What is a Toenail?
Just as animals have claws, humans beings have nails which are nothing, but a thick coat of protein (keratin) protecting and covering our fingers and toes. The nail consists of dead skin cells and this is why we don’t have nerve endings present in our nails.
Our toenail consists of three primary main structures:
Nail Plate: This is the hard shell, which is visible to the eye and which we refer to as “toe nail.”
Nail Matrix: This is the soft tissue present under the nail plate, which is protected by the nail plate.
Nail Bed: This is the living skin, which is present directly under the nail plate. Nail matrix and nail bed are responsible for the growth of the nail plate or toe nail.
Just like our normal skin, the nail matrix and nail bed constantly shed dead cells and new cells get pushed up to the outer layer. Hardening of these dead skin cells result in formation of nail plate and the new cells slowly develop and push their way up and push the nail plate forward slowly.
Toe Nail Problems
Why Does the Toenail Stop Growing?
Rarely does the toenail not actually grow. Many people who observe that their toenail is not growing, most of the times, what happens is that the toenail is growing, but very slowly. Our fingernails grow thrice as fast as toenails, which can give the impression that the toenails are not growing. It takes about six months for a fingernail to grow all the way back and about 18 months for the big toenail to grow completely back. This time increases as one gets older, because the skin loses its elasticity as we age and also the rate of turnover of the new skin cells also decreases.
There are many causes for the toenail not growing, such as trauma, infection, inflammation etc. Many people lose nails including toenail due to some accident, injury, trauma etc. Constant trauma to the toes endured during jogging, running, hiking etc. can also lead to loss of toenails or wear and tear of the toenails. Fungus or some other infection also can lead to separation of nail plate from the nail bed, after which there is re-growth of a new one. Sometimes, there will be no re-growth of the toenail. The reason could be sometimes simple or it can be something serious also. If the loss of toenail is infection or trauma, then it is better to wait for a couple of months to see if there is any re-growth.
If the big toe nail is not growing even after some months have passed, then it could be because the nail matrix has been damaged, as it is responsible for turning the dead skin cells into the hard keratin covering, which is our nail. The damage to the nail matrix can be from injury to the matrix, disease or side effects of certain drugs. If the process of filling the cells into the nail plate is disturbed, then it will also stop the toenail from growing.
If you haven’t lost your toenail, but it has stopped growing, the reason for this could be consistent and gradual wear and tear of the toe nail which can be a result of frequently walking barefoot. Sometimes if the toenail gets worn out, then also it appears that there is no growth at the tip of the toenail. Certain activities like persistently walking barefoot, wears away the nail tips, so it appears that they are not growing as they never need to be cut.
Fungal infection can also stop the growth of the toenail, as the end of the nail plate can become weak and crumbly and keep on breaking instead of growing further. Infected toe nails appear brownish or yellowish in color and look thick, crooked and appear unhealthy.
Treatment for Toenail not Growing
If the toenail hasn’t been growing for many months, then it means there has been some damage to the nail matrix and its best to consult a podiatrist.
Tests such as capillaroscopy can be done to see if there is any constriction of the capillaries, which has lead to interruption of the process of the nail plate-formation. If the cause of the nail matrix damage is bacterial or fungal infection, then anti-fungal or antibiotic medication will be prescribed.
- Cleveland Clinic. (2020). Nail Problems and Injuries https://my.clevelandclinic.org/health/diseases/11901-nail-problems-and-injuries
- American Academy of Dermatology Association. (n.d.). Nail fungus: Overview https://www.aad.org/public/diseases/a-z/nail-fungus-overview
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