The Problem With Nails – About Toenails


Gee … They Don’t Seem To Do Much … But They Can Sure Can Create Problems
It is my observation that most of my patients over 70 years of age have difficulty reaching and seeing their toenails. They may not have enough strength to cut them, anyway.  Frequently, nails left uncut properly are painful and limit weight bearing activities and the choices of foot gear. Additionally, people in this age group commonly demonstrate clinical findings consistent with advancing peripheral vascular disease (poor circulation). These observations include impalpable pulses in the feet, the diminished presence of hair, textural changes in skin, such as wrinkling  and thiness, additional pigmentation of the skin as well as edema(swelling).  More serious  changes are indicated by changes in the color of the feet in which the color of the skin appears reddened or purplish. This is particularly noticeable when the feet and legs are dependent. Sitting for long periods with the legs down stresses the cardiovascular system, especially in people with these advanced vascular disease changes. There may be temperature changes as well with the toes and foot feeling cold to touch. These are clear indications of greatly diminished circulation in the feet and toes. Some patients also demonstrate neurological changes especially in the toes in which the sensations of sharp versus dull, cold versus heat, vibration, light touch and position senses are diminished to variable extents.

Nail characteristics may change throughout life, affected by micro trauma, (e.g. pressure from shoes) or acute trauma. The nails themselves are commonly observed to be thickened and incurvated. Circulation also effects how nails grow. Pressure from incurvated edges is painful. Small skin breaks may occur causing local redness and pain. Additionally, many people have mycotic nails. This means that a fungal organism exists in the nail plates and, although this is not dangerous, it is another reason to make the nails thickened and nearly impossible to cut. Thick, uncut mycotic nails become a source of “athletes foot”, a fungal disease condition of the skin.

Maybe It’s Not A Good Idea For You To Cut You Own Nails …… Consider This.

Under most insurance plans, the conditions mentioned above are objective findings which support coverage of nail cutting, which is also referred to as nail debridement. For example, under Medicare guidelines, a qualified patient is INSURANCE ELIGIBLE for debridement of nails approximately every 10 weeks.