Let’s take a look at what makes up your toenail. A nail is made up of several layers:

• Nail bed: the skin below the nail plate which contributes to the health of the nail plate.
• Nail matrix: the “ root ” of the nail cells. This where the nail grows from and out to the of your finger.
• Nail plate: the “ hard “ part of the nail that you feel and see. It is made out of keratin. This is what protects the skin underneath. This is made up of dead compact cells that give the nail some flexibility. Your hair and skin have the same type of similar cells.
• Eponychium: are living cells - they are clear and located at the base of the nail plate. This is the area that should not be peeled back with a manicure as it will introduce the potential for infection. The eponychium and the cuticle form a protective seal around the nail plate.
• Cuticle: is a layer of dead cells that move forward from the cells of the eponychium that also make a protective clear seal around the nail. This is what is cut or pushed back during a manicure. This should be done with care as removal could cause an infection.

Toenails can reflect disease processes such as heart, kidney and blood disorders as well as a type of cancer called melanoma. Some of the most common problems seen with toenails are:

• Ingrown toenails: occur when the toenail is cut wrong, tight shoes or hitting your toenail. The area around the side of the toenail may become red, swollen or drain pus. Please seek medical attention immediately as this could result in a severe infection which could cause the loss of a toe especially if you have diabetes or circulation issues.
• Fungal toenails: occur when the toenail becomes yellow, very thick and may crumble when trimmed. This can be caused by a fungus or even trauma to the toenail over time. Treatment options include topical, oral and surgical removal. Before starting any medications, nail cultures must be done as the medications only kill certain funguses.
• Melanoma: is seen in the toenail usually by a dark discoloration which can lift the nail. This type of cancer can move to other areas in the body and lead to a toe, foot or leg amputation. Please seek medical attention immediately for this condition as it could lead to death. 

This is why it is important to inspect your toenails daily to spot any changes and discuss them with your podiatrist.