Why Do My Toenails Grow Sideways

1. Foot trauma

Repeatedly hurting your feet — or minor foot trauma — can damage the toes and nail plates, eventually leading to onychogryphosis. For example, wearing shoes that are too small for you every day can cause foot trauma. Onychogryphosis can also develop if you have a condition like hammer toe. Treatment can be as simple as wearing shoes that are the correct size. You can also use splints and pads to train the toes and nails to grow normally.

2. Fungal infection

Onychomycosis is a fungal infection that causes the nails to become thick, crinkly, and brittle. This infection mostly affects toenails but can also impact fingernails.

Research shows up to 50 percent of Onychomycosis cases complicate or may lead to ram’s horn nails. Doctors diagnose Onychomycosis by examining skin tissue that is swabbed or scraped from under an affected nail. Oral and topical antibiotics can be used to treat fungal infections.

3. Psoriasis

Psoriasis is a fairly common autoimmune disease that causes the body to produce extra skin cells. These extra cells build up and form red, dry, scaly patches of skin. These skin growths can also affect the nails.

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Roughly half of people with psoriasis experience nail changes. Roughly one third of people with nail psoriasis have onychomycosis.

Steroid injections in the nail beds may be able to treat these growths. Taking antifungal medication may also help. If these treatments don’t work, you may need surgery.

4. Peripheral vascular disease

Peripheral vascular disease, also called peripheral artery disease (PAD), causes the arteries in your legs to build up with plaque. This reduces blood flow to your legs and feet. Without proper blood flow, you may notice sores on your legs or feet, and slow or unusual nail growth. If left untreated, PAD can lead to onychogryphosis. Smoking is a main risk factor for developing PAD. Treatment options include lifestyle changes, medication, and surgery to clear the artery of plaque.

5. Ichthyosis

Ichthyosis is a rare skin condition that prohibits the body from shedding dead skin cells. A common symptom of this genetic condition is thickened or deformed nails, which can turn into onychogryphosis in some cases. Ichthyosis is normally diagnosed at birth when a baby is born with collodion membrane on their skin. Topical creams and oral retinoids are the most common treatment methods. If onychogryphosis develops, surgery may be necessary.

6. Tuberous sclerosis complex

Tuberous sclerosis complex (TSC) is a rare genetic disease that causes benign tumors to grow throughout the body. TSC is typically diagnosed because of the skin problems associated with it, including nail deformities. While the nail deformities go away in some cases, they may get worse over time, turning into ram’s horn nails. Other symptoms of TSC include cognitive impairment, autism, and seizures. Treatment for ram’s horn nails associated with TSC is surgery.

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