Changes in your toenails are fairly common. You might notice discoloration, thickening, or even that the toenail is starting to detach from the nail bed. Often, these changes are caused by either trauma or fungal infection.
Fungal infections, also known as onychomycosis, can affect up to 14% of people. Trauma can also cause changes in the toenail, whether from stubbing your toe or wearing shoes that don’t fit properly.
When a toenail dies, it can be painful and unsightly. Here’s what you need to know about the causes of a dead toenail and what your treatment options are.
Toenail Fungus: A Common Culprit
Toenail fungus is often the reason a toenail dies. Here’s what you should know.
Identifying Toenail Fungus (Onychomycosis)
Onychomycosis is a fungal infection of the nail. It happens more often in toenails than fingernails. Fungi, yeasts, and molds live on our skin all the time, and they tend to flourish in warm, damp spaces. Since our feet are often sweaty and enclosed in socks and shoes, they’re a great environment for these organisms to thrive.
Why Toenail Fungus Is Difficult to Treat
Treating toenail fungus can be tricky. Nail tissue is hard and thick, so it’s tough for medications to penetrate and do their job. What’s more, just because the symptoms of the fungus disappear doesn’t mean the fungus is gone for good. This is why the clinical cure rate (meaning no symptoms are present) can be lower than you might expect. It’s possible for the fungus to hang around even when you don’t see it.
Options and expectations for treating toenail fungus
If you’re dealing with a dead toenail caused by fungus, you have several treatment options to consider.
Home remedies and OTC treatments
Some people try home remedies for toenail fungus, such as soaking their toes in a mixture of vinegar and water, or applying antifungal substances like crushed garlic paste or tea tree oil.
Over-the-counter (OTC) products are another option. According to the American Academy of Dermatology, 60% of people see some improvement after using OTC treatments for a few months.
Prescription treatments
If home remedies and OTC treatments aren’t effective, your doctor may prescribe a topical or oral medication.
Topical prescription treatments include amorolfine, efinaconazole, tavaborole, and ciclopirox. Clinical cure rates for these products range from 35% to 60%.
Oral prescription drugs include fluconazole, griseofulvin, itraconazole, and terbinafine. These medications have a higher clinical cure rate, around 80%.
Laser therapy
Laser therapy is another treatment option for toenail fungus. Clinical cure rates for laser therapy vary, ranging from 60% to 75%.
Trauma and other causes of “dead” toenails
Many things can cause a toenail to die.
Trauma-induced toenail damage
Often, dead toenails are caused by some kind of trauma, which can sometimes lead to complications like a green toenail after injury. Ill-fitting shoes can rub and cause irritation, for example. Sports injuries or accidents like dropping something heavy on your foot can also damage the toenail.
When you traumatize a toenail, it may turn black or gray.
When to seek professional help
If you think your toenail is dead and you are unsure about the cause or treatment, or if you think it might be infected, you should see a podiatrist.
Signs of infection include inflammation, redness, and discharge.
Prevention and Aftercare
Once your dead toenail has healed, it’s important to take steps to prevent the issue from recurring. Here are a few tips:
- If you had a fungal infection, use separate clippers for healthy and infected nails. It’s also a good idea to wear new shoes.
- Diluted vinegar soaks can help prevent reinfection.
- Wear shoes that fit well and are appropriate for your activities (especially during sports).
Frequently Asked Questions
What does a dying toenail look like?
A dying toenail often exhibits discoloration, ranging from yellow or brown to black. It might appear thickened, brittle, or detached from the nail bed. You may also notice swelling, redness, or pain around the nail if there’s an underlying infection.
Should I let my dead toenail fall off naturally?
It’s generally recommended to let a dead toenail fall off naturally to minimize the risk of infection and trauma to the nail bed, potentially avoiding the need for toenail removal. Keep the area clean and covered with a bandage. If the toenail is partially attached and causing discomfort, consult a podiatrist.
What do diabetic toenails look like?
Diabetic toenails can exhibit various changes, including thickening, discoloration (yellow or brown), fungal infections, and ingrown nails. Due to reduced blood flow and nerve damage, individuals with diabetes are more prone to foot problems and should monitor their toenails closely.
Does hydrogen peroxide get rid of toenail fungus?
Hydrogen peroxide has some antifungal properties and may help to lighten the appearance of a fungal toenail infection. However, it’s generally not effective at completely eradicating the fungus. Consult a doctor for prescription treatments or other proven methods.
How do you fix a dead toenail?
“Fixing” a dead toenail often involves letting it detach naturally, keeping the area clean and protected, and addressing any underlying issues like fungal infections. A new nail will eventually grow in its place. Consult a podiatrist for guidance and to rule out any complications.
In Closing
Toenail problems can be caused by fungal infections or trauma. There are treatments available for both, but prevention is key. If you’re not sure what’s causing your toenail problems, if you’re not sure how to treat them, or if you think you might have an infection, be sure to see a podiatrist for expert help.