Can Toenail Fungus Lead to Developing Ingrown Toenails? A Podiatrist Explains

What is Toenail Fungus?

Toenail fungus, also known as onychomycosis, is a common fungal infection of the toenails. It is caused by dermatophytes, fungi that feed on keratin, the protein that makes up the surface of the skin, nails, and hair.

Dermatophytes thrive in warm, moist environments like inside shoes and socks. If conditions are right, the fungi can infect the nail bed and begin feeding on the nail. As the infection progresses, the toenail can become discolored, thickened, brittle, or distorted in shape.

Toenail fungus is contagious and can spread from person to person in damp public places like swimming pools, showers, and locker rooms. It can also be contracted from surfaces where fungi may be present. Symptoms develop slowly and it may take a few months for the infection to become visible.

Common Signs and Symptoms of Toenail Fungus

• Thickened, brittle, or ragged toenails
• Distorted nail shape
• Dull, opaque and yellowish nails
• White, black, or yellow streaks on nails
• Nail detachment from the nail bed
• Foul smelling nail debris
• Green, black, or brown discoloration under the nail

What Causes Ingrown Toenails?

Ingrown toenails occur when the edge of the nail grows into the surrounding skin. As the nail grows, it digs deeper into the skin and soft tissue of the toe, creating redness, swelling, infection, and pain.

There are several potential causes and risk factors for ingrown toenails:

Common Causes of Ingrown Toenails

• Improperly trimmed nails
• Heredity
• Nail or toe trauma
• Abnormal toe structure
• Excessive sweating or moisture
• Tight shoes or socks
• Aggressive toenail fungus

Cutting the nails too short, rounding the edges, or uneven trimming can allow the nail edge to dig into the skin and become ingrown. Some people are simply prone to ingrown toenails due to inherited nail and toe anatomy.

Injury to the nails or toes can also increase risk if swelling pushes the nail edge into the skin. Some people have a toenail shape or structure that encourages ingrowth. Excessive sweating or wearing tight shoes and socks can exacerbate the problem.

Severe cases of toenail fungus may potentially worsen ingrown toenail development. As the infected nail becomes thick and deformed, it can put pressure on the skin and drive the edge into the toe.

Can Toenail Fungus Cause Ingrown Toenails?

While toenail fungus itself does not directly cause ingrown toenails, it can potentially increase the risk in some cases. Heres how:

Fungal Nail Thickening

As the fungal infection progresses, the nail often becomes substantially thickened and spongy. This fungal debris presses on the soft tissue of the toe, essentially pushing the nail edge into the skin.

Irregular Nail Growth

The infection disrupts normal, straight nail growth. The thickened nail grows in an irregular, curved or wavy pattern. These distortions in shape can drive the nail edge into the skin.

Nail Detachment

In advanced cases, the toenail may start detaching from the nail bed as the fungus destroys the nail root. Partially detached nails are more likely to become jagged and sharp at the edge.

Nail Fragility

Fungal infection causes nails to become brittle and prone to cracking or breaking. Jagged nail edges left after breaking increases chances of ingrowth occurring.

Treatment Complications

Aggressive treatment of advanced toenail fungus cases sometimes leads to permanent nail distortion. The most effective toenail fungus treatments kill part or all of the nail root, altering nail regrowth. This can increase ingrown toenail risk.

Other Causes of Toenail Abnormalities

While fungus is the most common cause of toenail discoloration and thickening, there are other possible causes to be aware of:

Psoriasis

Skin condition that can affect fingernails and toenails. Creates redness, pitting, and abnormal nail growth.

Trauma

Injury to the nail or toe can cause bruising and blood beneath the nail, creating discolored streaks.

Nail Bruises

Bleeding beneath the nail from injury shows up as reddish brown or black streaks or spots on the nails.

Melanoma

Rare form of skin cancer that sometimes affects toenails. Causes dark nail discoloration and streaks.

Warts

Viral infection that can develop under and around nails. Appears as thickening and roughness.

Lichen Planus

Chronic inflammatory condition that can affect nails. Causes ridging, splitting, and nail detachment.

Yellow Nail Syndrome

Rare condition leading to thick, slow-growing, yellowish nails with no cuticle.

Is it Toenail Fungus or Something Else?

Since many nail conditions have similar symptoms, it can be hard to tell whats causing nail changes without professional testing. Here are some ways to discern likely fungus:

• Fungus usually begins at the tip or sides of the nail and spreads
• Look for increasing brittleness, dullness, or thickening of the nail
• Presence of debris under nail - dry flakes or wet-looking material
• Odors coming from the nail
• Multiple nails affected, especially big toe and little toe

See a doctor promptly if you notice any nail changes to determine the cause and get proper treatment. Trying to self-diagnose can delay getting appropriate care.

Getting an Accurate Diagnosis

To confirm whether nail changes are caused by fungus, there are several effective diagnostic tests:

Physical Exam

Looking closely at the affected nails, a doctor can often detect key signs of fungal infection.

Potassium Hydroxide (KOH) Test

Scrapings from underneath nails are put in KOH solution to highlight fungus for examination under a microscope.

Fungal Culture

Lab test where nail clippings or scrapings are allowed to grow to identify what fungus may be present.

Biopsy

Removing a small nail sample to examine fungus or other abnormalities under the microscope.

Once the culprit is identified through testing, proper treatment can begin.

Treating Toenail Fungus

Treating toenail fungus can be challenging, but diligent treatment can eradicate even stubborn infections. Treatment options may include:

Medications

Oral antifungal drugs or prescription lacquers or solutions applied directly to the affected nails.

Laser Therapy

Focused laser light applied to the toenail kills the underlying fungus.

Surgery

In severe cases, outpatient surgery can remove part or all of the infected nail.

Successful treatment requires patience as it takes time for damaged nails to grow out and be replaced with new, healthy nails.

Preventing Toenail Fungus

Preventing toenail fungus involves many of the same measures as treating ingrown toenails:

• Wear clean, dry socks and rotate shoes daily
• Trim nails straight across and avoid rounding edges
• Disinfect nail tools before each use
• Wear shower shoes in public areas like gyms and pools
• Avoid picking at nails or skin around nails
• Keep feet clean and dry
• Treat injuries promptly to avoid infection

Seeing a podiatrist periodically to get nails trimmed professionally can also help avoid problems.

Preventing Ingrown Toenails

Preventing ingrown toenails involves proper nail and foot care:

• Trim nails straight across, not rounded at edges
• Trim only the tips, not too short into corners
• Wear properly fitted shoes to avoid excess pressure on toes
• Treat fungal infections early to avoid thickened nails
• Soak feet in epsom salts regularly to reduce inflammation
• Apply petroleum jelly daily to nail edges to help keep skin soft
• See a podiatrist if you have recurrent ingrown nails

Catching and treating ingrown toenails early before extensive infection and swelling develops can help avoid more extensive treatment.

When to See a Podiatrist

Its important to consult a foot doctor promptly at the first signs of toenail fungus or ingrown toenails. Key times to schedule an appointment include:

• Toenail changes dont resolve on their own within a few weeks
• You experience pain, swelling, or infection
• Nail debris or odor persists despite cleaning
• You have diabetes or poor circulation
• Nails become thick, brittle, distorted, or detached
• You develop recurrent ingrown toenails

A podiatrist can properly diagnose the underlying problem and provide specialized treatments tailored to your individual situation.

Professional Treatments for Ingrown and Fungal Toenails

In more advanced cases, a podiatrist may provide treatments like:

Prescription Medications

Oral or topical drugs to clear fungal infections and reduce inflammation and discomfort.

Nail Correction

Cutting or reshaping nails to remove ingrown edges and contour into a normal shape.

Partial Nail Removal

Surgical removal of part of the affected nail and nail root to allow for normal regrowth.

Chemical Cauterization

Applying agents like phenol to the nail bed matrix to stop part of the nail from growing.

Permanent Nail Removal

In severe cases, permanent surgical removal of the entire affected nail.

Getting professional treatment can help resolve fungal and ingrown toenail issues before they become serious infections requiring hospitalization.

When to Consider Nail Removal

Permanent nail removal surgery may be recommended if:

• Fungal infection fails to resolve with medications and continues worsening
• Severe ingrown toenails recur despite correction procedures
• Permanent deformation prevents trimming nails properly
• Infection spreads deeper into nail bed and toe tissue
• Diabetes or poor circulation impedes healing
• Gangrene or ulceration occurs from infection
• Osteomyelitis infects the underlying bone

Total nail removal under local anesthesia is sometimes the only way to eliminate chronic problems and pain. After surgery, the nail does not regrow.

Coping After Nail Removal Surgery

Adjusting to life after nail removal takes some adaptation:

• Keep dressings dry until fully healed
• Expect mild postoperative pain manageable with medication
• Wear open-toed shoes during recovery
• Some activity restriction will be needed initially
• Use antibiotic ointment and bandages until the nail bed heals
• Avoid soaking until healing completes

With proper self-care, the nail bed toughens up and usually becomes much less sensitive within a few weeks.

When to Seek Emergency Care

Seek prompt emergency medical care if you experience:

• Red streaks extending from the nail up the foot or leg
• Pus or foul-smelling discharge from the toenail
• Fevers, chills, nausea, or vomiting
• Difficulty walking or bearing weight due to toenail pain
• Swelling, redness, or warmth extending beyond the toe

These signs may indicate a serious spreading infection that could become life-threatening without swift treatment.

Bottom Line

Toenail fungus itself does not directly cause ingrown nails. However, fungal infections can lead to thickened, distorted nails more likely to have jagged edges digging into the skin.

Both conditions share similar causes like improper trimming, nail trauma, hereditary factors, and irritating footwear. Addressing these issues can help avoid complications.

Seeking timely professional treatment is key to resolving infections before they can worsen. With proper care, clear and healthy looking nails can be restored.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.