Toenail Problem

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, poor circulation and infection. Problems with toenails can be successfully treated by a podiatrist.

Ingrown toenail

One of the most common problems treated by podiatrists 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.

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 that don’t press on the toes.

Fungal infections

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 your podiatrist.

Inflammation of the skin alongside the nail

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).

Deformed or brittle nails

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 podiatrist can improve the health of your nails and help diagnose and treat more serious nail concerns.

Things to remember

• 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 podiatrist can improve the health of your nails and make walking more comfortable.