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"Why is the top of my big toe dark and hard?"

ZocdocAnswersWhy is the top of my big toe dark and hard?


Hi, I'm and 18 year old male and the top of my big toe seems to have a hard brown crust forming on the top of it, I assumed it was my shoe irritating it but since a recent change of shoes no difference has been made to it.


It sounds like the most probable cause of your problem is an infection of the skin at the side of the toenail. This is called a paronychia. It can occur because of an ingrown toe nail, or because of trauma to the skin around the nail. Poorly fitting shoes are another common cause. One the bacteria gain entry, they set up an infection which causes swelling and pain of the nail fold. This can lead to abscess formation and leaking of pus from the site. I recommend seeing your primary care doctor to help determine if this is in fact what is going on. Most simple cases of paronychia can be managed by wearing properly fitting shoes, good skin hygiene, and soaking the infected area in warm salt water daily. After soaking, you can dry the area off and apply some topical antibacterial ointment. However, more involved cases may need lancing to drain out the pus or they may need oral antibiotic medications prescribed by your doctor. Your primary care doctor will be able to confirm the diagnosis and will be able to help you decide what state the infection is in and what form of treatment is best suited to your case.

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