A fingernail that appears to be growing sideways is usually a sign of misalignment, curvature, or damage rather than true horizontal growth. This common concern often manifests as the nail plate curving sharply into the surrounding skin or growing at an unusual angle away from the fingertip. The misalignment is frequently tied to the nail matrix, the specialized tissue underneath the cuticle where new nail cells are generated. Since replacement takes around six months, correcting a sideways growth pattern is a gradual process requiring consistent attention. Understanding the root cause of the curve is the first step toward encouraging the nail to follow a straighter path as it grows out.
Why Fingernails Start Growing Sideways
The architecture of the nail is primarily determined by the nail matrix, and any disturbance to this area can lead to a permanent change in growth direction. One of the most frequent causes of sideways growth is trauma, such as a crushing injury to the fingertip or repeated pressure. This damage can permanently alter the angle of the nail bed or matrix, causing the new nail plate to emerge with a deviation or excessive curvature.
Another common mechanical cause is improper trimming, which often leads to an ingrown nail. When the nail is cut too short or the edges are aggressively rounded, the remaining corner can press or embed itself into the skin fold, encouraging the nail to grow inward instead of straight out. This inward growth presents as a noticeable sideways curve.
The change in shape can be symptomatic of an underlying medical condition affecting the nail plate or surrounding tissue. Fungal infections (onychomycosis) can cause the nail to thicken, become crumbly, and deform its growth pattern. Inflammatory skin conditions like psoriasis can also affect the nail matrix, leading to pitting and discoloration. Systemic issues like iron deficiency anemia can cause “spoon nails” (where the nail curves inward and upward), while other conditions can lead to clubbing (where the nail curves excessively around the fingertip).
At-Home Techniques for Correcting Nail Alignment
Managing a sideways-growing nail at home focuses on relieving pressure and gently guiding the new nail growth into a healthier trajectory. Patience is necessary, as correction relies on the six-month growth cycle of the fingernail. Begin by ensuring the nail is soft, which is achieved by soaking the affected finger in warm water for a few minutes before trimming or filing.
Proper filing and shaping techniques are foundational for encouraging straight growth and preventing ingrown tendencies. Always use a clean, sharp nail clipper and cut the nail straight across, avoiding the temptation to deeply round the corners. After clipping, use a fine-grit nail file to smooth any sharp edges, filing gently in one direction to prevent splitting or fraying the nail tip. The goal is to leave a small amount of white nail visible at the edge, ensuring the nail does not become too short.
For minor cases where the nail edge is just beginning to press into the skin, a gentle lifting technique can redirect the growth. After softening the nail, carefully lift the offending nail corner and insert a tiny, sterile piece of cotton or dental floss underneath. This wedge acts as a buffer, separating the nail and the skin fold, which helps guide the nail plate to grow above the skin. The material should be replaced daily to maintain hygiene and prevent bacteria introduction.
Minimizing external pressure is important for long-term correction. Avoid wearing tight gloves or engaging in activities that cause repeated impact or pressure on the nail, as this can exacerbate the misalignment. Regular moisturizing of the hands and cuticles helps maintain the pliability of the surrounding skin and nail, making the nail plate less brittle and easier to manage. Consistently following these steps for several months is the best way to see improvement.
Recognizing When to Seek Professional Treatment
While many instances of sideways growth can be managed effectively at home, certain signs indicate the need for professional medical intervention. The appearance of an infection is a significant reason to consult a healthcare provider promptly. Symptoms such as increasing pain, severe swelling, redness, warmth around the nail fold, or the presence of pus or fluid suggest bacteria have entered the skin.
A medical professional should evaluate cases where the nail deformation is severe or persistent despite diligent home care. This includes nails that are excessively thickened, deeply discolored, or severely curved, such as in conditions like onychogryphosis (ram’s horn nail). If the nail change accompanies other unexplained symptoms like fever or pain, or if the cause of the misalignment is unknown, a medical opinion is warranted to rule out underlying systemic diseases.
The specialist to consult depends on the suspected cause and severity. A dermatologist is the appropriate specialist for diagnosing nail diseases, such as fungal infections or nail psoriasis, and for addressing issues related to the nail matrix. A podiatrist can also treat complex or recurring nail problems, especially if the issue involves significant ingrowth or requires a minor surgical procedure. Treatment options range from prescription topical or oral medications for infections to minor in-office procedures like temporarily bracing the nail or surgically removing the embedding nail edge.