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What Are Unsightly Toenails?
Causes
Symptoms
Risks
Treatment
If you ignore the injury
Prevention

It can be disheartening to walk through your days feeling dissatisfied or embarrassed about the appearance of your nails. We see many patients who have resorted to wearing close-toed shoes or socks around the home for months or even years. Thankfully, treating unsightly toenails can now be simple when you have the right tools and technology, like our Brisbane podiatrists do.

What Are Unsightly Toenails?

Unsightly toenails describe the changing appearance of toenails that have become undesirable or unattractive. While this may seem small, it can be extremely distressing for many people, especially as the appearance of the toenails continues to worsen over time.

What Causes Unsightly Toenails?

Some common causes of toenails that have changed appearance include:

Toenail fungus

This is probably the leading cause of changes to the appearance of toenails we see and treat. A fungal nail infection can lead to:

• Yellow, white or brown nail discolouration
  
• Nail thickening
  
• Flaking or brittleness
  
• The nail lifting from the nail bed (causing that area to turn from pink to white)
  
• Debris beneath the nail
  

Fungal nail infections often start with small spots or streaks on the nail and progressively worsen over time, making early treatment ideal. If you think you may have a fungal nail infection, you need to read about the easiest treatment - PACT.

Nail trauma

Nail trauma describes damage to the nail, either in a short time frame, such as when something heavy lands on the toe or it is stubbed, or progressive damage from trauma occurring over time, such as from tight footwear that presses on the nail with every step. 

While some trauma causes damage to the toenail itself, meaning the nail may grow thick or distorted, other trauma can lead to bleeding beneath a large portion of the nail. Over time, the effects of the dried blood beneath the nail can cause it to separate from the nail bed, and require it to be trimmed very far back for hygiene purposes, leaving only a small amount of the toenail behind. 

Ingrown toenail

Having multiple ingrown toenails can lead to your toe often looking red, swollen, having discharge and more. These symptoms can also lead to maceration of the skin surrounding the nail, and weakening of the nail itself.

Psoriasis

Psoriasis is an autoimmune condition that doesn’t just affect the skin, it can change the way your nails look too. If you have psoriasis, you might notice small dents or pits in your nails, thickening or crumbling, or even a yellowish-brown discolouration. In some cases, the nail can start lifting from the nail bed, which can be mistaken for a fungal infection. Because the symptoms overlap, getting the right diagnosis is important to make sure you’re treating the real cause.

Ageing

Just like our skin changes over time, so do our nails. As we get older, nails can become thicker, more brittle, or develop ridges. They might start looking more yellow or dull, and they don’t grow as quickly as they used to. While these changes are completely normal, they can make nails more prone to cracking or fungal infections, which is something to keep an eye on.

Poor circulation

When there’s less blood flow to the feet, the nails often show it first. Poor circulation, which is common in conditions like diabetes, can cause nails to grow more slowly, become brittle, or even develop a bluish or purplish tint. The weaker structure also makes them more vulnerable to infections, so keeping an eye on nail health is especially important for those with circulation issues.

Underlying health conditions

Your nails can tell you a lot about your overall health. Conditions like diabetes, thyroid disorders, or nutritional deficiencies can lead to noticeable changes, from brittle or slow-growing nails to discolouration or even a spoon-like shape.

Symptoms Of Unsightly Toenails

The main symptom of unsightly toenails is their cosmetic appearance and the impact it has on a person's confidence, shoe options, and quality of life. If the nail thickens or begins to lift away, this may also cause discomfort. The most severe symptoms in terms of pain come from an ingrown toenail, which can be excruciatingly painful and bring with it redness, swelling, bleeding, discharge, and more.

Risk Factors For Unsightly Toenails

While some risk factors like stubbing your toe or other toenail trauma is unpredictable, other risk factors for unsightly toenails include:

• Participating in sports that require tight or narrow shoes like soccer or rock climbing
  
• Wearing shoes that are too small, or have a narrow toe box
  
• Walking in bare feet in gym changing rooms, public showers and public swimming pools where fungus is more easily contracted, which can infect the toenails
  
• Having a poor nail trimming technique, such as ‘picking’ at the nails or trimming deep down the sides of the nail, which can lead to an ingrown toenail
  
• Having conditions like psoriasis, which can also affect the appearance of your toenails
  

Can Unsightly Toenails Be Treated?

Absolutely - and you don’t have to damage your toenail further in the process by covering it up with salon pedicures. Depending on the cause of the change in appearance of your toenails, we have a range of treatment options available, which include:

Thinning and trimming the toenails

As part of our skin and nail care appointments, we use medical-grade instruments to easily trim even the toughest and thickest toenails. Afterwards, we use a burr to reduce the surface thickness of the nail down to a more comfortable and often more aesthetically pleasing level, which also removes any surface level discolouration, spotting or streaking if present. 

Keryflex nail restoration: A healthy, clear new nail

Keryflex is a type of cosmetic nail restoration  that transforms nails in one appointment from discoloured and damaged to shiny, clear, and healthy-looking. Keryflex works by creating a safe, breathable and flexible nail over the existing nail that feels and acts like a real nail. It doesn’t cause any damage to the nail beneath and lets the original nail grow out while looking great. The nail is non-porous and doesn’t allow moisture to penetrate between the natural nail and the Keryflex nail. This means it won’t irritate or cause further damage, and it won’t exacerbate any existing fungal nail infections or other conditions. In fact, Keryflex contains an antifungal agent (Piroctone Olamine) to help inhibit the growth of existing fungal infections.

PACT fungal nail treatment: Getting rid of fungal nail infections

PACT is an anti-fungal nail treatment that uses a high-powered LED light paired with a unique gel that is sensitive to light. It kills and destroys nail fungus without causing any damage or harm to the healthy nail or the surrounding skin. 
 

Ingrown nail surgery: Permanent treatment for ingrown toenails

For those whose nail appearance is affected by the presence of one or recurring ingrown toenails, we offer ingrown nail surgery called a partial nail avulsion. This is a safe, effective and permanent solution where a small portion of the edge of the nail is removed and doesn't regrow. The procedure is painless as it’s completed under local anaesthetic and is done within one hour.

Total nail avulsion: Removing the entire toenail

For some of our patients, their toenails have been so badly damaged by a range of conditions or problems that they choose to have the entire toenail removed to start with a ‘blank slate’, hoping that the nail will regrow healthy and clear. We often see this work successfully after the toenail has been badly damaged from trauma. This procedure is also performed under local anaesthetic.

What Can Happen If I Ignore My Unsightly Toenails?

In most cases, discoloured toenails that are left untreated progressively worsen over time: 

• Fungal nail infections can progress from mild spots or streaks to covering the entire surface of the nail
  
• Toenails that are growing thicker from repeated trauma like tight, narrow footwear can continue to thicken and become more damaged, leaving even less room in the toe box and a greater amount of pain and discomfort for your toes
  
• Ingrown toenails can continue to grow deeper down the side of the nail, continuing to be very painful, while leaving you vulnerable to infection
  

How To Prevent Unsightly Toenails

If your nails have already changed in their appearance, preventing unsightly toenails from progressing or recurring starts with having them accurately diagnosed and treated, identifying the cause, and putting the right prevention steps in to protect yourself in the future. This can look like:

• Wearing thongs in public showers, change rooms and pool areas to reduce the likelihood of picking up nail fungus. We have a range of Archies available for purchase for a comfortable and podiatrist-recommended thong option.
  
• Having those in your household with a fungal infection treated promptly to help prevent the spread from sharing floors and surfaces
  
• Avoiding footwear that is too small, presses on your toenails, or causes you pain
  
• Trimming your nails straight across using nail scissors, and without curving deep down the sides to help prevent ingrown nails
  
• Looking out for the warning signs that changes in the appearance of your nails may be starting, and treating them promptly
  

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