodist/Podiatrist)
- All-Ways Foot Care (Greater Vancouver) - to find a foot care nurse in your local area email us at info@allwaysfootcare.com.
- A corn or callus is a patch of hard, thickened skin on the foot that is formed in response to pressure or friction.
- Corns and calluses may be signs that the person has some kind of underlying foot disorder, such as joint deformities or misalignments.
Never try to treat corns and calluses yourself - seek advice from a foot care nurse.
