Upward-growing toenails, medically known as onychogryphosis, occur when the nail plate thickens and curves, often resembling a ram’s horn. This condition typically affects the big toe, causing the nail to lift away from the nail bed at the front. The nail’s appearance can range from slightly elevated to significantly distorted, becoming hard and discolored. This growth can cause discomfort and make routine nail care challenging.
Why Toenails Grow Upward
Several factors contribute to toenails growing upward, often acting in combination. Repetitive trauma is a common cause, such as dropping heavy objects on the toe or consistent pressure from ill-fitting shoes. This stress can damage the nail matrix, leading to a thickened, upward-curving nail.
Aging also plays a role, as nails naturally thicken and harden over time due to slower growth and changes in keratin production. Fungal infections (onychomycosis) can alter the nail’s structure, causing it to become brittle, discolored, and thick, contributing to upward growth. Systemic health conditions like psoriasis, which affects skin cell turnover, can also cause nail changes, including thickening and lifting.
Poor circulation, often associated with diabetes or peripheral artery disease, can impair nutrient delivery to the nail matrix, resulting in abnormal growth. Certain nutritional deficiencies, such as iron deficiency, may weaken nails and predispose them to unusual growth patterns.
Managing Upward Toenails at Home
Managing upward-growing toenails at home involves reducing thickness and preventing complications. Begin by soaking your feet in warm water for 10-15 minutes to soften the nails, making them easier to manage. Applying a urea-based cream after soaking can further soften and thin the nail plate.
When trimming, always cut the nail straight across, avoiding rounding the corners or cutting them too short, which can lead to ingrown nails. Use sturdy, straight-edged clippers designed for thick nails to ensure a clean cut. Gently file the top surface of the nail with a coarse nail file to reduce its thickness, being careful not to file down to the nail bed.
Properly fitting footwear is also important. Choose shoes with a wide, deep toe box that allows ample room for your toes to move freely without pressure on the nails. Avoid shoes that are too tight or pointed, as these can exacerbate the upward growth by applying constant pressure to the nail.
When to Seek Professional Help
Professional medical intervention, typically from a podiatrist, is necessary in specific situations. If you experience persistent pain, redness, swelling, or pus around the nail, these are signs of a potential infection requiring immediate medical attention. Infections can worsen rapidly, especially in individuals with compromised immune systems or conditions like diabetes.
Difficulty walking or performing daily activities due to the nail’s thickness or shape also indicates a need for professional care. A podiatrist can safely thin the nail using specialized tools, a process known as debridement, which is often more effective and safer than home attempts. If the nail becomes too thick or hard to manage with home care, professional assistance is needed.
For individuals with underlying health conditions such as diabetes, peripheral vascular disease, or nerve damage, any toenail issue warrants a visit to a healthcare professional. These conditions can increase the risk of serious complications from minor foot problems. In severe cases, where conservative treatments are insufficient, a podiatrist might recommend partial or complete nail removal to resolve the issue.
Steps to Prevent Upward Growth
Preventing upward-growing toenails involves consistent foot and nail care. Always wear properly sized shoes and socks that do not compress your toes. Ensure there is at least a thumb’s width of space between your longest toe and the end of your shoe to prevent repetitive trauma.
Maintain good foot hygiene by washing your feet daily with soap and water and drying them thoroughly, especially between the toes. Keeping feet clean and dry helps prevent fungal infections, which can contribute to nail thickening. Regularly inspect your toenails for any early signs of thickening, discoloration, or upward curvature.