Uneven, rippled toenails, a change that mostly occurs as a result of nail dystrophy, such as transverse nail striae, or transverse nail grooves. These symptoms are mainly due to dysfunction of the nail matrix portion, or damage to the nail matrix. There may also be congenital factors that cause the nail changes, and in the case of congenital factors, all toenails may appear to have the same changes. If it is formed by a fungal infection, mostly a nail fungus that develops as a result of long-standing ringworm of the feet, especially gray nails, similar symptoms may occur. This condition needs to be treated differently, and if it is caused by nail fungus disease, prompt antifungal treatment is needed.