Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Toenail Problems: More Than Cosmetic
Toenail problems are among the most common reasons patients visit Balance Foot & Ankle in Howell and Bloomfield Township, Michigan. While some nail conditions are primarily cosmetic, others can cause significant pain, limit activity, and in diabetic or immunocompromised patients, become truly serious. Understanding the range of toenail conditions and their appropriate treatment ensures problems are addressed correctly rather than managed ineffectively at home.
Ingrown Toenails (Onychocryptosis)
Ingrown toenails occur when the nail edge grows into the surrounding skin, causing pain, redness, swelling, and potentially infection. Most commonly affects the great toe. Caused by improper nail trimming (rounded edges), narrow footwear, inherited nail curvature, or repetitive trauma. Stage 1 (inflammation without infection) responds to proper nail trimming and soaking; Stage 2-3 (with infection and granulation tissue) requires professional treatment. Partial nail avulsion with matrixectomy permanently narrows the nail to prevent recurrence.
Toenail Fungus (Onychomycosis)
Fungal nail infection causes thickened, discolored (yellow-brown-white), brittle, and distorted nails. Affects up to 14% of the general population, increasing with age, diabetes, and immunosuppression. Diagnosis is clinical but should be confirmed with nail sample culture or PCR before committing to prolonged antifungal treatment. Topical antifungals (ciclopirox, efinaconazole, tavaborole) have modest cure rates (15-25%). Oral terbinafine (12 weeks for toenails) achieves 50-60% mycological cure rates. Laser treatment has variable evidence. Complete nail regrowth after cure takes 12-18 months.
Thickened Toenails (Onychauxis/Onychogryphosis)
Thickened nails from trauma, repeated microtrauma, poor circulation, or aging can become difficult and painful to trim. Onychogryphosis (claw-like, curved thickened nail) is a specific severe form. Professional debridement by a podiatrist restores manageable nail contour. These nails are not inherently fungal — culture distinguishes thickened nails from onychomycosis.
Black Toenails (Subungual Hematoma)
Black discoloration under the nail from bleeding (subungual hematoma) typically follows trauma — too-short shoes, downhill running, or direct impact. Acute, painful hematomas causing significant pressure are drained by nail trephination (creating a small hole in the nail plate) for immediate relief. The black color persists until the nail grows out. Any dark streak under the nail without clear trauma history should be evaluated — subungual melanoma, though rare, must be excluded.
Nail Care for Difficult Nails
Patients with thick, fungal, or otherwise difficult nails — particularly diabetics who cannot safely perform their own nail care — benefit from regular professional nail trimming at Balance Foot & Ankle. Medicare covers routine nail care for qualifying diabetic patients. Call (810) 206-1402 to schedule nail care or evaluation of any concerning nail changes.
Foot or Ankle Pain? We Can Help.
Balance Foot & Ankle — Howell & Bloomfield Township, MI
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When to See a Podiatrist for Toenail Problems
Toenail conditions — from fungal infections and ingrown nails to trauma and discoloration — are among the most common reasons to visit a podiatrist. At Balance Foot & Ankle, Dr. Tom Biernacki diagnoses and treats all toenail conditions with in-office procedures and prescription treatments.
Learn About Our Toenail Treatment Options | Book Your Appointment | Call (810) 206-1402
Clinical References
- Gupta AK, Versteeg SG, Shear NH. Onychomycosis in the 21st century: an update on diagnosis, epidemiology, and treatment. J Cutan Med Surg. 2017;21(6):525-539.
- Zuber TJ. Ingrown toenail removal. Am Fam Physician. 2002;65(12):2547-2552.
- Baran R, Dawber RP, Haneke E, et al. A text atlas of nail disorders. 3rd ed. London: Martin Dunitz; 2003.
Insurance Accepted
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Podiatrist-recommended products
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Ingrown relief
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☎ (810) 206-1402Book Online →More Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
PowerStep Pinnacle Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
The podiatrist-recommended over-the-counter orthotic.
OOFOS Recovery Slide
- The Original Recovery Footwear.
- Finding Your Size - For your perfect fit, consult the “size chart” link above. Wear a half size? In general, we recommend that women who wear a ½ size size UP, and men who wear a ½ size size DOWN
- OOahh - An evolution of the OOriginal, the OOahh slide features our proven foundation of OOfoam technology + patented footbed design with a slide-style strap that has become a best-seller in the OOFOS line
- OOfoam Technology - Our revolutionary OOfoam technology absorbs 37% more impact than traditional footwear foams to reduce the stress on your feet, joints & back. Plus, the closed-cell foam is machine washable and designed to minimize odor
- Patented Footbed - Our patented footbed cradles and supports arches to reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier. Recovery is faster. And yOO feel better
Impact-absorbing recovery sandal — wear after long days on your feet.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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