It is commonly believed that bunionettes are caused by tight, pointy-toed shoes like high-heeled pumps and narrow flats. The truth is that this foot deformity is actually caused by genetic factors and often runs in families. Because of this, both men and women can get bunionettes.

However, wearing shoes with small toe boxes that pinch the toes together can make the misaligned bones worse. Because women tend to wear these kinds of shoes more often than men, bunionettes are much more common in women. Also, because women are more likely to want to wear trendy, narrow shoes than men, they are more likely to seek treatment for bunionettes, so they are diagnosed more frequently.