20 Common Toenail Problems and What They Mean
- Sondema Tarr
- Aug 22, 2023
- 6 min read
Updated: Aug 30
Toenails can reveal more about your health than you might expect. From fungi to nutrient deficiencies to health probelms what shows up under the nail often tells a deeper story. Below, discover 20 common toenail issues and what each may mean for your health.
Table of Contents:
A. Common & Treatable
B. Nail Growth & Texture Changes
C. Color Changes
D. Body Wide Causes
1. Onychomycosis (Nail fungus)
Onychomycosis is the medical term for nail fungus, a common fungal infection of the nails of your toes
Nail fungus can lead to thick, brittle, and toenails that are different colors like white, yellow, or brown. Nail fungus can sometimes even have a smell.
Caused by several different types of fungus, this condition often starts at the tip of the nail and spreads underneath towards the cuticle.
To diagnose nail fungus, a nail biopsy is taken and sent to a lab for to test for fungus, bacteria, or even yeast. This is important to do, because many different nail problems can look like nail fungus, but are not.
Treatment for nail fungus can include either pills taken by mouth, laser treatment of the nail fungus, topical medications that are applied on the nail, and an integrative approach, looking at your diet, lifestyle, and stress levels, to optimize your body to clear the fungus.
2. Ingrown Toenails
An ingrown toenail happens when the edge or corner of a toenail grows into the surrounding. skin, causing pain, redness, swelling, and even drainage that is blood-tinged, or contains pus.
Common causes of an ingrown toenail can include incorrect nail trimming and shoes that are too tight.
Onyfix is a non-surgical nail correction system that can slowly correct an ingrown toenail over time.
Severe cases may require surgery to remove the ingrown part of your toenail.
3. Subungual Hematoma
Subungual hematoma occurs when blood pools or builds up beneath the toenail, often due to trauma like dropping something on your toe, or even just the toes hitting against the inside of your shoes.
It results in pain and a red, purple, or black look to the toenail.
Small hematomas can be managed at home, but larger ones might need to be drained to relieve pressure and pain.
4. Onychogryphosis (Ram's Horn Nails)
Onychogryphosis is a very thick, curved, toenail that looks like a ram's horn.
Onychogryphosis can be caused by, trauma, or even certain health conditions.
Regular trimming and filing of the toenails are one way to manage the discomfort and effects of onychogryphosis.
Once Ram's Horns nails form, they will not go back to their normal shape. Permanent toenail removal can take out the nail, making sure that nothing grows back.
5. Pincer Nails
Pincer nails cause the sides of the toenail to curve inward. This tye of nail can be very painful, and lead to chornic ingrown toenail problems.
Trimming the toenails straight across can offer some pain relief
Onyfix can also be used to help train the toenail to grow out pain-free over time.
Nail surgery is also used in pincer nails to remove the borders of the toenail that cause pain, or to remove the whole toenail completely.
6. Beau's Lines
Beau's lines are horizontal grooves or ridges that appear across the toenails due to a temporary interruption in nail growth.
Beau's lines can be seen after illness, hospitalization, surgery, or nutrient deficiencies.
7. Koilonychia (Spoon-Shaped Nails)
Koilonychia causes toenails to become thin and concave, looking like a spoon
Iron deficiency anemia is a common cause, along with other health conditions
8. Trachyonychia (Twenty-Nail Dystrophy)
Trachyonychia causes rough and thin nails, often affecting all 20 nails.
It can be related to conditions like eczema or alopecia areata.
This is one nail problem of your toes that oftentimes is seen in the fingernails as well.
9. Melanonychia
Melanonychia is the name given to a nail that is brown or black in color
This color of the nail is caused by melanin, the same pigment which makes your skin darker.
Because of this melanonychia is more commonly seen in racial groups that tend to have darker skin.
Other causes of melanonychia can also include certain medications, trauma, and fungal or bacterial infection.
In some cases, melanonychia can be a sign of cancer. If you are noticing any new pigment changes to a toenail, it is important to see a foot doctor at once. A biopsy will be taken to rule out, or confirm cancer.
10. Yellow Nail Syndrome
Yellow Nail Syndrome is characterized by thickened, slow-growing, and yellowish toenails.
Most commonly yellow toenails are caused by staining from nail polish.
Other reasons for yellow toenails are lung and lymphatic disease.
Green Nail Syndrome
Green Nail Syndrome is when the nails will actually turn shades of green, caused by a bacterial infection.
Green Nail Syndrome can be caused by acrylics, or other nail enhancements that are left on longer than recomended.
Trimming away of the infected part of the toenail, and topical medications are used to treat Green Nail Syndrome
12. White Nail Syndrome
White Nail Syndrome also known as Leukonychia is when the nails turn white.
White Nail Syndrome can be seen commonly after nail polish removal, especially when nail polish has been left on for longer than reccomended. Other causes of Whte Nail Syndrome include fungal infection, or trauma.
If the white spots on your nails are not growing out over time, a nail biopsy is the best way to find out what the cuase of your White Nail Syndrome is.
13. Mees' Lines
Mees' lines are horizontal white bands across the toenails, often caused by a temporary stop in nail growth due to illness or chemotherapy.
14. Terry's Nails
Hallmarks of Terry's nails are a white nail plate with a narrow pink band at the tip.
Terry's nails are commonly seen in people with liver disease and diabetes.
15. Half-and-Half Nails (Lindsay's Nails)
Half-and-half nails look very similar to Terry's Nails, but the locations of the colors are opposite.
Half and half nails feature a red or brown tip with a white band as the base.
This condition can be associated with chronic kidney disease and other systemic disorders.
16. Psoriasis
Psoriasis can affect the skin and toenails, causing pitting of the toenails, toenail color changes, and separation of the toenail from the toenail bed.
The toenails affected by psoriasis may become thick and ridged.
17. Nail-Patella Syndrome
A genetic disorder, Nail-Patella Syndrome is characterized by abnormalities in the toenails, knees, and elbows.
Toeails may be absent, very small, or have signs of pitting or ridges.
18. Nail Lichen Planus
Nail Lichen Planus involves inflammation and scarring of the nail root, leading to pitting, ridges, and toenail thinning.
This is commonly seen with the skin condition lichen planus.
19. Median Nail Dystrophy
Median Nail Dystrophy causes splitting, ridging, and thinning of the toenails.
The exact cause of median nail dystrophy is unclear, but trauma and certain health conditions can contribute to this.
20. Alopecia Areata
Alopecia areata is an autoimmune disorder that can lead to hair loss and nail changes, including nail problems on your toes.
Pits in the toenails and white spots are commonly seen in toenails affected by alopecia areata.
Key Takeways
Your toenails can say a lot about your overall health, and changes shouldn’t be ignored. While some nail problems are cosmetic or temporary, others may signal underlying conditions that need medical attention. If you’ve noticed constant changes in your toenails — changes in color, pain, thickening, or separation — it’s best to see a doctor.
At Direct Podiatry Arizona, I take a patient-centered approach to diagnosing and treating nail conditions, whether it’s fungus, ingrowns, or more complex changes. My goal is to restore both the health and appearance of your nails so you can feel confident and comfortable again.
Schedule Your Appointment At Direct Podiatry Arizona Today
Are you dealing with nail problems of a toe or toes and live in the Phoenix area? My name is Dr. Tarr, and I am the owner of Direct Podiatry Arizona in Tempe. To view my available appointment times, click here.
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