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Thickened toenails or onychogryphosis, are a result of damage to the nail matrix causing the nail to grow abnormally thick. This can be a result of direct trauma to the nail bed and matrix, which is where the nails growth occurs, often caused by dropping an object onto the toes, or even via repetitive micro trauma from tight footwear of slipping forward into the end of your shoes. Other causes of thickened toenails can include Peripheral Vascular Disease, Psoriasis, Icthyoses (a rare skin disorder) and a Fungal infection of the nail.
Treatment is generally straight forward and pain free, it involves thinning of the nail plate. Surgical intervention is rarely recommended.
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Nail bed trauma
Nail bed trauma can present in many different forms, can be quite painful and result in the loss of the toenail. It is usually a result of direct or repetitive trauma to the toe resulting in bleeding under the toenail and pain, redness f the end of the toe and throbbing with eventual detachment of the nail from the nail bed. Whilst the nail generally regrows, the new nail can growth may not be as uniform as it was previously with thickening, ridging, impaired adherence or even curvature changes compared with the previous nail. However, occasionally there can be more sinister issues causing these nail bed changes, which may include but not limited to pterygiums, exostoses (extra bone growth under the nail), or melanomas. If you have any concerns about the appearance of your nail seek the opinion of your Podiatrist or GP.
Treatment involves trying to preserve the integrity of the nail unit and reducing pain, whilst removing the fluid from under the nail where appropriate, and making appropriate footwear and padding choices to maintain normal daily activity.
Nail Infections (Fungal nails)
Nail infections or onychomycosis is a fungal infection of the toenails that may involve any component of the nail unit, including the matrix, bed, or plate. Onychomycosis can cause pain, discomfort, and disfigurement or the nail not to mention the potential psychological effects.
Onychomycosis has 5 main subtypes, as follows:
Distal lateral subungual onychomycosis (DLSO)
White superficial onychomycosis (WSO)
Proximal subungual onychomycosis (PSO)
Endonyx onychomycosis (EO)
Raynaud's Phenomenon & Chilblains
What is Raynaud's Phenomenon & Chilblains?
Raynaud's Phenomenon & Chilblains are both intermittent circulatory disorders precipitated by cold temperatures or when in contact with cold objects. Raynaud’s phenomenon typically occurs in the fingers and toes and is triggered by cold temperatures. Cold weather or holding cold objects can trigger Raynaud’s phenomenon. It is caused by spasm of the blood vessels in response to the cold, reducing the blood flow to the extremities. Toes (& fingers) will turn white, then a bluish color, and finally red.
The white color occurs when blood vessels constrict and reduces blood flow to the fingers and/or toes. The extremity then appears bluish (cyanosis) from the resulting lack of blood flow and oxygen. As the vessels relax, blood rushes back into the extremities resulting in dark red hue to the skin and can burn and be painful.
Causes of Raynaud's Phenomenon & Chilblains
Raynaud’s phenomenon can develop on its own for no known reason or it can be associated with other diseases, usually autoimmune diseases such as lupus, scleroderma, dermatomyositis, and rheumatoid arthritis.
Similar to Raynaud's Phenomenon is Chillblains (or erythema pernio). Similar to Raynaud’s phenomenon, Chillblains are a vasospastic response to a cold stimuli. People can develop painful lesions and itchy bumps on the fingers or toes or even ulcerate. Chilblains, can develop with a day of cold exposure and last for several weeks.
How can Southport Podiatry Clinic help?
Treatment involves keeping the extremities warm, by wearing appropriate socks and shoes to ensure the feet are kept warm. Natural fibres are generally better insulators that synthetic. Generally, the condition is self-limiting and does not require treatment, but if the lesions ulcerate they may require to be dressed. You should speak with your podiatrist about your treatment options.
To make an appointment with a Podiatrist at Southport Podiatry Clinic, please call us on 07 5531 3877.
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