A Swollen Toe Nail Bed Causing A Deformed Nail

A Swollen Toe Nail Bed Causing A Deformed Nail

A case of a Swollen Toe Nail Bed: A patient recently sent an email asking about one toenail that is thick and painful for the last 25 years after a surgery to that big toe joint. The other big toenail on the other side(the normal foot) is normal.

What can be done about this?

Basically- Just one toenail is messed up on my foot. Why?


Swollen Toe Nail Bed
Swollen Toe Nail Bed


Here is what’s probably happening to your nail:

You have chronically thick and swollen toenail bed (or if multiple nails swollen nail beds) that is forming a callus underneath it

It’s tough to tell without knowing your biomechanics or history- but the skin under the nail has become really thick and inflamed and is likely experiencing chronic trauma. This prevents the nail from growing in normally (think of it like a big callus under and around your nail) Either your nail was damaged somehow- or you have a rigid toe or something is compressing and causing pain in the nail which is constantly there (even if not overly painful) – It probably has to do with why you had the surgery.
This leads to the skin under the nail swelling and the nail loosening away from the skin, the skin becomes like a callus and this allows fungus to get under there. This makes the skin under the nail stay thick and the nail doesn’t have a chance to grow back properly.

Studies are now showing if you can correct the cause- the nail should usually grow back normally! So that is good news!


3 things have to be done for your Swollen Toe Nail Bed

1)Correct the pain and chronic irritation- I can’t tell from the picture but it could be anything- arthritis in the toe(jamming it against the shoe), a shorter leg(needing a harder push off), bad shoes(compressing the toe), previous injury that never healed(leading to a short or long toe or joint arthritis)-  anything that is causing your toe to constantly be irritated! This needs to be corrected and prevent your toenail from being further callused under the nail.

2) The nail may have to be removed and allowed to regrow if it is separated at all from the skin underneath it (if it was firmly attached and the color was normal that means its properly attached to non-thick skin underneath it)

3)If there is fungus under the nail that needs to also be treated.

Sorry for the lack of details, but hopefully this gets you on the right track!


More Resources for Swollen Toenail Bed:

Hard Painful Toenail


Other Related Nail Problems:

See if any of these other problems apply to your situation!

  1. Toenail Fungus

  2. Very Long Toenails

  3. Ingrown Toenail

  4. Toenail Falling Off

  5. Black Streaks Under The Nails

  6. White Patches On Toenails

  7. Black Spot Under The Toenail

  8. Red Spot Under The Toenail

  9. Toenail Coming Off The Nail Bed

  10. Toenail Psoriasis 

About the author

The Modern Podiatrist (Foot and Ankle Specialist Doctor):Today's podiatrist is required to undergo rigorous medical training that licenses them as physicians with equivalent legal standing to the MD and DO degree (These are physician recognized licenses most common only in the USA). Although admittedly the training does differ between the three degrees. The differences are listed below.In Michigan Podiatrists are trained and authorized to perform surgery in the foot and ankle up to the tibial tubercle below the knee.All our podiatrists and foot doctors have undergone rigorous training including a 4 undergraduate college degree, writing the medical school entrance exam (MCAT), followed by a 4 year medical school degree (DPM - Doctor of Podiatric Medicine),Once podiatrists in the USA complete the rigorous 4 year medical school courses, they are required to complete a minimum of 3 years of a surgical and non-surgical residency program. Some podiatrists and foot doctors then choose to go on to further fellowship training specializing in various forms of specialty such as diabetic surgery or reconstructive foot and ankle surgery.The training is not over yet! Each podiatrist must be judged by a governing body where they submit their surgical cases and are reviewed regularly to ensure excellent results. This is a career long evaluation with board qualifications and certifications every few years.So have faith that today's podiatrist is your best choice for your foot and ankle problems! We are able to approach you foot and ankle problems from a non-surgery perspective, but that when necessary we can provide you with the treatment that you need!All articles written by this account are considered to be for educational purposes only. It is impossible for us to truly assess your condition and the advice we give here is meant to give you a basis to then follow up with your podiatrist and foot doctor later.If you have any questions at all, or there is anything that we can help you with, please feel free to contact our office or email us. Podiatrists provide medically necessary treatment which should be covered by valid insurance plans, we are not a cosmetic or elective medical specialty.