Ingrown Toenails An ingrown toenail (onychocryptosis) occurs when a section of the nail penetrates the skin, often resulting in the toe becoming inflamed, painful and infected. Most ingrown toenails affect the big toe but the smaller toes can also be affected. The condition may vary in severity from slight discomfort with swelling at the tip of the toe to the entire side of the nail becoming acutely painful often discharging fluid, particularly if infection is present, and the development of enlarged flesh surrounding the nail (granulation tissue).. Some nails press into the skin without piercing the tissue and this is known as an involuted rather than ingrown nail. This can also be painful as a corn/callus is commonly found down the side of the nail as a reaction to the nail pressure.
What causes an ingrown toenailThe following are the main factors involved in the cause of ingrown toenails :-
- The main risk factor is the shape of the nail. Some people have the first toenail that is more curved from side to side rather than being flat, making them more likely to become ingrown. The shape of our nails can be inherited but is also affected by pressure, either from the way we stand and walk, to the type of footwear we choose.
- Poor nail cutting can influence how the remaining nail continues to grow. Cutting toe nails very short or at an angle down the side of the nail may result in the new nail growing in. Trimming too far down the sides or tearing rather than cutting nails is a common cause of an ingrown toenail.
- Footwear with a narrow or shallow toe box is more likely to increase pressure between the skin in the nail fold and nail, increasing the risk of an ingrown nail.
- Previous trauma to the nail may alter the shape of the nail, making it more prone to becoming an ingrown nail
- Ingrown toenails are often a symptom of a foot that is unstable. Pressure at the front of the foot is often due to the back of the foot not held in a level position to the ground and this may need to be looked into as part of the treatment.
- Those with swollen feet or a ‘chubby’ or fleshy toe are more likely to have an ingrown nail.
- Excessive perspiration of the feet can often be a contributory factor, particularly if one or more of the above are also present. Those with sweaty feet may find the skin has less resistance to pressure and can be pierced more easily.