Common nail conditions.

We provide care for the entire foot—including your nails.

Toenails can provide early signs of other conditions. For example, pitted toenails with increased
thickness can indicate psoriasis. Any toenail discoloration or infection should be evaluated by your
doctor. Many of the conditions we regularly see can be resolved with topical or oral medications.

Below are some of the nail conditions we treat on a daily basis.

BLACK TOENAIL


Description

Subungual hematoma (black toenail) is blood trapped beneath the toenail. It’s usually caused by blunt trauma; dropping a heavy object on the toe or chronic friction from rubbing against the shoe, which is common in runners.

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Symptoms

A black, purple, or red area under the nail. The nail may come loose, but will most often stay intact and the bruise fades as the nail grows out. If the subungual hematoma is large and causing pain, medical treatment is needed.

Treatment

Most cases require no treatment, although a biopsy of the nail may be performed. If your doctor determines that the melanonychia is secondary to a systemic condition and/or dermatologic disease, the underlying condition must be treated.

DARK STREAK


Description

Melanonychia is a tan, brown or black lengthwise streak or line on the toenail plate caused by increased melanin production. It is most common in people with darker skin and affects up to 77% of African Americans over the age of 20 and almost 100% of those over 50.

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Symptoms

A dark line running lengthwise on the toenail (usually the big toe). Melanonychia does not cause pain. The wider and darker the streak is, the greater the concern of malignancy. Fortunately, very few people with Melanonychia actually have subungual (nail) melanoma.

Treatment

Most cases require no treatment, although a biopsy of the nail may be performed. If your doctor determines that the melanonychia is secondary to a systemic condition and/or dermatologic disease, the underlying condition must be addressed.

INGROWN TOENAIL


Description

An ingrown toenail occurs when a sharp corner of the toenail digs into the skin at the end of, or side of, the toe. Any toenail can become ingrown, but the condition is primarily found in the big toe.

Symptoms

Pain and inflammation at the spot where the nail digs into the skin. The inflamed area may grow extra tissue or drain yellowish fluid. Left untreated, an ingrown toenail can progress to an infection or even an abscess that requires surgical treatment.

Treatment

Treatment involves removing the offending nail border. This procedure is performed in our office and usually takes about ten minutes. You will likely be able to leave our office in the very shoes you arrived in. Aftercare includes daily soaking and topical antibiotics.

RAM’S HORN NAILS


Description

Onychogryphosis is a condition in which the toenails thicken and adopt a severe curve causing them to grow into long, curved shapes resembling a ram’s horn.

Symptoms

The toenails are yellowish-brown, thick, curved, and indeed look more like horns than nails. As the nails are no longer flat, trimming with clippers or scissors is nearly impossible.

Treatment

Removal of the nail is common and can be performed relatively painlessly. If the condition is treated early, you stand an excellent chance of avoiding the pain, inflammation, and various infections that could otherwise result.

TOENAIL FUNGUS


Description

Onychomycosis is the most common nail disease in adults. Toenails are far more likely to be affected than fingernails. As many as 90% of elderly people have the condition. Its frequency is increasing and is related to diabetes and suppressed immunity.

Symptoms

Discolored, thickening toenails which can disfigure or split. The condition starts as a cosmetic concern. However, if untreated, it can progress to where the nails become so thick that they press against the insides of the shoes and cause pain.

Treatment

Toenail Fungus is commonly treated with antifungal creams or gels and/or oral medication. Regular nail trimming is essential. Rarely, a severe case may require one or more of the infected toenails to be surgically removed.

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