1. Using of certain drugs or substance dependence

2. Prolonged use of chemicals over the nails. (e.g. nail varnish)

3. Poor nail care and trimming techniques

4. Trauma to the toenail(s). This can cause poor nail growth or formation

5. Fungal nail infection

6. Other medical conditions such as thyroid, heart, lung and liver diseases; skin conditions such as psoriasis; micronutrient deficiencies like iron deficiency anaemia

You can prevent the recurrence by the following measures:

Do not cut your nails down the edges

Do not attempt to dig and clean under your nails with sharp instruments

Do not pick or peel your nails

• Treat the underlying cause (medical condition, fungal infection, ill-fitting footwear) until new healthy nail is formed.
• Regular debulking and thinning of the nail which can be achieved by regularly filing by yourself or trained healthcare providers.

When should I seek medical treatment