3 April 2011

Why is my new toenail not growing properly

Online podiatry help – Damaged Toenail

"Quite some time ago (last year), someone accidently pushed a chair down on my foot directly on one of my toenails. It went black and then fell off..since then it’s never really healed properly. The picture shows that up until the line there’s normal nail growth whereas after that a really thin nail grows but it never fully grows anymore than shown and its also very easy to peel off as its not proper nail. The picture shows the nail once the bit has been peeled off, is there anyway to treat this so the proper nail grows back"

Ridge along a new toenail
Ridge along toenail

Answer: Damaged Toenail

When you severely damage a toenail it can become "fatally" damaged and a new toenail might start growing. The new toenail that subsequently grows doesn’t just grow from the base in a normal way i.e. it wont be full thickness and smooth for quite a long time. The new toenail will be undulating, flaky and uneven at first and will often grow forward like a ripple in a wave on the beach. It takes time for the toenail to become smooth the whole of its length and often patients and worried their toenail will never look like a normal toenail again, but mostly it does, it just takes time.

A new toenail will take anything from 6 months to 1.5 years or more to fully grow again and look exactly as it did before the damage. Normally the new toenail will grow underneath the old toenail but sometimes if the damage has been so severe and the old toenail is no longer in place, the new toenail will just be there growing on its own. New toenails can sometimes ingrow as they move forward and this can happen if the space that is normally reserved for the toenail is no longer there and the new toenail has to find its own space as it grows.

When the old toenail eventually falls off exposing the new toenail underneath you can often see a horizontal line across the new toenail and past this point you might notice a very soft, wispy, thin piece of new nail right at the top end of the toenail. Normally this thin wispy nail becomes thicker and harder as the toenail grows and eventually you wont see it anymore

Sometimes when a toenail is very severely damaged the nail cells at the base of the toenail are so disturbed that unfortunately the toenail will never grow properly again and typically a vertical line can always be seen in the new toenail or the toenail might be thicker than it once was. Sometimes the nail cells are not able to fully support a complete new toenail and the toenail partly grows and then a new toenail starts growing again, this process repeating itself time and time again for ever. If this is the case you will normally always see a horizontal line across the toenail.

Toenails can be very severely damaged in a number of ways, examples are a heavy object dropping onto the area, badly stubbing your toe, or a horse standing and grinding its hoof on your toe. Even a foot or leg operation such as hip replacement can cause a new toenail to start growing. Why? Because the blood supply to the area is temporarily compromised. Also some drugs or medication, including chemotherapy, can have a devastating effect on toenails. As an aside, some acne drugs can cause ingrown toenails because the skin is more delicate than it normally is whilst the medication is being taken. Toenails that constantly fail, constantly fall off, or constantly start regrowing need investigating because there could be an underlying medical reason for this.

It is very easy for a toenail to become infected with a fungal infection after it has been damaged. A healthy intact toenail is a good barrier to fungal spores but once a toenail has been compromised it can be very easy for fungal spores to gain access to the toenail. Read my posts on fungal nail infections for more information on this – see Help my toenail has gone brown and thick Part 1 and Help my toenail has gone brown and thick Part 2

Photos of a damaged toenail and new toenail slowly growing up

Photos of a damaged toenail and new toenail slowly growing up
Damaged bruised toenail, the toe was badly stubbed a few months earlier. Note the new toenail starting to grow at the base of the nail

Photos of a damaged toenail and new toenail slowly growing up
Above toenail close up – the new toenail at the base of the nail is flaky, ridged and soft
Photos of a damaged toenail and new toenail slowly growing up
Photo taken 3 months after the photo above. The new toenail is now looking very smooth at the base however it is still ridged, flaky and soft where the old toenail is still partly on top of it
Photos of a damaged toenail and new toenail slowly growing up
One month later. The old toenail has now come off exposing the whole of the new toenail. Note the red marks on the toenail are nail varnish. Nail varnish should only be used on new toenails for special occasions. Remove the nail varnish as soon as you can.

Photos of a damaged toenail and new toenail slowly growing up
One month later. This photo is now 8 months since the original stubbing of the toe.

1 comment to Why is my new toenail not growing properly

  • Bryan

    I have a problem with my toenail and if anyone knows what it could be, I’d really like to know. I removed two ingrown nails on both sides of my left toe (the big one) and for the last 4 months the regular nail has been growing very thin. Right now half of the toenail is thin (the bottom half) and it’s growing out with each day, and after about a week or so you can clearly see that the new nail has grown more. The problem is that the new nail is soft and very painful with every step I take. At first I thought maybe the pain was coming from remnants of an ingrown nail, but after digging and discovering nothing for the last two weeks, I know it’s the toenail itself causing the pain. The more it grows out, the more painful it becomes. The best way to describe the pain is a pressure-like pinch with every step. Is there a solution to this? Do you think the best option is to just remove the entire nail? Or will the nail harden back to its normal state?

About Me

My name is Sue Ferguson and I am a chiropodist and podiatrist working in private practice in Tenterden, Kent, in the south east of England.

Sue Ferguson, Chiropodist and Podiatrist
Sue Ferguson
Tel: 01580 765546

I am registered with the Health Professions Council, the regulatory body for health professionals and I have been treating feet for over 20 years.

For further information about my chiropody practice see my practice website where you will find lots of tips and information.

From a professional point of view I find feet, foot conditions and shoes fascinating. I spent the first part of my life waiting for the Internet to be invented and now it's here I want to share my enthusiasm about feet with you all.

Facebook - Sue Ferguson, Chiropodist and Podiatrist Follow me on Facebook
Twitter - Sue Ferguson, Chiropodist and Podiatrist Follow me on Twitter