Onychorrhexis of the Toenails

Our toe nails are often called the mirrors of our health as so many medical problems can affect the health and look of the toe nails. These nails can be affected by local problems or by systemic problems. The local problems can be trauma to the nail, an ingrown nail or a callus that develops down the side of the nail edge. Systemic problems could be poor circulation, and arthritis problems or a deficiency of some nutrients – all of these sorts of problems can affect the appearance of the toenail. There are quite a lot of medical conditions that can cause quite a lot of different nail conditions.

One of these such nail problems is a condition called onychorrhexis. The name is derived from the Greek words, ónycho- which is for "nail" and rhexis which means for "bursting". Onychorrhexis appears as longitudinal ridging with shallow parallel striations or furrows with ridges that affect the superficial layers of the nail plate. There may be some chipping at the distal or free end of the nail plate due to the fragility of the nail. Onychorrhexis is a normal part of aging and is very common in older people and in these cases the appearance is generally of no consequences. While it is associated with aging, it can also be associated with an underlying medical condition. Just how bad the longitudinal riding is will depend on just how much damage is done to the nail matrix at the base of the nail where it grows from by the underlying medical problem that is causing it. Onychorrhexis is not painful but due to the ridging that chipping at the distal edge of the nail may lead to splits in the nail that can become painful. Some of the medical conditions that can cause the nail to go like this include lichen planus, psoriasis; iron?deficiency anaemia, poor circulation, rheumatoid arthritis, anorexia nervosa or bulimia, pityriasis rubra pilaris, zinc deficiency and a nail condition called trachyonychia. Picking at the nails or nail biting can cause it and so can the frequent use of nail polish remover also be a factor. A fungal infection of the nail can also give a similar appearance.

The treatment of onychorrhexis is probably not needed as there is nothing that can be done due to it being a normal part of aging. There may be some improvement in the appearance of the nail with the treatment of the underlying or associated condition if that is the cause of the appearance of the nail. It is really important to take proper care of the nails with frequent trimming of the nails. If the amount of the free edge of the nail is kept low and the nail kept short, it is less likely that the free or distal edge of the nail will chip or split. All problems that can occur with the nail can be due to local problems or systemic medical problems. It is important that the cause of the problem is determined so the right treatment can be given.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.