Onychogryphosis is a nail condition with a very distinctive effect. It causes nails to resemble claws, due to unusual thickness and curving. It can affect both toenails and fingernails and there are many possible causes. These include diabetes, nail injury, poor nutrition, permanent shoe pressure, infections or bad blood circulation.

The condition makes nail grow so much that they look like claws or even the horns of a ram. This is why an alternative name for this issue is ram's horn nails. The overgrowth of nails causes them to have a deformed shape, with a very thick plate. They also lose their natural color and become yellow. There can be multiple possible causes of onychogryphosis, one of the most common are the use of shoes that don't fit properly and are too tight. Other issues that cause it are various injuries and infections, as well as a low supply of blood to the nail area. Poor hygiene, such as dirty or untrimmed nails, can also affect them and lead to this condition. Toenails have a higher risk to develop it, due to tight shoes, while elders are more commonly affected by it since blood circulation reduces with age and less nutrients reach the nails.

Congenital onychogryphosis is a rare but very severe variant of this condition, which affects all of the 20 nails. By contrast, congenital onychogryphosis tend to be common on the fifth toe and is considered harmless. Most people are even unaware of it and it is usually ignored.

The most common cause of this condition is wearing improper shoes, which are too tight and put pressure on one or more toenails. The nails have a natural reaction to damage and they grow thicker to resist pressure, curving up or down in the process. A number of conditions lead to onychogryphosis as a side effect, for example an abnormal vein network, congestive heart failure or diabetes. These diseases reduce the blood supply to the body's extremities and cause the condition on all of the nails. Various physical activities, such as hard manual labor, can also damage them.

Onychogryphosis is uncomfortable when the nails become so thick and curved that they can't be trimmed easily. Since the nails might also be infected by fungi, it's not a good idea to ask for a professional manicurist or pedicurist to cut them for you. On the hands, onychogryphosis also causes a hygiene problem. Even if you wash your hands a lot, various material will still accumulate under the nails no matter what you do to remove it, leading to sanitary concerns.

If you suffer from onychogryphosis, the best thing to do is to contact either a general practitioner or a specialist podiatrist. They can perform a few tests for a definitive diagnostic, such as an assessment of the nail's response to damage and full blood counts. Another useful test is the one that measures the supply of blood to the body's extremities. The patient's daily activities and choice of shoes will also be checked as part of the investigation.

If any fungal infection is identified, it will be treated immediately. The doctor will then address the main symptom of onychogryphosis. Simply trimming the nails and monitoring them further is a common option if the condition is not very severe and there is no constant damage that could make it worse. This is because the nails sometimes recover by themselves, if the source of pressure has been eliminated. Wearing special shoes, that don't stress the nails at all, is also a possible solution for this problem.

If the affected nail suffers permanent damage, it is possible for the condition to become irreversible and the nail keeps growing thick and curved. You can either accept it and just trim the nail very often, or remove it for good. Since nail removal is permanent, it is considered a radical treatment option. Many people would rather live with their thick yellow nails that require constant maintenance.

What are the causes of onychogryphosis?

Onychogryphosis has many possible causes but in some cases there isn't any obvious one. The most common of all potential causes is direct damage to the nail, which injured the structural cells. This can be the effect of outdoor activities such as sports or an accident, like dropping a heavy object on the nails. Wearing shoes that are too tight or don't fit well is another common issue, as well as improper hygiene (not trimming your nails on time) or a poor diet that fails to supply enough nutrients. Other causes are fungal nail infections, peripheral vascular disease, a low blood circulation to the extremities and many other conditions such as diabetes.

Treatment options

Onychogryphosis can be easily prevented with a few simple measures. Make sure you always protect your feet by wearing shoes that fit well, with quality socks. Trim your nails constantly, avoid using nail polish and keep them hydrated by applying moisturizing cream after you take a bath or a shower. Soaking your feet in warm salt water also helps prevent onychogryphosis.

Depending on how severe the condition is and the particular symptoms, there are a number of available treatments. If your nail blood circulation is good, a modern therapy is to use a carbon dioxide laser or phenol to completely destroy the nail matrix. In very severe cases, a saturated solution of phenol can be applied to remove the nail for good and eliminate the pain.

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