Ingrown nail causes. Ingrown Toenails: Causes, Symptoms, and Effective Treatments

14.07.202303.07.2023 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. When should you seek medical attention for an ingrown toenail. How can you prevent ingrown toenails from occurring.

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Understanding Ingrown Toenails: A Common Foot Problem

Ingrown toenails are a prevalent and often painful condition that affects many people, particularly teenagers. This issue occurs when the edge of the toenail grows into the surrounding skin, causing discomfort, redness, and potential infection. While any toenail can become ingrown, the big toe is most commonly affected.

What exactly happens when a toenail becomes ingrown? The sides of the nail curl downward and dig into the skin, leading to irritation and inflammation. In some cases, this can progress to infection, causing more severe symptoms and requiring medical intervention.

Common Causes of Ingrown Toenails: From Trimming Habits to Footwear

Several factors can contribute to the development of ingrown toenails:

Improper nail trimming techniques
Wearing shoes that are too tight or short
Trauma to the toe, such as stubbing or having it stepped on
Genetic predisposition (congenital cases where the nail is too large for the toe)
Repetitive pressure from certain activities or sports

How does improper nail trimming lead to ingrown toenails? When you cut your toenails too short, especially on the sides of your big toes, you create an environment where the nail is more likely to grow into the skin. Many people tend to taper the corners of their nails to match the shape of their toes, but this technique can encourage the nail to curl downward and penetrate the skin.

The Role of Footwear in Ingrown Toenail Development

Can your choice of shoes really affect your risk of ingrown toenails? Absolutely. Wearing shoes that are too tight or too short puts pressure on your toes, potentially forcing the nail to grow abnormally. This is particularly true for shoes with narrow toe boxes that squeeze the toes together.

Recognizing the Symptoms: Early Signs to Advanced Complications

Identifying an ingrown toenail early can help prevent more serious complications. What are the initial signs to watch for?

Tenderness or hardness around the edge of the toenail
Swelling of the skin next to the nail
Pain when pressure is applied to the toe
Redness around the toenail

As the condition progresses, you may notice more severe symptoms:

Increased pain and swelling
Redness spreading beyond the immediate nail area
Warmth in the affected area
Pus or drainage from the site
Difficulty wearing shoes or walking comfortably

Diagnosing Ingrown Toenails: When to Seek Professional Help

While minor cases of ingrown toenails can often be managed at home, certain situations warrant a visit to a healthcare professional. When should you consider seeking medical attention?

If you have diabetes, circulation problems, or a weakened immune system
When there are signs of infection (excessive redness, warmth, pus)
If home remedies haven’t improved the condition after a few days
When pain is severe or interferes with daily activities
If you experience recurring ingrown toenails

How do healthcare professionals diagnose ingrown toenails? Typically, a visual examination is sufficient. The doctor will assess the affected toe, looking for signs of infection and determining the severity of the ingrown nail. In some cases, they may gently probe the area to check for pus or other signs of complication.

Home Remedies and Self-Care: Managing Minor Cases

For mild cases of ingrown toenails, several home remedies can provide relief and promote healing:

Soak the affected foot in warm water for 15-20 minutes, 3-4 times daily
Keep the foot dry between soaks to prevent bacterial growth
Wear comfortable, roomy shoes or sandals to reduce pressure on the toe
Use over-the-counter pain relievers like ibuprofen or acetaminophen if needed
Gently lift the edge of the ingrown nail and insert a small piece of cotton or dental floss to encourage proper growth

How effective are these home remedies? While they can be quite helpful for minor cases, it’s important to monitor the condition closely. If there’s no improvement after 2-3 days or if symptoms worsen, it’s time to consult a healthcare professional.

The Cotton Method: A Temporary Solution

Can placing cotton under the nail edge really help? This technique, known as the cotton method, can provide temporary relief by separating the nail from the skin. Here’s how to do it safely:

Soak the foot in warm water to soften the nail and skin
Gently lift the edge of the ingrown nail using a clean, blunt tool
Insert a small piece of sterile cotton or waxed dental floss under the nail edge
Change the packing daily and after each foot soak

While this method can be effective, it’s crucial to maintain proper hygiene to prevent infection. If you’re unsure about performing this technique or if it causes pain, consult a healthcare provider.

Medical Treatments: When Professional Intervention is Necessary

In cases where home remedies are ineffective or when infection is present, medical treatment may be necessary. What options do healthcare professionals have for treating ingrown toenails?

Partial nail avulsion: Removing the ingrown portion of the nail
Complete nail plate avulsion: Removing the entire nail (less common)
Matricectomy: Removing part of the nail bed to prevent regrowth
Oral antibiotics: Prescribed for cases with infection

The Partial Nail Avulsion Procedure

How is a partial nail avulsion performed? This common procedure involves the following steps:

The toe is numbed with a local anesthetic
The ingrown portion of the nail is carefully cut away
The nail bed is left undisturbed to allow for proper regrowth
The area is dressed to promote healing

Recovery from this procedure typically takes 3-4 months as the nail regrows. It’s generally effective in eliminating the ingrown edge and preventing it from cutting into the skin as the nail grows forward.

Prevention Strategies: Keeping Ingrown Toenails at Bay

While some cases of ingrown toenails are due to genetic factors, many can be prevented with proper foot care and habits. What are some effective prevention strategies?

Trim nails straight across, avoiding rounding the corners
Keep nails at a moderate length, not too short or too long
Wear shoes that fit properly with adequate room in the toe box
Use protective footwear in activities that risk toe injury
Practice good foot hygiene, keeping feet clean and dry

Proper Nail Trimming Technique

How should you trim your toenails to prevent ingrowth? Follow these guidelines:

Use clean, sharp nail trimmers
Cut straight across, avoiding curved cuts
Don’t cut nails shorter than the edge of the toe
File any sharp edges with an emery board

By maintaining these habits, you can significantly reduce your risk of developing ingrown toenails.

Special Considerations: Ingrown Toenails in High-Risk Individuals

Certain groups of people are at higher risk for complications from ingrown toenails. Who should be especially vigilant about foot care?

People with diabetes
Individuals with peripheral neuropathy
Those with poor circulation
People with compromised immune systems

Why are these groups at higher risk? Conditions like diabetes can impair sensation in the feet, making it harder to detect early signs of ingrown toenails. Additionally, poor circulation can slow healing and increase the risk of infection. For these individuals, regular foot checks and prompt treatment of any foot issues are crucial.

Foot Care Tips for High-Risk Individuals

If you’re in a high-risk group, how can you best care for your feet? Consider these tips:

Inspect your feet daily for any changes or signs of injury
Moisturize your feet to prevent dry, cracked skin
Wear clean, dry socks and change them daily
Never go barefoot, even indoors
Have regular check-ups with a podiatrist or foot care specialist

By following these guidelines, you can help prevent ingrown toenails and other foot complications that could lead to more serious health issues.

The Impact of Lifestyle on Ingrown Toenail Risk

Your daily activities and lifestyle choices can influence your risk of developing ingrown toenails. What factors should you be aware of?

Occupation: Jobs that require prolonged standing or tight safety shoes
Sports: Activities that put repetitive pressure on the toes
Footwear choices: Regularly wearing high heels or tight shoes
Hygiene habits: Poor foot hygiene or excessive moisture

How can you mitigate these risks? If your job or hobbies put you at higher risk, take extra care to wear properly fitting shoes and practice good foot hygiene. Consider using protective toe caps or padding in shoes for high-impact activities. For those who must wear certain types of footwear for work, try to give your feet a break when off-duty by wearing comfortable, roomy shoes.

The Role of Nutrition in Nail Health

Can your diet affect your toenails? While not directly linked to ingrown toenails, overall nail health can be influenced by nutrition. A balanced diet rich in these nutrients can promote strong, healthy nails:

Protein
Biotin
Omega-3 fatty acids
Vitamin E
Zinc

By maintaining a healthy diet and staying hydrated, you can support overall nail health, potentially reducing the risk of nail-related issues.

Ingrown Toenail – OrthoInfo – AAOS

If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail. Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe. But this technique may encourage your toenail to grow into the skin of your toe. The sides of the nail curl down and dig into your skin. An ingrown toenail may also happen if you wear shoes that are too tight or too short.

An ingrown toenail.

When you first have an ingrown toenail, it may be hard, swollen and tender. Later, it may get red and infected, and feel very sore. Ingrown toenails are a common, painful condition—particularly among teenagers. Any of your toenails can become ingrown, but the problem more often affects the big toe. An ingrown nail occurs when the skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. Redness, pain and swelling at the corner of the nail may result and infection may soon follow. Sometimes a small amount of pus can be seen draining from the area.

Ingrown nails may develop for many reasons. Some cases are congenital—the nail is just too large for the toe. Trauma, such as stubbing the toe or having the toe stepped on, may also cause an ingrown nail. However, the most common cause is tight shoe wear or improper grooming and trimming of the nail.

The anatomy of a toenail.

Nonsurgical Treatment

Ingrown toenails should be treated as soon as they are recognized. If they are recognized early (before infection sets in), home care may prevent the need for further treatment:

Soak the foot in warm water 3-4 times daily.
Keep the foot dry during the rest of the day.
Wear comfortable shoes with adequate room for the toes. Consider wearing sandals until the condition clears up.
You may take ibuprofen or acetaminophen for pain relief.
If there is no improvement in 2-3 days, or if the condition worsens, call your doctor.

You may need to gently lift the edge of the ingrown toenail from its embedded position and insert some cotton or waxed dental floss between the nail and your skin. Change this packing every day.

Surgical Treatment

If excessive inflammation, swelling, pain and discharge are present, the toenail is probably infected and should be treated by a physician (see left image below). You may need to take oral antibiotics and the nail may need to be partially or completely removed (see middle image below). The doctor can surgically remove a portion of the nail, a portion of the underlying nail bed, some of the adjacent soft tissues and even a part of the growth center (see right image below).

Possible treatment options for an ingrown toenail.

Surgery is effective in eliminating the nail edge from growing inward and cutting into the fleshy folds as the toenail grows forward. Permanent removal of the nail may be advised for children with chronic, recurrent infected ingrown toenails.

If you are in a lot of pain and/or the infection keeps coming back, your doctor may remove part of your ingrown toenail (partial nail avulsion). Your toe is injected with an anesthetic and your doctor uses scissors to cut away the ingrown part of the toenail, taking care not to disturb the nail bed. An exposed nail bed may be very painful. Removing your whole ingrown toenail (complete nail plate avulsion) increases the likelihood your toenail will come back deformed. It may take 3-4 months for your nail to regrow.

Unless the problem is congenital, the best way to prevent ingrown toenails is to protect the feet from trauma and to wear shoes and hosiery (socks) with adequate room for the toes. Nails should be cut straight across with a clean, sharp nail trimmer without tapering or rounding the corners. Trim the nails no shorter than the edge of the toe. Keep the feet clean and dry at all times.

Proper and improper toenail trimming.

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Ingrown Toenails: Causes, Symptoms, and Diagnosis

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Home treatment

To treat your ingrown toenail at home, try:

soaking your feet in warm water for about 15 to 20 minutes three to four times per day (At other times, your shoes and feet should be kept dry.)
pushing skin away from the toenail edge with a cotton ball soaked in olive oil
using over-the-counter medicines, like acetaminophen (Tylenol), for the pain
applying a topical antibiotic, such as polymyxin and neomycin (both present in Neosporin) or a steroid cream, to prevent infection

Try home treatments for a few days to a few weeks. If the pain worsens or you find it difficult to walk or perform other activities because of the nail, see your doctor.

If the toenail does not respond to home treatments or an infection occurs, you may need surgery. In cases of infection, stop all home treatments and see your doctor.

Surgical treatment

There are different types of surgical treatments for ingrown toenails. Partial nail removal only involves removing the piece of nail that is digging into your skin. Your doctor numbs your toe and then narrows the toenail. According to the NHS, partial nail removal is 98 percent effective for preventing future ingrown toenails.

During a partial nail removal, the sides of the nail are cut away so that the edges are completely straight. A piece of cotton is placed under the remaining portion of the nail to keep the ingrown toenail from recurring. Your doctor may also treat your toe with a compound called phenol, which keeps the nail from growing back.

Total nail removal may be used if your ingrown nail is caused by thickening. Your doctor will give you a local pain injection and then remove the entire nail in a procedure called a matrixectomy.

After surgery

After surgery, your doctor will send you home with your toe bandaged. You will probably need to keep your foot raised for the next one to two days and wear special footwear to allow your toe to heal properly.

Avoid movement as much as possible. Your bandage is usually removed two days after surgery. Your doctor will advise you to wear open-toe shoes and to do daily salt water soaks until your toe heals. You will also be prescribed pain relief medication and antibiotics to prevent infection.

Your toenail will likely grow back a few months after a partial nail removal surgery. If the entire nail is removed down to the base (the nail matrix under your skin), a toenail can take over a year to grow back.

If left untreated, an ingrown toenail infection can cause an infection in the bone in your toe. A toenail infection can also lead to foot ulcers, or open sores, and a loss of blood flow to the infected area. Tissue decay and tissue death at the site of infection are possible.

A foot infection can be more serious if you have diabetes. Even a small cut, scrape, or ingrown toenail may quickly become infected due to the lack of blood flow and nerve sensitivity. See your doctor right away if you have diabetes and are concerned about an ingrown toenail infection.

If you have a genetic predisposition to ingrown toenails, they may keep coming back or appear on multiple toes at once. Your quality of life may be affected by pain, infections, and other painful foot issues that require multiple treatments or surgeries. In this case, your doctor may recommend a partial or full matrixectomy to remove the toenails causing chronic pain. Read more about foot care and diabetes.

Ingrown toenails can be prevented by making several lifestyle changes:

Trim your toenails straight across and make sure that the edges do not curve in.
Avoid cutting toenails too short.
Wear proper fitting shoes, socks, and tights.
Wear steel-toe boots if you work in hazardous conditions.
If your toenails are abnormally curved or thick, surgery may be necessary to prevent ingrown nails.

A:

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Ingrown toenail: symptoms, causes, treatment

An ingrown toenail is a common ailment. It is the ingrowth of the edge of the nail plate into the human flesh. This usually occurs on one or both sides, but central ingrowth may also occur.

Main causes

In the vast majority of cases, pathology is formed on the legs, and one of the main reasons for this is the wrong choice of shoes. It puts pressure on the nail, and it moves towards the skin.

The most common causes of an ingrown toenail are:

inability to properly trim nails;
genetic facto;
fungal disease: some types of fungi destroy the nail plate, causing it to change its shape;
deformity of the foot (often as a result of wearing smaller shoes), flat feet;
Injury to the finger that pierced the nail plate and prevented it from growing as it did before.

Symptoms of disease

The first manifestations of the disease are usually not paid too much attention, although it is quite easy to prevent complications at an early stage. The signs of an ingrown toenail are:

first, the skin surrounding the nail turns red, then swelling forms in this area, pain appears when touching it;
pus and blood begin to ooze from the damaged area, as the nail digs deeper into the skin, provoking an infection;
if nothing is done, the ingrown part of the nail becomes denser, its deformation is almost irreversible; bone tissue is affected. At this stage, the disease becomes chronic. It is no longer possible to permanently fix the nail, but there is a chance to avoid a relapse with proper care.

Diagnosis of disease

Having discovered the symptoms of an ingrown nail, it is necessary to go for an examination to a specialist – a surgeon as soon as possible in order to prevent the possible development of the disease.

In the advanced stage, when there is a clear infection (severe redness and swelling speak of it), laboratory tests can be prescribed:

complete blood count;
blood sugar test (done to rule out diabetes).

In rare, especially advanced cases, an x-ray of the hand or foot is performed to exclude the fact of damage to the bone tissue.

Treatment features

Treatment of an ingrown nail begins with getting rid of acute symptoms, namely, with the surgical removal of the interfering edge of the nail plate, relieving inflammation.

Initial treatment

Further, the following options are possible to prevent a recurrence of the situation:

Acrylic correction of ingrown toenails – carried out approximately once every 6 months. Contrary to popular belief, the generally accepted nail extension performs not only an aesthetic, but also a healing function. With its help, the nail plate acquires the correct shape without growing into the skin of the finger;
hardware pedicure – can be cosmetic and performed by a pedicure master, as well as medical: with the fixation of special plates (performed by a specialist with a medical education).

However, both options are effective only in the initial stages of nail ingrowth into the skin. In the case when pus has formed or bone tissue has suffered, they are ineffective.

Advanced treatment

If an ingrown toenail is a serious concern, then you will most likely have to resort to more drastic measures.

Correction of the nail with a plate. A special plate is applied to a part of the nail from the outside, which controls the degree of pressure on it. It gently aligns the nail from the edge, thereby giving it a different shape, harmless to the skin.
Ingrown toenail laser correction – allows you to achieve a quick and effective result. The disadvantage of this procedure is its relative high cost. Does not completely remove the nail plate, gently removing only its excess part. The procedure is completely painless, however, if there is an inflammatory process on the nail, it must first be removed with anti-inflammatory drugs.
Radio wave exposure – is the removal of the overgrown part of the nail with the help of radio waves. The procedure is fast, effective, painless and does not require additional preparatory steps. It implies the introduction of local anesthesia, the treatment of the nail with a scalpel, the necessary nozzles and an antiseptic.
Surgical treatment of an ingrown toenail – used in advanced cases, when pus accumulates under the skin around. It is carried out under local anesthesia, requires separate preparation (preliminary diet, refusal of antibiotics and a number of other drugs). The whole operation takes about half an hour and requires some post-operative care (in particular, changing the dressing, washing the finger, applying an antibiotic ointment and a timely visit to the surgeon).

FAQ

Can an ingrown toenail be treated at home?

It is possible to correct the situation only at the very initial stage, but, unfortunately, in most cases, patients skip it, noticing the problem only when additional help is already required.

What does an ingrown toenail look like?

It is an overgrown nail plate, one edge of which digs into the skin. When pressed, it can cause pain.

What preventive measures should be taken to avoid the problem of an ingrown toenail?

You should purchase high-quality shoes that have the appropriate certificates, mainly from natural materials and always in size. Do not wear smaller shoes. If the shoes are crushing, they should be discarded. It is also necessary to properly trim the nails (use nail scissors or nippers) and periodically give the foot a break from wearing any shoes.

Ingrown toenail: which specialist should I contact?

The following specialists are involved in the treatment, depending on the stage of development of the disease: pedicure master, podologist, surgeon.

Ingrown nail. Causes. Treatment.

Ingrown toenail. Causes. Treatment.

January 15, 2020

Ingrown toenail is a very common disease that can occur in almost every person. From the studies of various authors, it is known that both male and female patients, of all ages, of any profession and occupation, are susceptible to an ingrown nail. Ingrown nails occur mainly on the first (rarely on the second) toe of the lower extremities and are more often detected on the right foot. On the inside of the nail, ingrowth occurs 7-8 times more often and is more severe than on the outside.

An ingrown toenail can appear due to various provoking factors. However, the main reasons should be highlighted:

· Wearing the wrong shoes. So wearing tight or narrow shoes due to pressure on the corners of the fingers can cause the nail to grow into the nail fold. In addition, sweating in such a situation becomes a favorable condition for the fungal process.

Hereditary causes. When diagnosing this pathology in the next of kin, it is necessary to monitor the condition of the fingers even more carefully, since a predisposition to the disease is inherited.

Incorrectly done manicure. Not everyone knows how to cut their nails correctly. Meanwhile, excessive trimming of the edges of the nail causes trauma to the skin.

· Congenital deformities of the feet can also cause the nail plate to grow into the skin.

· Injury to the foot is a provoking factor for crashing.

· Fungal infection of the feet causes an increase in the number of layers in the nail. Further, the thick nail plate quickly grows into the skin roller.

The main symptoms of an ingrown toenail:

· sensation of discomfort and pain in the area of incision;

development of inflammatory changes in the skin in the affected area;

occurrence of an unpleasant odor from the lower extremities;

· at a later date, a purulent discharge may appear in the pathological area.

In order not to think about what an ingrown nail is, the treatment of this disease and its complications, it is enough to follow a few simple rules.

Wear only loose and comfortable footwear.

· Promptly treat orthopedic diseases.

· Do not start the development of the fungal process of the foot.

Use the correct nail clipping technique.

Since the initial manifestations of the disease are treated with conservative methods, it is necessary to seek the help of specialists at the first symptoms.

Conservative methods.

Their main goal is to combat purulent-inflammatory processes and reduce the intensity of pain in the affected area of the finger, prevent its injury and create conditions for the unhindered growth of the nail plate.

For this, lotions with antiseptic solutions, hot foot baths with potassium permanganate or anti-inflammatory infusions of plant origin (calendula), Levomikol, antimicrobials, such as Baneocin in the form of an ointment or powder, are used. All this is combined with the displacement of inflamed soft tissues hanging as a result of edema, the application of gauze rollers or / and bringing under the sharp edge of the nail plate (if possible) gauze strips or thin rollers soaked in an ointment or solution containing antiseptic components. In the process of treatment, it is necessary to correctly periodically cut the nail in compliance with antiseptic measures and use loose shoes.

The use of conservative treatment is justified only at the initial stages of the disease, as well as in cases where the patient refuses more radical methods or is unable to use them for any reason.

Orthopedic techniques

They are characterized by great variety and have been used in different versions for a long time. The principle of their action is the gradual extension and increase in the radius of curvature of the nail plate by changing the direction of tension.

As a result of this, the edges of the ingrown nail are lifted and separated from the tissues of the nail fold, which helps to reduce pressure on them and reduce the degree of ingrown. Pre-rigid areas of the nail are treated with a softening compound.

Custom made metal springs or staples, identical to brackets, are used for orthopedic treatment. In recent years, correction of the ingrown nail with plates has been quite often used.

Flat leaf springs made of polymer materials are adapted to the curvature of the nail by means of a drill and glued to it with their entire surface using a special adhesive. On top of such plates, it is possible to apply nail polish. They are changed once a month. The whole process of treatment takes 3-4 months.

Recurrence of the disease is also possible after orthopedic treatment.

Surgical treatment.

Depending on the degree of nail plate ingrowth, the course of the disease (infection, discharge of pus, etc.), the first case of the disease or relapse, one of the methods of surgical treatment is selected.

· Resection (partial removal of the nail). Part of the nail plate that has grown into the skin is removed. The operation is performed under local infiltration anesthesia on an outpatient basis. There are two types of resection: marginal wedge resection and selective resection of the matrix (growth zone). Without removal of the matrix, relapses very often occur, repeated surgical interventions are necessary.

· Avulsion operation (complete removal of the nail). The operation consists in complete excision (tearing off) of the nail plate without damaging the soft tissues along the edge of the nail bed. Therefore, over time, the nail grows back. It is carried out most often with the development of an infectious-inflammatory process. This type of surgical treatment of onychocryptosis is traumatic, after which frequent relapses are noted.

· Vandenbos operation (removal of skin at the base of the nail). The operation is performed under local anesthesia, consists in removing the skin along the edge of the nail and does not affect the nail plate. After surgery, relapses are very rare. But such a surgical intervention is traumatic, after which the healing period is quite long.

Syme operation (complete removal of the nail matrix). This type of surgical intervention consists in the removal of the nail matrix, skin flap transplantation and partial osteotomy of the phalanx.