Why Is My Toenail Growing Sideways?

Your toenail is growing sideways because the nail plate is following the path set by the nail matrix — the tissue under your cuticle where the nail is actually made. When that matrix is damaged, scarred, or shaped differently than usual, new nail cells get pushed out at an angle instead of straight forward. The nail isn’t misbehaving on its own. It’s doing exactly what the tissue beneath it is telling it to do.

This is more common than most people realize, and it usually has a clear mechanical or structural explanation. Sometimes it’s an injury you remember. Sometimes it’s years of narrow shoes pressing the toe into an unnatural position. And sometimes it’s simply the shape you were born with. What matters is figuring out which one applies to you, because the fix depends entirely on the cause.

Why Is My Toenail Growing Sideways?

The nail matrix sits just beneath the skin at the base of your nail, partly under the cuticle. It produces keratin cells that harden into the nail plate and push forward. If the matrix is healthy and symmetrical, the nail grows straight. If part of the matrix is injured or compressed, the cells produced in that area emerge at a different angle, and the nail curves or tilts to one side as it grows out.

A few things can redirect that growth:

• Physical trauma — stubbing your toe, dropping something on it, or repetitive pressure from tight footwear can scar the matrix
• Nail surgery or removal — if part of the matrix was destroyed during a procedure, regrowth can be permanently altered
• Fungal infection — thickens and distorts the nail plate, which can make it appear to grow sideways even when the matrix is fine
• Congenital shape — some people simply have a matrix that produces a wider or angled nail from birth
• Onychogryphosis — a condition where the nail thickens dramatically and curves, often seen in older adults or people with poor circulation

One clarification worth making: a nail that looks sideways may actually be growing straight but sitting on a toe that has shifted. Bunions, hammertoes, and joint changes from arthritis can rotate the entire toe, which makes the nail appear angled when it isn’t.

Is a Sideways Toenail Always a Health Problem?

Not necessarily. Some people have a nail that grows at a slight angle their whole lives with no pain, no infection, and no functional issue. If it doesn’t hurt and the surrounding skin is healthy, it may simply be your normal anatomy.

The concern arises when the angled nail starts pressing into the skin beside it. That pressure can cause:

• Pain when wearing shoes
• Redness and swelling along the nail fold
• Recurring ingrown nails
• Skin breakdown that allows bacteria to enter
• Difficulty trimming the nail without causing damage

An ingrown toenail that becomes infected needs medical attention. Signs of infection include increasing pain, pus, significant redness, and warmth. People with diabetes or poor circulation should treat any toe infection seriously and seek care promptly, because these conditions reduce the body’s ability to fight infection and heal.

What Causes a Toenail to Curve Into the Skin?

Curving and sideways growth are related but not identical. A nail that curves downward at the sides — sometimes called pincer nail — presses into the nail folds and can cause the same pain and infection risks as a sideways-growing nail.

Pincer nails are often caused by:

• Genetic tendency toward tightly curved nails
• Pressure from shoes that squeeze the toes together
• Age-related changes in nail thickness and shape
• Certain medications, including some used for acne and other conditions
• Underlying bone changes in the toe

Some research suggests that beta-blockers and retinoids may contribute to nail curvature in certain people, though the evidence is not strong enough to say these medications cause it in most users. If you notice a sudden change in nail shape after starting a new medication, mention it to your doctor.

Can You Fix a Toenail That Grows Sideways?

Whether it can be corrected depends on why it’s growing that way. If the matrix is permanently scarred, the nail will likely continue growing at that angle. No topical product or home remedy can change the direction a damaged matrix produces nail cells.

What can be done:

• Proper trimming — cut the nail straight across, not rounded at the corners, and don’t cut it too short
• Footwear changes — shoes with a wide toe box reduce pressure on the nail folds
• Orthonyxia (nail bracing) — a small wire or bracket is attached to the nail to gradually train it to grow flatter; some clinicians use this, though evidence for long-term effectiveness varies
• Partial matrix removal — a podiatrist or dermatologist removes the portion of the matrix producing the angled edge, so the nail grows back narrower and straighter
• Full nail removal — in severe cases, the entire nail and matrix may be removed permanently

The choice depends on how much pain you’re in, how often you get infections, and whether the cause is treatable. A podiatrist can assess whether the matrix is damaged and discuss options. This is not something to self-treat if you have diabetes, circulation problems, or an active infection.

When Should You See a Doctor for a Sideways Toenail?

See a doctor or podiatrist if you have:

• Pain that interferes with walking or wearing shoes
• Signs of infection — pus, spreading redness, warmth, or fever
• Diabetes, peripheral artery disease, or immune suppression
• A nail that has changed shape suddenly without injury
• Repeated ingrown nails on the same toe
• A dark streak or discoloration under the nail that wasn’t there before

That last point matters. A new dark band under a toenail should be evaluated, especially if it’s widening or involves the cuticle. In rare cases, this can indicate melanoma, which can occur under the nail. Most dark spots are from trauma or fungus, but a doctor can tell the difference.

What Happens If You Leave It Alone?

If the nail isn’t causing pain or infection, leaving it alone is reasonable. Many people live with an angled toenail for decades without problems.

If it is causing pressure or recurrent infections, ignoring it tends to make things worse over time. Repeated inflammation can lead to chronic swelling of the nail fold, which is called hypertrophic granulation tissue. That makes the nail even harder to manage and increases infection risk.

The bottom line: a sideways toenail is a mechanical issue, not a mystery. The nail grows where the matrix tells it to. If you want to change the direction, you have to address the matrix — and that usually means seeing a professional.