Dealing with Toenail Issues: Causes, Symptoms, and Treatment Options

Nail issues

Hello Doctor, I would like to ask about an issue I have been experiencing.
About 3.4 years ago, I stubbed my little toe against the foot of my bed.
At that moment, there was bruising under the nail.
After a few days, since the toe was still painful, I went to see a doctor.
I wasn't sure which specialty to visit, so I went to orthopedics.
An X-ray was taken, and the doctor indicated that there was no bone injury, so the matter was left unresolved.
A few weeks later, I noticed that a new nail was growing, and the original nail had fallen off.
The new nail has been growing very slowly, and after observing for a while, I found that it is not as strong as my other nails and is slightly angled upwards.
Occasionally, after taking a shower, the nail becomes soft, and I experience some pain at the base of the nail when walking.
This situation has persisted until now.
Although it is not a major issue, it is somewhat bothersome, and I would like to know if there are any treatment options available.
Would using a nail hardener be helpful? Thank you, Doctor.

Lynn, 20~29 year old female. Ask Date: 2021/05/07

Dr. Li Zhonghuai reply Surgery

Hello! If you have an irregular toenail growth due to an injury to the nail bed, and you are concerned about it, it is advisable to seek medical attention for toenail removal.
Proper trimming of the nail bed can lead to a more aesthetically pleasing nail growth.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/05/07

More Info

Dealing with toenail issues, particularly after an injury, can be quite frustrating and uncomfortable. Based on your description, it seems that you experienced trauma to your toenail, which led to a series of changes in its growth and structure. Here’s a comprehensive overview of the potential causes, symptoms, and treatment options for your situation.

Causes
1. Trauma: The initial injury you sustained by kicking the bed frame likely caused damage not only to the toenail itself but also to the nail matrix, which is the tissue under the base of the nail responsible for nail growth. This trauma can lead to changes in how the nail grows, its thickness, and its overall appearance.

2. Nail Growth Issues: After trauma, it’s common for the new nail to grow more slowly and potentially take on an abnormal shape. This can result in a nail that is softer, thinner, or more prone to bending or curling upwards.

3. Infection: If there was any break in the skin or if the nail bed was exposed during the injury, there is a possibility of developing a fungal or bacterial infection, which can also affect the nail's appearance and health.

Symptoms
- Pain: You mentioned experiencing pain at the base of the nail, especially after bathing. This could be due to pressure on the nail bed or inflammation around the nail.

- Nail Texture and Growth: The new nail being softer and growing at an angle can indicate that the nail matrix was affected by the initial trauma.

- Discoloration: If there is any discoloration or changes in the nail's color, it may suggest an underlying issue, such as an infection or a chronic condition affecting nail health.

Treatment Options
1. Observation: Since the issue has persisted for several years without significant worsening, a conservative approach may be appropriate. Regular monitoring of the nail for any changes in color, shape, or pain levels is essential.

2. Nail Care: Keeping the toenail trimmed and clean can help prevent further issues. Avoiding tight footwear that puts pressure on the toenail is also advisable.

3. Topical Treatments: Applying a hardening nail polish or topical treatments designed for strengthening nails may provide some benefits. These products can help protect the nail and potentially improve its strength over time.

4. Pain Management: If the pain persists, over-the-counter pain relievers such as ibuprofen or acetaminophen may help alleviate discomfort.

5. Consultation with a Specialist: If the pain continues or worsens, or if you notice signs of infection (such as redness, swelling, or discharge), it would be wise to consult a podiatrist or dermatologist. They can provide a more thorough examination and may suggest treatments such as:
- Nail Removal: In severe cases where the nail is causing significant pain or is deformed, partial or complete nail removal may be necessary.

- Fungal Treatments: If a fungal infection is suspected, antifungal medications may be prescribed.

6. Surgical Options: In cases where the nail continues to grow abnormally or causes recurrent pain, surgical intervention may be considered to correct the nail growth or to remove the nail matrix.

Conclusion
In summary, while your toenail issue may not seem severe, it is essential to monitor it closely and take appropriate steps to manage any discomfort. Using hardening nail polish may help, but if symptoms persist or worsen, seeking professional medical advice is crucial. A podiatrist can provide tailored treatment options based on a thorough assessment of your condition. Remember, taking care of your feet is vital for overall health and well-being, so don’t hesitate to seek help if needed.

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