Foot health

03 December 2008

Your toenails

Nails, both those on the hands and feet, are the only skin appendages that are not located in the skin itself. There are a few conditions that affect the toenails.

Nails, both those on the hands and feet, are the only skin appendages that are not located in the skin itself. Nails are made of keratin, which forms a hard, protective structure. Keratin is produced in the nail matrix by dividing skin cells.

Nails consist of six specific parts – the root, the nail bed, the nail plate, the cuticle, the perionychium (the tissue surrounding the nail) and the hyponychium (the area beneath the free edge of the nail).

Toenails grow much slower than fingernails do and take 12 – 18 months to be replaced completely. Toenails grow at a rate of approximately 1 mm per month.

There are several conditions which can affect the toenails.

Toenail problems
There are several conditions which can affect the toenails.

Ingrown toenails
The name 'ingrown toenails' suggests that it is always the toenail growing into the skin, but half the time the skin on the side of the nail grows over the edge of the nail, so the name can be a bit misleading. Many different things can cause ingrown toenails, from having arthritis, stubbing a toe on something, incorrect trimming of toenails, very tight stockings or narrow shoes.

Ingrown toenails can quickly become red and infected – and if you try and fix the toenail yourself, you could actually make things worse. There are several over-the-counter preparations that can harden the skin and shrink the soft tissue next to the nail. If the inflammation persists, it is, however, best that it be treated by a physician or a podiatrist.

Find out more about ingrown toenails.

Fungal infections
Nail fungal infections can cause permanent damage to your nails. They can be painful and difficult to get rid of. They are mostly caused by a fungus that falls in the group called dermatophytes, which is similar to the type that causes athlete's foot. The main fungal infection of the nail is called 'ringworm of the nail'.

This condition can occur just in the nail, or it can spread to the toenail from a general foot infection. The fist obvious symptoms include a whitish (sometimes also darker colours) discolouration of the nail. The nail becomes thicker, and if left untreated, may actually be destroyed.

People most at risk include sportspeople, people who wear tackies, those whose jobs require them to wear rubber footwear and people who live a warm and humid climate.

Read more about fungal infections of the toenails

Black toenails
Athletes often find that their toenails go darker or black – especially those who run long distances or train for marathons or ultramarathons. The reason for this is that the top of the toenail hits the running shoe continuously and this causes bruising under the toenail.

Usually this condition is not painful, but can create conditions ideal for fungal infections under the toenail. It is also a cause for concern when toenails of diabetic suddenly turn darker.

Treatment consists of trimming the loose nail and applying topical antibacterial or anti-fungal medication. To prevent this condition, it is essential to get properly fitting shoes and, in some cases also stretching the calf muscles. Having tight calf muscles often results in the toes hitting the top of the shoe with greater force, which can result in black toenails.

Read more:
Ingrown toenails

South African Podiatry Association (SAPA)


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