Known as ‘onychocryptosis’, this is a common, painful condition which occurs when the skin on the side of the toenail grows over the edge of the nail or when the nail grows into the skin.
It is most common on the big toe, however it can develop on the other toes.
Usually the side of the nail penetrates deeply and it is difficult to see the edge. Some will just have a nail that appears deeply embedded down the side or sides of the nail. In some, the corner or a small spike of nail may penetrate the skin. It can be extremely painful, red and inflamed and in more severe cases can result in an infection, pus and bleeding. The toe may become red and inflamed.
Ingrown toenails can develop for many reasons:
In some cases the nail is more curved than usual rather than being flat, this will cause the edge of the nail to grow in. The most severe example of this type of nail is one in which both sides of the nail are very curved, this is more commonly called a ‘pincer nail’ and the shape is usually inherited, but can be influenced by trauma or shoe pressure. Trauma, such as stubbing a toe or having one stepped on can cause a piece of nail to jam into the skin.
Incorrect trimming is widely regarded as the most common cause. The nails should be cut straight across avoiding cutting too low at the edge or down the side. The corner of the nail should be filed and be visible above the skin.
Cutting after a bath or shower is recommended as the nails are soft. Pressure from an adjacent toe, a bone deformity (e.g. bunion), tight-fitting footwear or hosiery can also be causative factors.
Signs and Symptoms
Ingrown nails should be treated as soon as they develop. Unfortunately the first sign of an ingrown nail problem is pain. If the skin is red, painful or swollen on the sides of the nail, there may be an infection.
The ingrown nail is in a warm, often moist, bacteria-rich environment, this provides a convenient entry for germs that cause infection.
The offending spike of nail must be removed using sterile instruments, after this some antiseptic dressing is required for a few days, which in most cases will clear the infection. In some cases a course of antibiotics may be required. For nails that are excessively curved, a nail brace may be applied, which over time and as the nail grows will straighten the curvature.
In recurrent cases it may be advisable to have a surgical procedure to remove the offending side of the nail. The cells responsible for making that section of nail are destroyed through the use of a chemical.
People attempting to self-treat an infected toenail may worsen the problem.
Diabetic persons should consult a registered Chiropodist or their GP for all foot abnormalities.