17 Jun

Do you have very long toe nails?

Very long Toe Nails are a frequently encountered problem that is easily correctable! Follow our guide to learn how.

1 Very Long Toe Nails

Very long toe nails treatment

What  causes very long toe nails?

If you have very long toe nails and it is not fungal nails (onychomycosis) then it is almost always a condition called onychogryphosis or mechanically induced nail trauma. The stem cells that grow the nail are permanently damaged and you have a very thick and difficult to trim nail- but it is usually a normal color. This is especially common on the first and the fifth toenails.

Symptoms

  • Thick, crumbly and tender nails that can result in an ingrown toenails.
  • The surface of the nails becomes thick and rough.
  • This pressure is transferred into the nail bed and causes pain.
  • They can impair walking by injuring the adjacent toenails and but becoming long and curved.

Prevention

  • Most likely your shoes are too small, get bigger ones!
  • Check if you are sore at your big toenail and fifth toenail, this means too tight.
  • Keep you nails trimmed with a heavy duty nipper.
  • Use a moisturizing agent on the nail.

Causes

  • Most commonly in people who work on their feet all day.
  • Most common cause – Small shoes that constantly crush the base of the nails or long distance running or athletics that create chronic rubbing against the shoe.
  • Pregnancy(swollen toes) is a very common cause of thick nails!
  • Injury, infection, peripheral vascular disease, diabetes or even malnutrition

Home  treatment for very long toe nails

  • Soak the foot in warm water 3-4x per day for 15-30mins, this will make the nail and the skin softer easier trimming of the nails. It also makes the nails softer for using an emery board or a pumice stone to make the nails smoother on top.
  • If the nail is ingrown and causing you any pain: Soak the nail as above and try to lift the nail and put some gauze or a bandaid underneath the sharp and painful corner. WATCH VIDEO.
  • Be careful attempting to cut out the ingrowth yourself, if you cut yourself at all go see a podiatrist immediatly, especially if you have diabetes, you have unusually bad foot circulation or any other systemic medical condition.
  • Avoid heels or tight shoes until the nails become softer and you are able to cut the thickness down. It is good to use a Brannock device to measure your shoe in width, length and arch length.
  • When trimming your nails, cut straight across. Do not round the corners.
  • Keep the nail thin and make sure the nail curvature remains decreased.

Podiatrist treatment for very long toe nails

  • Essential to go see the podiatrist if this ever comes back or if the nail ever penetrates your skin after trying to take care of it at home.
  • Early treatment can be splints, cotton wicks, plastic strips, plastic tubes down the side of the nail, plastic type glue under the corner is possible.
  • The physician can attempt a nail avulsion.
  • The 1st step is to resect the nail after some numbing medication is used, then correct the underlying problem, whether it be nail dystrophy or nail fungus.
  • The 2nd step is to see if it comes back in 1-2 months. An X-ray should be taken to rule out a bone spur under the nail.  A nail avulsion may be attempted- this is a permanent resection of that border of the nail ensuring it will never grow back.
  • Tetanus prophylaxis may be needed. 1st the podiatrist will numb around the base of the toe, then cut back on the nail and use sodium hydroxide or phenol in the nail bed to keep the nail from growing back If an infection is present- Antibiotics will be necessary, then the toe is covered by ointment and gauze- you will be back on your feet in no time!
  • More extensive surgery can be used in very severe cases to remove the entire nail. The nail matrix is then treated with Phenol to prevent re-growth.

For more information on very long toe nails see this link.

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