6 Common Toenail Conditions

Unwanted toenail conditions can happen to the best of us and they can range from embarrassing and unsightly to painful and frustrating. The good news is there are various treatments available for toenail conditions that can restore nails back to good health. Here are 6 common toenail conditions, their symptoms, and how they can be treated.

Green Nail Syndrome

Green Nail Syndrome also known as chloronychia is an infection of the nail bed that results in a greenish to blue-ish appearance.  When the toenail has experienced a trauma that causes the nail to lift off the nail bed, it creates a welcoming environment for the bacteria known as Pseudomonas aeruginosa to make its home.  Along with discoloration, one may experience red or tender cuticles.

This is a common condition among those that have their hands or feet exposed to water often, such as healthcare providers, dishwashers, military recruits or scuba instructors.

Because this condition happens under the nail, it can not be washed or filed off.  It needs to be treated with other methods.  Treatment options include: cutting off part of the affected nail, keeping nails dry, topical or oral antibiotics, homeopathic methods of a diluted vinegar or bleach & water solution (1:4) and removal of the entire nail.


Paronychia is a bacterial infection in the skin around the fingernails or toenails that affects the skin at the base (cuticle) or up the sides of the nail. It often results in skin that is red, tender, swollen and oozing puss.

Paronychia often occurs from someone biting or pulling at the skin around their nails (such as hangnails) or having an ingrown toenail, but it could even be caused by a fungal infection.  When the skin becomes exposed, paronychia can find its way in and create an unpleasant experience.

Treatment for this condition starts with warm salt water foot soaks for 5-10 minutes 3-4 times per day.  This is to help reduce the swelling.  If this does not assist in providing you with relief your doctor may prescribe you an antibiotic or an antifungal medication.  If there is a puss pocket present, your doctor will assist in relieving the build up by draining the puss sack.

Nail Psoriasis

Nail Psoriasis is a common condition that can occur in those that have Psoriasis.  Symptoms of this condition include: tiny dents in your nails, white, yellow, or brown discoloration, crumbling nails, nails that separate from your toe, buildup beneath your nail and even blood under your nail.  Currently there isn’t a way to “prevent” nail psoriasis if you have psoriasis.  It can be controlled however, with treatment.  Treatments include, medications to treat both skin and nails, corticosteroids, laser treatment and clinical UVA exposure.

Black Toe Nails

Depending upon the cause, black toenails can be quite common.  Often black toenails are caused by a build up of blood under the nail from some sort of trauma.  They are very common among runners due to the constant pressure against the toe.  Sometimes the build up of blood can be quite painful, and if that is the case, seeing your doctor would be beneficial.  They would be able to help relieve the pressure by draining the blood build up.  In rare cases, a black toenail could be a sign of melanoma.  Early evaluation of melanoma can lead to better outcomes, so do not hold off on being evaluated.

Onychomycosis (Fungal Infection)

Onychomycosis is a common condition that occurs when a fungus infects the tissue underneath the toenail. The result is discoloration of the nail. Nail fungus may cause your nail to thicken and become brittle and even cause your feet to smell! It commonly involves several nails simultaneously. It often occurs in people with persistent moisture in their feet, such as with footwear that does not allow air circulation or in those who perspire excessively in their feet.

There are several methods for treatment depending upon how stubborn the fungus may be.  Often patients will start with an over the counter medication.  If that fails, then they will visit a podiatrist who will offer topical or oral medications or suggest laser therapy.

Ingrown Toenails

An ingrown toenail occurs when the nail itself starts to grow down and inward towards the toe, sometimes penetrating the skin.  It can be quite painful and uncomfortable.  An ingrown toenail often occurs due to poorly fitting shoes, when the nail is cut at an angle or if the nail experienced trauma.

Treatment includes soaking the foot in a warm salt water bath a few times a day or removing a portion of nail that is penetrating the skin.


If you suspect that you may have a common toenail condition that needs treatment, please call our office to see one of our Podiatrists at (707) 578-1222.