During the summer, we spend a lot of time in the open outdoors, wearing sandals and other open-toed footwear. However, in the situation that you have a dead toenail, it is only normal to be embarrassed and avoid social situations. After all, no one wants to look at a toenail with a strange color, cracked, or even detached from the nail bed.
In this article, we will discuss the main causes of dead toenails, onychomycosis, and trauma. We will also teach you about risk factors and how to remove a dead toenail so that a healthy one can grow back.
Contents
First Stage: Dead Toenail
As the warm season approaches and we wear open-toed shoes more often, a dead toenail can become a significant concern, causing discomfort and embarrassment. The initial stage of a toenail dying, often referred to as the first stage of a dead toenail, is typically characterized by noticeable changes in color and texture. This can include a toenail turning white, yellow, or greenish-black as the condition worsens.
Main Causes of Dead Toenails
The most common causes of dead toenails are fungal infections (onychomycosis) and physical trauma. Fungal infections begin with symptoms like athlete’s foot and can spread to the nail, thriving in moist environments and eventually leading to the nail’s deterioration. On the other hand, trauma caused by incidents such as dropping a heavy object on the foot or repetitive injuries from activities like running can also lead to a dead toenail.
Risk Factors and Removal
Several risk factors can increase the likelihood of developing a dead toenail. These include frequent exposure to moist environments, such as public swimming pools or locker rooms and breeding grounds for fungi. Poor foot hygiene and pre-existing conditions like diabetes or a weakened immune system also contribute to the risk.
In cases where a toenail has died and stopped growing, removal might be necessary to prevent infection and allow a new, healthy nail to grow. This process involves carefully lifting and removing the dead part of the nail, ensuring that any underlying infections are treated to prevent further complications.
Prevention and Care
Preventing dead toenails involves maintaining good foot hygiene, keeping the feet dry and clean, and properly fitting shoes. If you frequent public pools or gyms, wearing protective footwear can help reduce the risk of fungal infections. Additionally, managing moisture through the use of antifungal powders or sprays can be effective in keeping the feet fungus-free.
Understanding the early signs of toenail problems and addressing them promptly can prevent the condition from worsening. If you notice any discoloration, thickening, or detachment of the toenail, consulting a podiatrist can provide the appropriate diagnosis and treatment options, ensuring your feet stay healthy and ready for summer footwear.
Onychomycosis, a main cause of dead toenails
When a toenail is affected by a fungal infection, it changes its structure and color. Often, the initial infection is represented by a condition known as athlete’s foot, with the fungal infection spreading to the toenails. It is important to understand that fungi require a wet and moist environment to survive and develop. When such conditions are ensured, the fungus will develop and affect the health of the nail. Left untreated, it will cause the respective toenails to die.
Fungal infections can be of various types, depending on the fungus present on the surface of the skin. In the initial stage, the toenail suffers from discoloration; its structure modifies with the passing of time. Infected toenails will also thicken, making them more difficult to trim. At the same time, they might become brittle or crumbly, with no injuries involved in the process.
Because of the fungal infection, toenails can present a distorted shape, curling or lifting from the nail bed. Some patients lose their natural luster, becoming dull in appearance. The more the infection invades the toenails, the more their color will change. This is why dead toenails have a greenish-black discoloration, suggesting a severe fungal infection.
What are the risk factors associated with fungal infections?
The environment is the most important risk factor to consider. Fungal microorganisms like dermatophytes thrive in warm and moist environments, such as public swimming pools, showers, or locker rooms. They can also be found in lake water, so you must know when swimming in such locations. Fungus easily infects personal hygiene items and footwear and is easily transmitted from one person to the other.
If you have a minor injury or cut on the skin, the susceptibility to fungal infection is increased. Combined with a warm and moist environment, such as one caused by excessive sweating, all the conditions for a fungal infection are guaranteed. For this reason, you have to follow excellent foot hygiene and do your best to keep your feet dry and cool.
If you have impaired blood circulation at the foot level, you will also present a higher risk of developing fungal infections. Such changes are encountered in people diagnosed with diabetes, making them prone to severe fungal infections. Aging is considered a risk factor; as a person ages, the nails become thicker, and the gap between the nail and the toenail bed increases, providing the fungus an excellent place to develop. A weakened immune system can leave the body praying to fungal infections, acute trauma, excess sweating, or other infections.
The treatment of the fungal infection depends on the actual fungus responsible for the problem. The sooner the treatment is started, the lower the risk of the respective toenail dying is going to be. In the situation where the toenail has already died and has stopped growing, the only solution is to remove it. Once the toenail has been removed, you must treat the underlying infection using the topical treatment recommended by the doctor (medicated antifungal cream).
Injuries can lead to dead toenails
In a lot of situations, the dead toenails are caused by acute or repetitive injuries at the level of the foot. For example, if a heavy object is dropped on your toes, the toenails will also likely suffer. In acute trauma, a blood-filled blister will form under the nail, causing it to become detached from the nail bed. As you can see below, this must be dealt with before removing the toenail.
Not only acute injuries can damage toenails, causing them to die, but also repetitive trauma. For example, the forefoot repeatedly strikes the shoe in runners or other professional athletes, causing the toenails to suffer. When other risk factors are added, such as excessive moisture and warmth, the toenail may suffer from both trauma and fungal infection (higher risk of death). Unfortunately, in case of injuries, no treatments can be taken; you will have to wait for the condition to solve independently.
Dead toenail removal
If a blister has formed under the toenail due to injury, this must be dealt with first. The blood-filled blister will create a sensation of pressure, causing the injured toenail to become painful. Because of the blister, the toenail will detach itself from the nailbed. Before draining the blister, clean the toe, patting it gently. Drain the blister using a sterilized needle and apply a gauze bandage, allowing the skin to heal. Keep in mind that fungal infections do not cause blood-filled blisters to form.
Once the skin has healed, it is time to remove the dead toenail. According to a guide on dead toenail removal[1], first and foremost, you have to wash your toes using warm water (preferably with soap). Dry them well and try to trim the upper portion of the dead toenail as much as you possibly can. It is time to remove a part of the toenail, stopping when you can no longer bear the pain. The revealed skin will be raw and tender, so you must cover it up using a gauze bandage. Make sure to apply antibiotic ointment to encourage healing and keep the risk of infection down to a minimum.
Allow the skin to heal before removing the rest of the nail (wait a couple of days). If you are patient, removing the final part of the nail will be less painful. Once you have removed the nail, clean the raw skin and apply antibiotic ointment, covering the affected toe with a bandage. You can use sterilized clippers to remove the dead toenail. Be prepared for some pain and bleeding, having sterile bandages close by. You can also take some non-steroidal anti-inflammatory medication or analgesics to relieve pain.
What happens once you have removed a dead toenail?
As mentioned above, the skin in that area would be raw and tender, requiring particular care until it heals. For this reason, you have to maintain excellent hygiene. Wash the area with warm and soapy water, then pat it gently dry and apply antibiotic ointment. Cover the raw skin with a loose bandage and avoid injuring the respective toe until the skin heals and the new, healthy nail begins to grow.
Allowing the skin to breathe will speed up the healing process. Avoid walking or engaging in strenuous physical activities, as this will bring a lot of blood to the area and prolong the healing process. Also, it is recommended to change the bandage each time you clean the raw skin. The bandage should be changed in case it gets wet or dirty to keep the risk of infection to a minimum.
If possible, avoid standing or spending too much time walking. You need to rest to bring down the pain and inflammation. The best position for healing is with the legs elevated. You can also apply an ice pack wrapped in a towel to improve the symptoms experienced.
As the new nail grows, it is recommended to avoid wearing shoes that are either too narrow or tight (this can cause additional trauma to the nail). You might also want to wear closed-toe shoes for a period to guarantee the nail bed the protection it needs to recover (especially if you are engaged in various physical activities or spend time in the open outdoors).
Always remember that infection is a possible complication of removing a dead toenail; if you experience severe inflammation or the skin in that area is warm and pulsating, you must go to the doctor. The same goes if you see purulent discharge from the wound or are running a fever (a sign of serious infection).
Conclusion
If a dead toenail bothers you, do not waste more time; visit the doctor. The specialist can help you remove the dead toenail and provide suitable treatment for the raw, exposed skin. If you have decided to remove the nail yourself, follow the advice recommended in this article and always keep the area clean and free of germs.
References
[1] How to remove a dead toenail (WikiHow). Retrieved from: http://www.wikihow.com/Remove-a-Dead-Toenail