Nail issues can range from mild cosmetic concerns to painful conditions that require medical attention. Problems like ingrown toenails, toenail fungus, and toenail infections are well-known. However, big toe subungual exostosis is often misdiagnosed or overlooked. At Best Foot Dr. NY, we specialize in diagnosing and treating a range of foot and nail conditions, including subungual exostosis. This article discusses the differences between this condition and other nail disorders so you can get the proper treatment.
What Is Subungual Exostosis?
A subungual exostosis is a bony growth that develops underneath your toenail. It most commonly affects the big toe and usually results from trauma, irritation, or pressure on the nail bed, resulting in the formation of excess bone tissue. As the growth increases in size, it pushes against your nail, causing pain and deformity.
Unlike conditions such as ingrown toenails or toenail fungus, which affect the nail itself, subungual exostosis originates from the bone beneath the nail.
How Does Subungual Exostosis Develop?
Several factors can cause subungual exostosis to develop on your foot:
- Trauma or repetitive pressure: A past injury, continuous friction from tight shoes, or frequent impact activities can trigger bone growth.
- Chronic irritation: Long-term stress on your toe joint could contribute to excess bone formation.
- Previous infections: Recurring nail infections can also cause this condition to develop.
Symptoms of Subungual Exostosis
- A firm, raised bump beneath your toenail
- Gradual nail lifting or distortion
- Pain or tenderness when pressure is applied to the nail
- Redness and swelling around the affected area
- Difficulty wearing shoes due to increased sensitivity
Unlike ingrown toenails, where pain is usually along the edges of the nail, subungual exostosis causes discomfort in the center or underneath the nail.
How Does Subungual Exostosis Compare to Other Nail Conditions?
Since this condition can look a lot like other nail problems, it can get misdiagnosed. Understanding the key differences can help you decide when to schedule a consultation with the best Brooklyn and Manhattan podiatrists at Best Foot Dr. NY.
Subungual Exostosis vs. Ingrown Toenails
Both conditions can cause nail pain and swelling, but they develop differently. With ingrown toenails, the nail grows into the surrounding skin, leading to redness, tenderness, and possible infection. This typically affects the sides of the nail rather than the area underneath it. Subungual exostosis, on the other hand, involves bone growth that pushes the nail upward, creating a different type of discomfort.
If the pain is concentrated at the edges of the nail and worsens when wearing tight shoes, you may have an ingrown toenail. Subungual exostosis is more likely if there is a noticeable hard bump underneath the nail.
Subungual Exostosis vs. Toenail Fungus
Toenail fungus primarily affects the texture and color of your nail. You might notice thickening, yellowing, and a crumbly texture, but it typically does not cause pain unless it gets severe. This contrasts with subungual exostosis, which alters the shape of your nail from underneath, lifting the nail plate. Additionally, while fungal infections spread over time, subungual exostosis is a localized growth that progressively changes your nail’s structure.
When you notice pain and a distinct elevation of the nail, a Best Foot Dr. NY nail surgeon could recommend subungual exostosis treatment.
Subungual Exostosis vs. Toenail Infection
Bacterial toenail infections tend to result from an injury, ingrown toenail, or untreated fungal infection. They cause redness, swelling, and pus formation around your nail. The pain associated with an infection is often from inflammation rather than pressure from a bone growth.
For infections, we usually prescribe antibiotics or drain the area, while subungual exostosis may require an X-ray to confirm the presence of a bone growth.
How Is Subungual Exostosis Diagnosed and Treated in the NYC Area?
Because subungual exostosis affects the bone beneath your nail, the best nail doctors at Best Foot Dr. NY use X-rays to confirm your diagnosis. A physical exam can help rule out other nail issues, but imaging is the best way to identify excess bone growth.
Treatment Options
The right treatment depends on the severity of your symptoms and how much the condition affects your daily life.
Non-Surgical Treatment
- Wear shoes with more room to relieve the pressure on your toe.
- Use protective padding to minimize irritation.
Surgical Treatment
If the subungual exostosis causes persistent pain or nail deformity, you could end up needing nail (removal) surgery. This procedure involves:
- Local anesthesia to numb the area.
- Partial or full nail removal, depending on how much the growth has affected the nail.
- Excision of the excess bone, followed by smoothing of the area to prevent regrowth.
- Stitching of the skin with a follow-up visit to check healing.
Recovery time is usually between two to six weeks.
Get the Best Nail Care in Brooklyn and NYC With Best Foot Dr. NY
If you’re dealing with persistent toenail discomfort, Best Foot Dr. NY offers specialized foot and nail care in Brooklyn. We can identify the difference between subungual exostosis and find the best treatment options. Contact us today to schedule a consultation and start down the path to better foot health.