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Onychogryphosis or Ram’s Horn Nails: Causes, Signs, Symptoms, Treatment, Prevention

Onychogryphosis or Ram’s Horn Nails is a medical condition in which there is overgrowth or hypertrophy of the nails resulting in long, curved nails which resemble a claw or a ram’s horn. The nails become thickened and deformed with discoloration of the nails with them appearing yellowish in color. The main cause is damage to the cells as a result of wearing ill-fitting or tight shoes, trauma or injury to the nail, infection of the nail, decreased blood supply to the nail; all these can cause Onychogryphosis or Ram’s Horn Nails. Onychogryphosis can also occur from lack of hygiene and neglect of the nails, such as not trimming the nails regularly. The toenails are more commonly affected than the fingernails. Elderly people more commonly have this condition as the blood supply to the nails diminishes with age.

Very rarely, severe congenital Onychogryphosis or Ram’s Horn Nails in all the twenty nail beds can occur. Congenital onychogryphosis of the fifth toe is quite common and is asymptomatic, so the patient rarely seeks treatment for it and is in fact not even aware of the problem.

Onychogryphosis or Ram's Horn Nails

Causes of Onychogryphosis or Ram’s Horn Nails

Sometimes, there is no clear cut cause for onychogryphosis; otherwise Onychogryphosis or Ram’s Horn Nails can occur from various causes including:

  • Damage to the cells from injury, such as dropping a heavy object on the nails or trauma from other activities and sports injuries.
  • Wearing tight shoes.
  • Infection of the nails, such as fungal infection.
  • Decreased blood circulation to the nails.
  • Medical conditions, such as diabetes, increase the risk of onychogryphosis.
  • Poor diet lacking in adequate nutrients can also result in this condition.
  • Neglect or not caring properly for the nails, such as not trimming nails regularly.
  • Peripheral vascular disease.

Signs & Symptoms of Onychogryphosis or Ram's Horn Nails

Signs & Symptoms of Onychogryphosis or Ram’s Horn Nails

  • The nail gradually becomes thick, long and deformed as they increase in length.
  • There can be yellowish discoloration to the nail.
  • The nail plate also becomes thick and tender.
  • Pain or discomfort in the affected nails upon pressure.
  • Nails which are long and curved can affect the adjacent toes resulting in more pain and infection.
  • If Onychogryphosis or Ram’s Horn Nails occurs due to fungal infection of the nails, then the nail becomes brittle, crumbly with yellowish discoloration.

Treatment of Onychogryphosis or Ram’s Horn Nails

Treatment Depends On The Severity And Symptoms Of The Condition And Comprises Of:

  • Nail plate avulsion along with surgical destruction of the nail matrix using carbon dioxide laser or phenol providing the patient has good blood circulation of the nails.
  • If it is very painful then the nail is usually removed by applying a saturated solution of phenol.

Prevention of Onychogryphosis or Ram’s Horn Nails

  • Always wear proper fitting shoes and comfortable socks.
  • Trim your nails regularly.
  • Avoid the application of nail polish.
  • Application of a moisturizing cream to the nails after a bath or washing your hands and feet helps in preventing this condition.
  • Soak your feet in warm salt water.


  1. DermNet NZ. (2020). Onychogryphosis https://dermnetnz.org/topics/onychogryphosis/
  2. Indian Journal of Dermatology. (2015). Onychogryphosis: An Update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372768/

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 19, 2023

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