Toenail Changes: Injury or Other Issues?

The appearance of toenails?

Doctor, my fourth toe on the left side of my right foot has a raised area at the base of the nail.
I trimmed it, and now it is higher in the front and lower in the back.
I play sports; could this be an athletic injury or something else?

Cai Xiansheng, 10~19 year old female. Ask Date: 2012/10/03

Dr. Liao Yaopan reply Family Medicine

Hello, based on your description, I am not very clear about your condition.
I still recommend visiting a clinic to better determine your health status.
Thank you for your message.
Changhua Hospital cares about you.

Reply Date: 2012/10/03

More Info

When it comes to changes in toenails, particularly in the context of sports and physical activity, there are several factors to consider. The description you provided indicates that the nail at the base has a raised appearance, and after trimming, it has become uneven, with the front being higher than the back. This could potentially be attributed to a few different causes, including trauma, fungal infections, or other underlying conditions.

Possible Causes of Toenail Changes
1. Trauma or Injury: Given that you are active in sports, it is quite possible that the toenail has experienced some form of trauma. This could be due to repetitive impact from running or jumping, which is common in sports like basketball or soccer. Such trauma can lead to a condition known as subungual hematoma, where blood collects under the nail, causing it to lift or change shape. If the nail bed was damaged, it might also grow back irregularly.

2. Fungal Infections: Another common cause of toenail changes is a fungal infection, which can cause the nail to become thickened, discolored, or distorted. Fungal infections often thrive in warm, moist environments, making athletes particularly susceptible if they frequently wear tight shoes or socks that do not wick moisture away.

3. Nail Growth Disorders: Sometimes, the way a nail grows can be affected by underlying health issues or genetic factors. Conditions such as psoriasis can also affect nail growth and appearance, leading to changes in thickness and texture.

4. Ingrown Toenails: If the nail is growing into the surrounding skin, it can cause pain and swelling, leading to changes in the nail's appearance. This is often exacerbated by tight footwear or improper nail trimming.

Recommendations
1. Observation: Monitor the nail for any changes. If the nail continues to grow unevenly or if you notice any signs of infection (such as redness, swelling, or discharge), it would be wise to seek medical attention.

2. Proper Footwear: Ensure that your shoes fit well and provide adequate support. Avoid tight shoes that can exacerbate nail issues.

3. Nail Care: Be cautious when trimming your nails. It’s best to cut them straight across and avoid cutting too close to the skin to prevent ingrown toenails.

4. Consult a Specialist: If the condition does not improve or worsens, consider consulting a podiatrist or dermatologist. They can provide a thorough examination and may recommend treatments such as antifungal medications if an infection is suspected or other interventions if there is significant trauma.

5. Rest and Recovery: If you suspect that the issue is related to sports activity, consider taking a break from high-impact activities to allow the nail and surrounding tissue to heal.

Conclusion
In summary, the changes you are observing in your toenail could indeed be related to sports injuries, but they could also stem from other issues such as fungal infections or nail growth disorders. It is essential to pay attention to any accompanying symptoms and seek professional advice if necessary. Proper nail care and footwear can help prevent further issues, and a healthcare professional can provide targeted treatment if needed.

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