Toenails not growing

Hello Dr Jankicevic,

I'm a 29 year old female and my problems are my big toes, specifically my toenails.

Three or four years ago I noticed that my left toenail stopped growing. That was followed by a dull pain in the nail root area accompanied by slight swelling and redness of the toe. After a couple of weeks the swelling, redness and pain went away by themselves, however the nail seemed to have stopped growing for about 5 months or so. During that period the nail was slightly discolored, a yellowish color. Apart from that and slightly increased thickness, the nail seemed normal. Lab tests were negative for fungus, and I was advised to have capillaroscopy done, which showed mild spasms of the capillaries (I hope I got that right). Maybe it's worth mentioning that the capillaroscopy was performed on my hands. After those 5-6 months, the nail started growing onwards again, but when the new nail tissue started appearing, it seemed like the old nail was growing in layers. The new tissue seemed completely normal. Everything was OK until a year ago, when it happened again. Now, it's happening on my other big toe as well.
I should mention that my index toes are now growing slower than the rest.
The dermatologists I saw had no answer to my problem, and they said I should try Panthenol cream. It didn't help.
I should also mention that I had no injuries, ingrown nails and that I wear comfortable footwear all the time.  Also, I have no known significant health issues and my diet is adequate, but I'm a smoker and I don't do much exercise.

My major concern is that there might be some underlying health issue.

Any advice would be much appreciated.

Thanks in advance
Jelena, Montenegro

[Bhupinder Kaur, MD]

Hello,
Toenails grow at about one-half or one-third the rate of the fingernails which is one tenth of a mm per day. You have already ruled out fungal infection of the toenails. However any disturbance in the circulation of toenails can restrict the growth of toenails. I suggest you to discuss this possibility with your doctor and if possible get a color Doppler of the vessels of the foot and toes done to confirm the diagnosis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[JelenaMNE]

Thank you very much for the advice. I will let you know as soon as i have new information about my condition.

Jelena, Montenegro