Ingrown nail causes. Ingrown Toenails: Causes, Symptoms, and Effective Treatment Options

16.07.202303.07.2023 by alexxlab

What are the main causes of ingrown toenails. How can you identify the symptoms of an ingrown toenail. What are the most effective treatment options for ingrown toenails. How can you prevent ingrown toenails from occurring.

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Understanding Ingrown Toenails: A Comprehensive Guide

An ingrown toenail is a common foot condition that occurs when the edge of the nail grows into the surrounding skin. While it may seem like a minor issue, ingrown toenails can cause significant discomfort and, if left untreated, lead to more serious complications. This comprehensive guide will explore the causes, symptoms, treatment options, and prevention methods for ingrown toenails.

Common Causes of Ingrown Toenails

Ingrown toenails can develop due to various factors. Understanding these causes is crucial for both prevention and effective treatment. Here are the most common reasons why ingrown toenails occur:

Poorly fitting shoes
Improper nail trimming techniques
Foot or toe deformities
Genetic predisposition
Injuries to the toe
Excessive pressure on the toes

The Impact of Footwear on Ingrown Toenails

Shoes that are too tight or fit poorly are one of the leading causes of ingrown toenails. When your toes are cramped in a confined space, it puts extra pressure on the nails, forcing them to grow inward. This is particularly common in people who frequently wear high heels or shoes with narrow toe boxes.

Nail Trimming Techniques and Their Role

Improper nail trimming is another significant factor in the development of ingrown toenails. Cutting your nails too short or rounding the edges instead of cutting straight across can encourage the nail to grow into the surrounding skin. Additionally, picking or tearing at the corners of the nails can create jagged edges that are more likely to become ingrown.

Recognizing the Symptoms of an Ingrown Toenail

Identifying an ingrown toenail early can help prevent more severe complications. The most common symptoms include:

Pain and tenderness along the edge of the nail
Redness and swelling around the affected area
Warmth in the surrounding skin
Possible discharge if an infection develops

Is it possible for an ingrown toenail to heal on its own? In some cases, minor ingrown toenails may resolve without intervention. However, if symptoms persist or worsen, it’s essential to seek proper treatment to prevent complications.

Effective Treatment Options for Ingrown Toenails

The treatment for an ingrown toenail depends on its severity and whether an infection is present. Here are some common approaches to managing this condition:

Home Remedies for Mild Cases

For mild ingrown toenails without signs of infection, the following home remedies may provide relief:

Soak the affected foot in warm water 3-4 times daily
Gently massage the inflamed skin
Place a small piece of cotton or dental floss under the nail edge
Keep the area clean and dry
Wear open-toed shoes or sandals to reduce pressure

When to Seek Professional Help

When should you consult a healthcare provider for an ingrown toenail? If home remedies don’t improve the condition within a few days, or if you notice signs of infection such as increased pain, redness, or discharge, it’s time to seek professional help. Additionally, individuals with diabetes, poor circulation, or nerve problems in the feet should always consult a healthcare provider for ingrown toenail treatment.

Medical Treatments and Procedures

In more severe cases, a healthcare provider may recommend the following treatments:

Partial nail avulsion: Removing the ingrown portion of the nail
Antibiotics: Prescribed if an infection is present
Phenol application: To prevent regrowth of the removed nail portion
Total nail avulsion: Complete removal of the nail in recurring or severe cases

Preventing Ingrown Toenails: Proactive Measures

Prevention is always better than cure when it comes to ingrown toenails. Here are some effective strategies to reduce your risk:

Wear properly fitting shoes with adequate toe room
Trim nails straight across, avoiding rounded edges
Keep feet clean and dry
Avoid tight socks or stockings
Protect your feet from injury

How often should you trim your toenails to prevent ingrown nails? It’s generally recommended to trim your toenails every 6-8 weeks, or when they start to extend beyond the tip of your toe. However, this can vary depending on individual nail growth rates.

Special Considerations for High-Risk Individuals

Certain groups of people are at higher risk for developing complications from ingrown toenails and require special attention:

Diabetic Foot Care

People with diabetes are more susceptible to foot problems, including ingrown toenails. They should:

Inspect their feet daily for any changes or signs of injury
Maintain good blood sugar control
Seek professional nail care if needed
Never attempt to treat ingrown toenails at home

Athletes and Active Individuals

Those who engage in regular physical activity, especially sports that involve rapid directional changes or kicking, are at increased risk for ingrown toenails. They should:

Choose appropriate footwear for their sport
Replace athletic shoes regularly
Use moisture-wicking socks
Pay extra attention to foot hygiene

When to Worry: Recognizing Complications

While most ingrown toenails can be successfully treated, complications can arise if left unaddressed. It’s crucial to be aware of potential warning signs that indicate a more serious problem:

Severe pain that interferes with daily activities
Signs of infection spreading beyond the immediate area
Fever or chills
Discoloration or hardening of the surrounding skin

Can an ingrown toenail lead to more serious health issues? In rare cases, untreated ingrown toenails can lead to a bone infection (osteomyelitis) or a skin infection called cellulitis. These conditions require immediate medical attention and can have serious consequences if not properly managed.

The Role of Proper Footwear in Toenail Health

Choosing the right shoes is not just about comfort; it plays a crucial role in preventing ingrown toenails and maintaining overall foot health. Here are some tips for selecting appropriate footwear:

Ensure there’s at least a half-inch of space between your longest toe and the shoe’s tip
Opt for shoes with a wide toe box
Avoid high heels or pointy-toed shoes for everyday wear
Choose breathable materials to reduce moisture
Replace shoes regularly, especially athletic footwear

How can you determine if your shoes fit properly? A good rule of thumb is to shop for shoes later in the day when your feet are slightly swollen. This ensures you get a fit that accommodates your feet at their largest.

The Impact of Occupational Footwear

Certain professions require specific types of footwear that may increase the risk of ingrown toenails. For example:

Construction workers wearing steel-toed boots
Healthcare professionals in tight, non-slip shoes
Military personnel in combat boots

If your occupation requires restrictive footwear, it’s essential to take extra precautions to protect your toes and maintain proper nail care.

Advanced Treatment Options for Recurrent Ingrown Toenails

For individuals who suffer from chronic or recurrent ingrown toenails, more permanent solutions may be necessary. These advanced treatment options aim to prevent the problem from recurring:

Partial Matrixectomy

This procedure involves removing a portion of the nail matrix (the tissue responsible for nail growth) to prevent the problematic part of the nail from regrowing. It can be done using various methods:

Chemical matrixectomy: Using phenol or sodium hydroxide
Surgical matrixectomy: Physically removing the nail matrix
Laser matrixectomy: Using laser technology to destroy the nail matrix

Nail Fold Excision

In some cases, the problem lies not with the nail itself but with excess skin surrounding the nail. A nail fold excision removes this excess skin, providing more space for the nail to grow normally.

What is the success rate of these advanced treatments? While individual results may vary, studies have shown that partial matrixectomy procedures have a success rate of over 90% in preventing ingrown toenail recurrence.

The Psychological Impact of Chronic Ingrown Toenails

While often overlooked, the psychological effects of chronic ingrown toenails can be significant. Individuals dealing with this condition may experience:

Reduced quality of life due to pain and limited mobility
Embarrassment or self-consciousness about foot appearance
Anxiety about participating in activities that expose the feet
Frustration with recurring symptoms despite treatment

How can individuals cope with the emotional aspects of chronic ingrown toenails? Seeking support from healthcare providers, joining support groups, and practicing self-care can help manage the psychological impact of this condition.

Emerging Research and Future Treatments

The field of podiatry continues to evolve, with ongoing research into new treatments and prevention methods for ingrown toenails. Some areas of current interest include:

Improved nail-growth inhibitors for more effective matrixectomies
Development of specialized nail-trimming tools for at-risk populations
Exploration of genetic factors contributing to ingrown toenails
Innovative materials for orthotic devices to redistribute pressure on the toes

What potential breakthroughs might we see in ingrown toenail treatment in the coming years? While it’s difficult to predict specific advancements, the focus on minimally invasive procedures and personalized treatment approaches is likely to continue.

The Importance of Regular Foot Health Check-ups

Regular foot examinations, especially for those at higher risk of foot problems, can play a crucial role in preventing and managing ingrown toenails. These check-ups may include:

Assessment of overall foot health and structure
Evaluation of nail growth patterns
Screening for early signs of ingrown toenails
Education on proper foot care techniques

How often should you have a professional foot health check-up? For most people, an annual check-up is sufficient. However, individuals with diabetes, circulatory issues, or a history of foot problems may need more frequent evaluations.

The Role of Podiatrists in Nail Care

Podiatrists are specialists in foot health and can provide expert care for ingrown toenails and other foot-related issues. They can offer:

Accurate diagnosis of nail and foot conditions
Professional nail trimming services
Custom orthotics to address structural issues contributing to ingrown nails
Advanced treatments for chronic or severe cases

By addressing ingrown toenails comprehensively and proactively, individuals can maintain healthy, pain-free feet and improve their overall quality of life. Remember, early intervention and proper care are key to preventing complications and ensuring long-term foot health.

Ingrown toenail: MedlinePlus Medical Encyclopedia

An ingrown toenail occurs when the edge of the nail grows into the skin of the toe.

An ingrown toenail can result from a number of things. Poorly fitting shoes and toenails that are not properly trimmed are the most common causes. The skin along the edge of a toenail may become red and infected. The great toe is affected most often, but any toenail can become ingrown.

An ingrown toenail may occur when extra pressure is placed on your toe. This pressure is caused by shoes that are too tight or fit poorly. If you walk often or play sports, a shoe that is even a little tight can cause this problem. Deformities of the foot or toes can also place extra pressure on the toe.

Nails that are not trimmed properly can also cause ingrown toenails:

Toenails that are trimmed too short, or if the edges are rounded rather than cut straight across may cause the nail to curl and grow into the skin.
Poor eyesight, inability to reach the toes easily, or having thick nails can make it hard to properly trim nails.
Picking or tearing at the corners of the nails can also cause an ingrown toenail.

Some people are born with nails that are curved and grow into the skin. Others have toenails that are too large for their toes. Stubbing your toe or other injuries can also lead to an ingrown toenail.

There may be pain, redness, and swelling around the nail.

Your health care provider will examine your toenail and ask about your symptoms.

Tests or x-rays aren’t usually needed.

If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don’t try to treat an ingrown nail at home.

Otherwise, to treat an ingrown nail at home:

Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry.
Gently massage over the inflamed skin.
Place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic.

When trimming your toenails:

Briefly soak your foot in warm water to soften the nails.
Use a clean, sharp trimmer.
Trim toenails straight across the top. Do not taper or round the corners or trim too short.
Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse.

Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem.

If this doesn’t work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist).

If the ingrown nail doesn’t heal or keeps coming back, your provider may remove part of the nail:

Numbing medicine is first injected into the toe.
The ingrown part of the nail is removed. This procedure is called a partial nail avulsion.
It takes 2 to 4 months for the nail to regrow.

If the toe is infected, your doctor may prescribe antibiotics.

After the procedure, follow any instructions for helping your nail heal.

Treatment usually controls the infection and relieves pain. The condition is likely to return if you don’t practice good foot care.

This condition may become serious in people with diabetes, poor blood circulation, and nerve problems.

In severe cases, the infection can spread through the toe and into the bone.

Call your provider if you:

Are not able to treat an ingrown toenail at home
Have severe pain, redness, swelling, or fever
Have diabetes, nerve damage in the leg or foot, poor circulation to your foot, or an infection around the nail

Wear shoes that fit properly. Shoes that you wear every day should have plenty of room around your toes. Shoes that you wear for walking briskly or for playing sports should also have plenty of room, but not be too loose.

When trimming your toenails:

Briefly soak your foot in warm water to soften the nail.
Use a clean, sharp nail trimmer.
Trim toenails straight across the top. Do not taper or round the corners or trim too short.
Do not pick or tear at the nails.

Keep your feet clean and dry. People with diabetes should have routine foot exams and nail care.

Onychocryptosis; Unguis incarnates; Surgical nail avulsion; Matrix excision; Ingrown toenail removal

Ingrown toenail

Dinulos JGH. Nail diseases. In: Dinulos JGH, ed. Habif’s Clinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Grear BJ. Disorders of nails. In: Azar FM, Beaty JH, eds. Campbell’s Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 88.

Marks JG, Miller JJ. Nail disorders. In: Marks JG, Miller JJ, eds. Lookingbill and Marks’ Principles of Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 21.

Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Ingrown Nails: Background, Pathophysiology, Etiology

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Treatment of an ingrown nail

Home / Directions / Medical cosmetology / Treatment of an ingrown nail

Onychocryptosis, or abnormal growth of the nail plate, the edge of which literally sticks into soft tissues, causes a lot of inconvenience to its owner: from acute pain at the site of an ingrown nail to the inability to wear stylish dress shoes. Until recently, the only way to get rid of such a problem once and for all was surgery. Today, you can do without surgery, during which, more often, nails ingrown into soft tissues, which bring considerable suffering, are removed from the big toes. A non-surgical technique for correcting deformed and ingrown nails is called orthonyxia. It involves the use of a special bracket to correct the shape of the deformed nail plate, which raises the nail, reducing pressure on the nail fold, and prevents ingrowth. Such a brace is a small plate that absolutely does not interfere with the usual way of life and even playing sports.

Ingrown toenail treatment methods
The most versatile and popular corrective brace for 67 years since its invention is the Fraser brace. It is made strictly individually for each nail in the same way as mesh braces for correcting teeth. Only from thinner medical wire. The central part of the brace is fixed in the middle of the nail that needs correction, and the gradual pulling of the ingrown edge of the nail upwards is ensured by hooks clinging to the edges of the nail plate. The effectiveness of a well-performed correction with Fraser brackets is very high – the nails after it look “like new”, and the costs are much lower than when using most other models of corrective brackets.

What is the treatment of ingrown nails with staples?
The most important advantage of the ingrown toenail correction method with corrective staples is that it is a bloodless and painless procedure.

By eliminating the root cause of the problem, that is, by precisely calculated tension, the sharp edges of ingrown nails from the soft tissues they have injured, corrective braces relieve the pain and discomfort caused by it. A place damaged by an ingrown nail, especially with additional treatment with anti-inflammatory and bactericidal drugs, is quickly restored.

Once an ingrown toenail is corrected, it grows properly and looks natural and healthy.

Who should not have their ingrown nails corrected with staples?
Persons suffering from malignant and fungal diseases of the nails, orthonyxia is categorically contraindicated. Correction of ingrown nails should not be carried out by patients with diabetes mellitus, as well as people who have voids, hematomas, longitudinal cracks under the nails, or the horny plate of the diseased nail exfoliates too much.

Causes of ingrown nails

In 50% of cases, an ingrown toenail occurs on the big toes after injury. It can also be a one-time emergency: bruises, broken fingers, etc. As well as long-term traumatic circumstances: uncomfortable, too tight shoes, too elastic tights and socks that squeeze the tips of the nails.

In second place among the causes of the formation of ingrown nails in people who do not have a hereditary predisposition to this is a poor-quality pedicure, during which the side corners of the nail plates are cut off.

Anatomical features of the structure of the nail plates, flat feet, fungal and a number of other systemic diseases that affect the entire body (cancer, tuberculosis, diabetes mellitus) can also cause the nail plates to grow into the surrounding soft tissues of the fingers. Flat feet can also provoke an ingrown toenail.

Elderly people are especially prone to ingrown nails. With age, the nail plate thickens, and its edges may take an irregular shape. Timely pedicure and regular filing of the thickness of the nail with the help of special devices will help to avoid the occurrence of onychocryptosis.

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Ingrown toenail: symptoms and causes.

An ingrown toenail on the big toes (namely, where this pathology occurs most often) is a very common and not always correctly solved problem. Pathology is characterized by a structural disorder in the development of the nail plate, which causes its abnormal formation and growth. As a result, there is a systematic ingrowth of the nail into the ridge of the nail bed, even after surgery or any other type of correction.

Ingrown toenail symptoms

It must be said that an ingrown toenail does not appear spontaneously; its development is preceded by a number of systematically repeated factors (most often) such as:

wearing tight shoes;
wrong pedicure;
fungal infection of the nails;
flat feet;
beriberi.

Separately, factors such as hereditary predisposition and serious injuries of the fingers in the root of the nail plate should be highlighted.

Often, one or all of these factors together lead to nail plate growth disorders and, as a result, to nail ingrowth into nail folds.

An ingrown toenail usually has severe, progressive symptoms. The first and main symptom of this pathology is redness in the area of the nail bed. Over time, if the cause has not been eliminated in time, soreness appears, first weak, then, as the nail grows, intensifying to an acute state. The pain can be localized both directly in the area of the nail bed, and spread throughout the finger and even affect the foot and neighboring fingers.

Along with pain and redness, characteristic swelling of the finger is often observed. “Swelling” is especially pronounced in the area of ingrown nail plate. It can be one-sided, if the nail grows into only one roller, or bilateral, if both rollers are damaged. Over time, swelling can spread to adjacent fingers and to the entire foot.

In addition, since an ingrown nail always provokes the development of an inflammatory process, the temperature of the surrounding tissues increases markedly. The sore finger “warms up”.

If the causes of ingrowth persist, as well as with the development of an inflammatory process in the area of the damaged nail fold, the patient first has a slight, and then a more pronounced increase in body temperature. In some cases, the temperature can rise to 38-38.5 degrees. At this stage, patients often forget about the problem with the nail and begin to be treated for colds.

Over time, the pain becomes so severe that the person loses the ability to move independently. Advanced forms of an ingrown nail can cause ulcers and suppuration in the area of the ingrown nail. An inflamed finger becomes a “prey” for all sorts of infections and viral diseases. Very often, fungal infections of the nails and feet occur against the background of a progressive ingrown nail, to which timely treatment has not been applied.