What Are They?
Toe and finger nails might be tough but they’re still subject to damage and disease. A gryphotic toenail (Onychogryphosis) is a nail disease that usually affects the big toenail.
The resulting malformed nail growth is not only unsightly but can affect the other toes and healthy foot function as well as create prime conditions for other infections to flourish.
Like all nail and skin diseases, Onychogryphosis indicates underlying health conditions that need to be addressed for full recovery. Onychogryphosis is most commonly seen in the elderly and dementia patients.
The pathology behind Gryphotic nails is still not completely understood.
The most common cause of onychogryphosis appears to be foot trauma or repetitive trauma to the nail plate known as “nail matrix damage”.
Wearing poorly fitting shoes that put too much pressure on your proximal nail matrix may damage the nail and cause it to grow in this abnormal way.
Causes of Gryphotic Toenails
Poor circulation associated with diabetes may also trigger the development of a Gryphotic toenail. Peripheral vascular disease or peripheral arterial disease causes diminished blood flow in your lower legs and feet and this can be very detrimental to healthy nail growth.
Onychogryphosis may also be associated with skin diseases and fungal infections including skin or nail psoriasis, dermatitis.
Poor hygiene often plays a role in the development of Onychogryphosis. Onychogryphosis can also make your feet more susceptible to fungal infections, ingrown nails and paronychia (infection of the skin around the nail). Congenital onychogryphosis may occur in babies but it is very rare.
Signs & Symptoms of Gryphotic Toenails
The nail develops as a yellow brown thickening of the nail usually on the big toe, although it can affect can affect the other toes as well.
The nail will grow unevenly at the proximal edge, meaning one side of the nail will grow faster than the other side, leading to a strongly curved nail.
The nail develops the typical “ram’s horn” or oyster shell appearance and ridges that lie across the nail will often be obvious on the nail. The nail grows upwards and sideways.
A gryphotic nail, if left untreated may become painful. Onychogryphosis can lead to associated conditions such as ingrown nails and additional skin and nail infections that increase the discomfort. Due to the nail growing upwards, it leaves the nail bed open to a fungal infection.
Treatment of a Gryphotic Toenail
It’s vitally important to seek treatment for Gryphotic nails as soon as possible. Correct diagnosis is vital in the first place. Your podiatrist has a range of nail treatment options to treat the problem and relieve pain.
Conservative treatment involves regular cutting, mechanical debridement and filing of the nails. It’s essential that you get a qualified podiatrist to do this as cutting in the wrong way may lead to other problems such as ingrown toenails or spread infection.
In severe cases, nail surgery may be necessary to remove the damaged nail.
Assess Your Footwear
Your podiatrist will examine your footwear and look for pressure points that might be damaging the nails.
Dense foam pads can relieve these pressure points, and custom orthotics can provide the entire foot with a healthier functioning environment. You may also need to look at wearing shoes that promote healthier foot function overall.
A correctly fitting shoe with a deep enough toe box can relieve pressure on your toenails. See the team at Erica Dash Podiatry, our entire team are trained shoe fitters.
If the Onychogryphosis returns, more invasive surgical techniques may be required right to the proximal nail fold. In any case, it is important to explore any underlying issues that might be causing the Gryphotic nail to develop.
You should see your doctor to rule out diabetes or other circulation diseases. This is important because diabetes-related circulation problems can result in gangrene and may require an amputation. You might need to see a dermatologist for help dealing with severe psoriasis and other skin conditions that could be causing the Onychogryphosis.
Nail health is important. See Erica Dash Podiatry today and we’ll make sure your nails are keeping you down.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.