What is onychophosis of the toenails?

Onychophosis is a common painful condition affecting the toenails that is commonly seen by Podiatrists. It can lead to discomfort and aesthetic concerns for individuals. This condition, characterized by the formation of callus-like growths in the groove down the sides of the toenail plate, often arises from a combination of mechanical, environmental, and personal factors. It is similar to an ingrown toenail, especially in the symptoms, but the nail does not in grow and the pressures cause a callus in the nail groove that is painful. The causes of onychophosis is primarily due to repeated friction or pressure on the toenail. Ill-fitting footwear, particularly shoes that are too tight or narrow, is a leading cause. Continuous rubbing between the toenail and the shoe can result in the formation of a callus-like thickening, known as onychophosis. Additionally, improper trimming of the toenails, which may lead to uneven edges or ingrown toenails, can contribute to the condition. The symptoms of onychophosis are often noticeable and can cause discomfort for individuals experiencing the condition when wearing shoes. One of the primary indicators is the presence of a thickened, yellowish, or discoloured area down the side of the toenail in the groove. As the callus-like growth progresses, it may extend beyond the nail bed, causing pain and sensitivity. In severe cases, onychophosis can lead to inflammation and infection, further complicating the condition.

There are a number of treatment options to address onychophosis. This usually requires a multi-faceted approach that focuses on relieving symptoms, preventing further progression, and promoting overall foot health. One key aspect of treatment is footwear modification. Individuals are advised to wear properly fitting shoes with adequate toe space to reduce friction and pressure on the sides of the toenails. Choosing breathable materials for shoes can also contribute to a healthier foot environment. Regular and proper toenail care is crucial in managing the problem, especially by a podiatrist. This includes trimming toenails straight across to prevent ingrown nails and avoiding the use of sharp objects to clean or shape the nails, as these practices can exacerbate the condition. In many cases, professional podiatric care may be necessary to address severe onychophosis. Podiatrists can safely and effectively remove the callused skin down the side of the nail. Additionally, topical treatments may be recommended to soften and reduce the thickness of the affected callused skin. Specialized creams or ointments containing keratolytic agents can help break down the excess keratin that contributes to the callus formation. Patients should follow their healthcare provider’s instructions carefully when using such products to achieve optimal results. In the cases that are ongoing the podiatrist may advise minor surgery to remove the edge of the nail that is causing the problem. Preventing onychophosis involves adopting proactive measures to safeguard the health of the toenails. This includes wearing appropriate footwear, practicing good toenail hygiene, and maintaining regular foot inspections. Individuals with pre-existing conditions such as diabetes should be particularly vigilant, as they may be more susceptible to complications associated with onychophosis. If you are concerned about this type of problem, then consult a podiatrist.

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