Fungal & Ingrown Nails

At North Platte Foot Clinic we know that the most common cause of unusual looking nails is a fungal infection that makes the toenail discolored and then disfigured over time. This is called onychomycosis and is usually caused by the athlete’s foot fungus. It can be a mild infection that looks like little white pits on the toenail, a moderate yellow collection of debris under the toenail or it can be a fully involved white chalky nail that is very irregular in shape and is often very painful in shoes.  However there are more causes than the ones listed above.

toenail-fungusSome people have psoriasis or eczema in their nails. These skin disorders can cause the nails to be quite thickened and start splitting and peeling. It can look like a fungal infection but a special test can tell the difference. Many people think they have fungus before they find out it is a skin condition. The nail changes usually start as a thickening or rippled look.  The nail will often start growing funny because of the psoriasis but then gets a secondary infection with fungus, so you can see both disorders together.

Nail changes can also be self-inflicted.  Most people will remember a trauma to the nail like dropping something on it or kicking a door.  The nail bed gets damaged and the nail never grows back correctly.  Other times the trauma may not be as evident.  Runners, tennis players and dancers often have chronic low level nail trauma that damages nail’s over time. These nails are usually thick and may have hard skin around them.

Black toenails can be caused by similar self-inflicted trauma but can also be a sign of an underlying melanoma or skin cancer. Although black toenails can be badge of toughness in the running community if you have black toenails in the absence of trauma contact us immediately for an evaluation.  Subungual melanoma kills.

Chemotherapy and some drugs can cause nail changes.  The nails will often become whiter and very thick.  The nails may be peeling off or very sensitive. You may see blistering around the nails and in the cuticle area.  Secondary bacterial infections can also occur and are dangerous if your immune system is depressed.

Nails can also be affected by your overall health. Very light pale nails can be a normal sign of aging, but can also be cause by an underlying health problem like anemia, malnutrition or liver disease. In some liver diseases the nails can be very white. Thyroid problems can cause the nails to be yellowed and somewhat peeling and crumbly. These are often confused with early fungus.

If you have discolored or strangely textured nails contact us for a consultation.  A biopsy of the nail’s end for a special stain can usually identify the underlying cause of your toenail troubles.

Most treatments fit into two major categories:ingrown-toenail

Fungus: There are a myriad of topical treatments which hardly ever work unless you only have one or two nails involved. Oral anti-fungals have significant side effect risk factors but do work most of the time. Laser therapy is a new approach with very promising outcomes and no real risks. No matter what the treatment, you need to be judicious about decontaminating all your shoe gear and trying to prevent reinfection. Recurrence rates are around 50%.

No Fungus: Topical therapy with a urea based nail gel helps to soften the nails and thin them out. Try to eliminate the trauma from tight running shoes or high heels. This is a maintenance issue because severely traumatized nails or nails thickened by an underlying dermatitis often are a lifelong issue but very controllable with a little daily self-care. Steroid injections to the nail bed can help with severely thickened nails caused by psoriasis or eczema.

Discolored/disfigured toenails are not normal and should be addressed. They are not all fungus and are not a natural part of the aging process. They can become more painful and irregular in time causing a myriad of problems. Black toenails should be addressed immediately.  Come see us if your toenails seem to be changing, at North Platte Foot Clinic we’re here to help.


Ingrown toenails are easily one of the more common and painful foot problems around. In fact, in a recent survey by the American Podiatric Medical Association, they were listed in the top three with heel pain and blisters as the other most common foot issues.

Also known as Onychocryptosis, there are a variety of ways that people end up suffering from ingrown nails. Excessive pressure on the outside of the big toe, stubbing or having a toe stepped on, tight socks and shoes, and even poorly trimming of your nails can cause ingrown toenails. Don’t forget the dreaded toenail fungus (Onychomycosis) which can cause an abnormally shaped nail that tends to get ingrown.

The pain isn’t easy to deal with, as most people are constantly on their feet.  Soreness and sensitivity along the margins of the toenails may lead to infection (watery discharge, blood, pus). If you think it’s infected, call North Platte Foot Clinic immediately

If uninfected, treat the feet by soaking them in salt water or warm soapy water. Drying them thoroughly, applying a mild antiseptic solution, and bandaging the toe will help.

By taking proper care of your feet, ingrown toenails can be prevented. Make sure your shoes fit properly. Don’t forget clean socks. Cut your nails straight across. Keep your toenail clipper clean. Please don’t pick at them or try to perform an operation in the bathroom.  Treat fungus as soon as you notice it.  If you have any questions regarding discolored or ingrown nails please call North Platte Foot Clinic, most nail issues are simple to fix if caught early.

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