Onychophosis: Signs, Causes, And How To Treat

Onychophosis occurs when the nail becomes thickened and hard, often leading to discomfort and aesthetic concerns. The condition can be triggered by various factors, such as repetitive trauma or pressure on the nail bed. Understanding the underlying causes of onychophosis is crucial in managing and preventing its recurrence. 

By addressing these root causes, individuals can take proactive steps in caring for their nails and promoting overall nail health. Remember, seeking advice from a healthcare professional is essential to address any concerns related to onychophosis.

What Are the Symptoms of Onychophosis

Onychophosis symptoms include thickened and discolored toenails, pain around the nail bed, swelling, and difficulty trimming nails. Infection and ingrown nails are common complications. 

Proper foot care and wearing comfortable footwear can help manage symptoms. Consult a healthcare provider for an accurate diagnosis and appropriate treatment.

  • Thickening of the toenail that may cause discomfort when wearing shoes or walking.
  • Yellow or brown discoloration of the nail, making it look unsightly and brittle.
  • Development of a foul odor coming from the affected toenail.
  • Formation of white patches or lines on the nail surface.
  • Pain or tenderness around the toenail bed, especially when pressure is applied.

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Causes of Onychophosis

Additionally, poor nail care habits, including cutting nails too short or irregularly, can contribute to the development of onychophosis.  Proper diagnosis and treatment are essential to address the underlying cause and improve nail health.

  • Onychophosis can be caused by ill-fitting footwear that puts constant pressure on the toenails, leading to thickening and hardening of the nail plate.
  • Fungal infections such as onychomycosis can result in onychophosis by causing the nails to become thick, discolored, and brittle.
  • Trauma to the toenails, such as repetitive microtrauma from activities like running or kicking sports, can trigger onychophosis by damaging the nail bed.
  • Poor nail hygiene practices, such as not trimming the nails properly or leaving them too long, can contribute to the development of onychophosis.

Types Of Onychophosis

Onychophosis, a common nail disorder, can be categorized into two main types: distal and lateral onychophosis. Distal onychophosis occurs at the tip of the nail, while lateral onychophosis affects the sides. 

Both types can result in pain, inflammation, and potential infection if left untreated. It is essential to seek medical attention for proper diagnosis and treatment.

  • Pincer nail onychophosis is a condition where the sides of the nail curve inward, causing discomfort and potential nail damage.
  • Traumatic onychophosis occurs as a result of repeated trauma to the nail, leading to thickening and distortion of the nail plate.
  • Subungual exostosis onychophosis involves the development of a bony growth underneath the nail, often causing pain and changes in nail shape.
  • Infectious onychophosis is characterized by fungal or bacterial infections of the nail, leading to discoloration, thickening, and crumbling of the nail.

Risk Factors

Risk factors for onychophosis include wearing tight or ill-fitting shoes, participating in activities that repeatedly stress the toenails, having a history of fungal infections, trauma to the toenail, and poor foot hygiene. 

Additionally, underlying health conditions such as diabetes, peripheral vascular disease, and immune system disorders can increase the risk of developing onychophosis.

  • Age is a significant risk factor for onychophosis, with older individuals being more prone to developing the condition due to natural changes in nail structure and blood flow.
  • Trauma or injury to the nail bed increases the risk of onychophosis as it can lead to abnormal nail growth and deformities.
  • Poorly fitting footwear that puts pressure on the toenails can contribute to onychophosis by causing repetitive trauma and damage to the nails.
  • Certain medical conditions like diabetes and peripheral vascular disease can impair blood circulation to the nails, making individuals more susceptible to onychophosis.

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Diagnosis of Onychophosis

To diagnose onychophosis, a healthcare provider will examine the affected nail closely to look for signs of abnormal growth or thickening. They may ask about your medical history and any symptoms you are experiencing. 

In some cases, a sample of the nail may be taken for further testing. Early diagnosis and treatment can help prevent complications and improve nail health.

  • Visual inspection: The most common method used to diagnose onychophosis involves visually examining the affected nails for signs of thickening, discoloration, or deformities.
  • Nail clipping: Collecting a sample of the affected nail for laboratory analysis can help confirm the presence of onychophosis and rule out other nail conditions.
  • Microscopic examination: By examining the nail sample under a microscope, healthcare providers can identify any fungal or bacterial infections that may be contributing to onychophosis.
  • Culture test: Culturing the nail sample in a laboratory setting can help determine the specific type of fungus or bacteria causing the onychophosis, guiding treatment decisions.

Treatment for Onychophosis

Treatment options for onychophosis include proper nail trimming, using cushioned insoles, wearing well-fitting shoes, and keeping the feet clean and dry. Over-the-counter treatments like medicated pads or creams can also help soften the affected area. 

In severe cases, a podiatrist may need to remove the excess skin or provide prescription medications. Regular foot care can help manage onychophosis effectively.

  • Soaking the affected area in warm water and gently filing down the thickened skin can help manage onychophosis, promoting gradual improvement in the condition of the nail bed.
  • Regularly moisturizing the feet and nails with emollient-rich creams or ointments can prevent excessive dryness and cracking, reducing the risk of onychophosis development.
  • Applying keratolytic agents containing salicylic acid or urea can help soften and exfoliate the thickened skin, aiding in the removal of dead cells and promoting healthier nail growth.
  • Wearing properly fitted shoes and avoiding tight footwear can alleviate pressure on the toes, reducing friction and the likelihood of developing onychophosis.
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Frequently Asked Questions

What are the common signs of onychophosis?

Ingrown toenail pain, redness, swelling, and tenderness are common signs of onychophosis. Treatment may involve soaking the foot and wearing proper footwear.

How should I care for myself with onychophosis—what should I do and avoid?

Care for onychophosis by keeping feet dry, wearing well-fitting shoes, trimming nails straight across, avoiding tight shoes, and seeking medical care.

What serious complications could arise from onychophosis?

Onychophosis can lead to infections, ulcers, and potentially sepsis if left untreated. Prompt treatment is essential to prevent complications.

How can onychophosis be treated and controlled?

Onychophosis can be treated by trimming excess skin, wearing properly fitted shoes, and using moisturizers. Regular foot care can help control it.

Can onychophosis return even after successful treatment?

Yes, onychophosis can return even after successful treatment. Proper foot care and regular follow-up appointments with a healthcare provider are recommended.

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