Question
Hi --

I am a 36 year-old woman.  Other than a history of asthma, and occasional anemia, I am healthy.  I have noticed that my toenails are hard to keep looking healthy because of separating layers with the big toe nail and detachment of the nails on the smaller toes.

With my big toe, the nail grows in layers and the layers catch and peel off, leaving an unevenly thin/thick toenail.  The smaller toes will seem to grow well, and then when they get to a certain length, they start becoming detached from the nail bed and will pop off if hit (I often wear open-toed sandals) or start peel from the nail bed. The separation occurs in the middle of the nail. The part that separates/pops off is thicker than the short nail that remains.

At one point, I thought that these issues were mine alone, but I just found out that my sister (who has not lived with me in decades) has the same experiences with her toenails. Also, my 9 year-old sons are having the peeling-layers problems as I do with my big toe.  Our toenails are not yellowed, or extremely thick, so I have been ruling out a fungus.  Also, our toenails are not constantly being injured.

Is this genetic? Something in our diets?  It's more ugly and annoying than anything, so if I can fix the issues, I'd love to.

Thank you so much for any insight you can provide.

Answer
HI Jessica,

It sound like you may have a fungal infection of the nail.  You can see these infections in some families.  They change the nail appearance but are not harmful to your body.  There are several treatments available. First you would need to see a podiatrist and confirm the diagnosis with a nail stain or culture.  There are pills and cream/liquids for treatment.  A new promising treatment is the Noveon laser that should be FDA approved for toenail fungus very soon.  It will be the first laser approved for destruction of nail fungus or onychomycosis.  There are other lasers such as the Pinpointe but it is not approved for onychomycosis in the US.  In addition, my research has shown that the Noveon laser is far superior in many ways.  Hope that helps.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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