Some may see it as vanity, but having healthy skin and nails on your feet is also extremely important, especially for people who suffer from systemic conditions such as diabetes or peripheral vascular disease.
Toenails can come in all shapes and sizes due to hereditary predisposition. Some people have very wide and flat nails, whilst others may curve excessively in to the skin at the sides of the nails. This nail curvature can be made worse by wearing shoes that are too tight.
Cutting Your Toenails
Your individual toenail shape will dictate how it is best to cut your own nails. In most cases it is okay to cut the nails with a slight curve that follows the natural skin line at the end of the toe. It is not usually advised to cut the toenails down the edge of the nail as this can cause the toenails to become ingrown.
Why do toenails become thickened or discoloured?
Toenails can become thickened or discoloured for a variety of reasons including trauma, aging, fungal infection, hereditary predisposition, excessive use of nail polish or other nail disease such as psoriasis or lichen planus. This can make them difficult to care for yourself. We can help practically by trimming and thinning out the nails as necessary, as well as advising any possible treatment for your particular condition.
Trauma to a nail can result from a single incident, such as dropping a book on your toe or kicking the end of the bed, or can occur subtly over a period of time from wearing shoes that are too tight. Sometimes bruising occurs, sometimes it doesn’t. You may notice a transverse ridge in the nail which grows up from the base of the nail. The ridge begins when the nail matrix (where the nail grows from beneath the skin) is damaged due to trauma. The ridge gradually grows out, and as long as there is no further trauma the nail can usually return to normal. In some cases, if the trauma is severe or occurs over a long period of time, the nail may lift from the nail bed or may become permanently thickened.
Fungal Infections of the Toenails
Fungal infection of the toenails is common and can present in a variety of ways. It is usually caused by the same organisms that cause tinea (or athlete’s foot). It may begin as a small amount of yellowing of the nail, a white area on top of the nail, or white chalky residue beneath the nail. If not treated it can progress to cover the entire nail plate and other nails. It can cause the nails to thicken and become brittle. There are a variety of ways to treat fungal infections including topical nail tinctures (available over the counter at the pharmacy), oral anti-fungal medications (requiring a script from your GP), or laser treatment. Your podiatrist will be able to advise what is best for you.
The Effects of Ageing on the Toenails
As people get older, it is common for the nails to grow more slowly and to become thicker. In general this is not a big problem, but it can make the nails much harder to cut. People who have systemic diseases or diseases which affect the circulation to the feet may also find that their nails grow more slowly, and sometimes they become thin and brittle.
Ingrown toenails can occur for a variety of reasons including poor nail cutting technique, footwear that is too tight or toenails that curve in to the skin excessively. A traditional ingrown toenail occurs when a small spike of nail has been left behind after the nails have been cut, and this spike grows in to the skin at the edge of the nail. In some cases the ingrown nail can be removed simply in one treatment, other cases require regular routine care to prevent the nail from ingrowing, and more chronic cases may require surgical removal of the edge of the nail.
Use of Nail Polish
Nail polish prevents the nails from being able to breathe, and when worn over long periods of time without a break, the nails can develop a white chalky spots on top, or they can yellow. It also provides an excellent area for fungus to grow. If nail polish is to be worn, it is best to only wear it for short periods at a time, and give the nails a break without any nail polish in between times.
There are many other conditions that can affect the nails of both the feet and the hands. In some cases you
may need to see a dermatologist to have your particular condition diagnosed and treated.