Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Sometimes, the bruise can lead to a fungal nail infection and can sometimes represent malignancy if the condition is chronic.
Treatment may include trimming the nail back and applying a topical antifungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied.
Diabetic patients should contact our office for evaluation if they experience any change in the color of toenails. The pressure causing the bruised nail may lead to a small sore under the toenail, which can lead to infection.
Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.
In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.
Ingrown toenails can be prevented by:
Trimming toenails straight across with no rounded corners.
Ensuring that shoes and socks are not too tight.
Keeping feet clean at all times.
Osteochondromas are benign bone tumors that form in the bone beneath the toenail. Osteochrondromas account for about half of all benign bone tumors, and occur mostly in children and young adults. Unless they cause irritation to the surrounding tissue, they are generally not painful.
In some cases, osteochondromas may cause a deformity in the toenail or lead to an ingrown toenail. When problematic, osteochondromas may be removed surgically. However, they can recur after the procedure.