Why Are My Toenails Not Growing?

How Fast Should Toenails Normally Grow?

Toenails grow at an average toenail growth speed of 1 to 2 mm per month. To help you visualize this, a single dime is approximately 1.35 mm thick. So, over an entire month, a healthy toenail grows a new length that is roughly equal to the thickness of a dime.

Changes in nail length and growth rate can vary depending on internal and external factors. Nail growth can fluctuate between different seasons or climates due to shifts in temperature and circulation. Nutrition, age, and natural hormonal changes can also lead to slower growth. Because growth happens gradually, many individuals only notice small, subtle changes in nail length. However, if your toenails not growing at all becomes noticeable over several months, it could signal a more serious circulatory issue.

Common Reasons Toenails Stop Growing or Grow Slowly

There are several reasons—both minor and medical—why a toenail not growing properly might occur:

• Poor Circulation: Restricted arterial flow prevents blood, oxygen, and nutrients from reaching the toes. Stunted nail growth are often caused by vascular conditions, including varicose veins, blood clots, atherosclerosis, and peripheral artery disease.
• Trauma to the Toenail: Stubbing a toe, dropping something heavy, or wearing overly tight footwear can injure the nail matrix, causing growth to slow or halt until the injury heals.
• Fungal Infections: Fungal pathogens invade the nail bed, causing brittle, thickened, or discolored nails that require treatment to restore healthy regrowth.
• Nutritional Deficiencies: A diet lacking iron, zinc, or B vitamins hinders keratin production—the essential protein for nail structure. Deficiencies can also cause skin issues, hair loss, and brittle nails.
• Aging and Natural Changes: Blood flow naturally decreases with age. After age 25, average nail growth speed drops by about 0.5% per year.

How Poor Circulation & PAD Progression Impact Toenail Health

The nail bed relies on a continuous supply of oxygenated blood delivered through tiny arterial capillaries. When peripheral artery disease (PAD) causes plaque buildup in the leg arteries, blood circulation to the lower extremities becomes restricted. This directly impacts peripheral artery disease toe nails in several ways:

• Nails may appear noticeably brittle, pale, bluish, or abnormally thick.
• Toenail growth on one foot may be significantly slower than on the other.
• When arterial blockage is severe, toenail growth can stop entirely.

Signs of PAD That May Accompany Nail Changes

Individuals with PAD toenails often experience additional vascular warning signs alongside slow nail growth:

• Cold Feet and Toes: Coldness in one or both feet is a key indicator of reduced blood flow, frequently accompanied by tingling or numbness.
• Discoloration of Skin and Nails: Yellowish or brownish tint in nails, pale or blue-colored toes, and shiny, dry skin on the legs.
• Leg and Foot Pain: Aching, cramping, or heaviness in the legs during light walking that subsides with rest (intermittent claudication). If PAD progresses to critical limb ischemia (CLI), resting pain may persist.

When to See a Doctor for Toenails That Aren’t Growing

If toenails not growing persist alongside circulatory risk factors, a vascular screening can provide an accurate diagnosis. Early treatment for PAD re-establishes healthy blood flow, prevents disease progression, and aids in improving toenail health.

At USA Vascular Centers, we offer effective, non-surgical outpatient PAD treatments:

• Angioplasty: A small balloon catheter is inflated inside the blocked artery to compress plaque and restore blood flow.
• Stent Placement: A tiny mesh tube is positioned within the artery to keep it propped open long-term.
• Atherectomy: Advanced tools are used to clear plaque accumulation directly from arterial walls.