An ingrown toenail is a painful condition of the toe that occurs when the sides or corner of the toenail digs into the skin at the end or side of the toe. The disease mostly affects the outer edge of the big toe, although the nail on both sides of the toe, or nail on any toe can become ingrown.
About 2% of newborn babies are noted at birth to have ingrown toenails because the growing nail plate is very short. It is rarely painful. The appearance rights itself within a year or so.
Treatment is dependent on the stage of the condition. However, at any stage of an ingrown toenail, the patient should avoid tight-fitting or high-heeled shoes. If possible, wear sandals until it has cleared up.
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Stage 2 ingrown toenail may require the administration of topical or oral antibiotics. Topical antibiotic ointments combined with local anaesthetic agents help to heal the toe faster and also provide pain relief by numbing the affected area. Surgical removal of the ingrown toenail may be required if the condition worsens.
Stage 3 ingrown toenail is often treated surgically. The surgical technique of lateral nail avulsion plus matricectomy is highly successful. A brief description of this procedure is given below.
An ingrown toenail may also be treated by a gutter splinter using slit plastic tubing to keep the nail, and the lateral nail folds apart. These are held in place by using tape or acrylic adhesive. An artificial nail may be sculptured using formable acrylic solution.
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Chemical or medical nail avulsion is a painless, slow way to remove damaged nails. As the process destroys the whole nail, it is rarely used for ingrown toenails.
DermNet does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.This article needs more medical referces for verification or relies too heavily on primary sources. Please review the contts of the article and add the appropriate referces if you can. Unsourced or poorly sourced material may be challged and removed. Find sources: "Ingrown nail" – news · newspapers · books · scholar · JSTOR (January 2020 )
An ingrown nail, also known as onychocryptosis from Greek: ὄνυξ (onyx) 'nail' and κρυπτός (kryptos) 'hidd', is a common form of nail disease. It is an oft painful condition in which the nail grows so that it cuts into one or both sides of the paronychium or nail bed. While ingrown nails can occur in the nails of both the hands and the feet, they occur most commonly with the toails (as opposed to fingernails), and for the most part are only problematic and painful on the big toe.
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The condition starts first from a microbial inflammation of the paronychium, and th a granuloma, which results in a nail buried inside of the granuloma.
Symptoms of an ingrown nail include pain along the margins of the nail (caused by hypergranulation that occurs around the aforemtioned margins), worsing of pain wh wearing tight footwear, and ssitivity to pressure of any kind, ev the weight of bedsheets. Bumping of an affected toe can produce sharp and ev excruciating pain as the tissue is punctured further by the nail. By the very nature of the condition, ingrown nails become easily infected unless special care is tak early to treat the condition by keeping the area clean. Signs of infection include redness and swelling of the area around the nail, drainage of pus and watery discharge tinged with blood. The main symptom is swelling at the base of the nail on the ingrowing side (though it may be both sides).
Onychocryptosis should not be confused with a similar nail disorder, convex nail, nor with other painful conditions such as involuted nails, nor with the presce of small corns, callus or debris down the nail sulci (grooves on either side).
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This section needs more medical referces for verification or relies too heavily on primary sources. Please review the contts of the section and add the appropriate referces if you can. Unsourced or poorly sourced material may be challged and removed. Find sources: "Ingrown nail" – news · newspapers · books · scholar · JSTOR (January 2020 )
The main contributor to onychocryptosis is footwear, particularly ill-fitting shoes with inadequate toe box room and tight stockings that apply pressure to the top or side of the foot.
Other factors may include the damp atmosphere of closed shoes, which soft the nail-plate and cause swelling on the epidermal keratin (evtually increasing the convex arch permantly), getics, trauma and disease. Improper cutting of the nail may cause the nail to cut into the side-fold skin from growth and impact, whether or not the nail is truly "ingrown". The nail bds inwards or upwards depding on the angle of its cut. If the cutting tool, such as scissors, is at an attitude in which the lower blade is closer to the toe than the upper blade, the toail will td to grow upwards from its base, and vice versa. The process is visible along the nail as it grows, appearing as a warp advancing to the d of the nail. The upper corners turn more easily than the cter of the nail tip. Holding the tool at the same angle for all nails may induce these conditions; as the nail turns closer to the skin, it becomes harder to fit the lower blade in the right attitude under the nail. Wh cutting a nail, it is not just the correct angle that is important, but also how short it is cut. A shorter cut will bd the nail more, unless the cut is ev on both top and bottom of the nail.
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One study compared patits with ingrown toails to healthy controls and found no differce in the shape of toails betwe those of patits and of the control group. The study suggested that treatmt should not be based on the correction of a non-existt nail deformity.
Ingrown toails are caused by weight-bearing (activities such as walking, running, etc.) in patits that have too much soft skin tissue on the sides of their nail. Weight bearing causes this excessive amount of skin to bulge up along the sides of the nail. The pressure on the skin around the nail results in the tissue being damaged, resulting in swelling, redness and infection. Many treatmts are directed at the nail itself and oft include partial or full removal of the healthy nail. However, failure to treat the cutaneous condition can result in a return of the ingrowth and a deformity or mutilation of the nail.
The most common digit to become ingrown is the big toe, but ingrowth can occur on any nail. Ingrown nails can be avoided by cutting nails straight across; not along a curve, not too short and no shorter than the flesh around it. Footwear that is too small or too narrow, or with too shallow a "toe box", will exacerbate any underlying problem with a toail. Sharp square corners may be uncomfortable and cause snagging on socks. Proper cutting leaves the leading edge of the nail free of the flesh, precluding it from growing into the toe. Filing of the corner is reasonable. Some nails require cutting of the corners far back to remove edges that dig into the flesh; this is oft done as a partial wedge resection by a podiatrist. Ingrown toe nails can be caused by injury, commonly blunt trauma in which the flesh is pressed against the nail causing a small cut that swells. Injury to the nail can cause it to grow abnormally, making it wider or thicker than normal, or ev bulged or crooked.
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Mild to moderate cases are oft treated conservatively with warm water and epsom salt soaks, antibacterial ointmt and the use of dtal floss. If conservative treatmt of a minor ingrown toail does not succeed, or if the ingrown toail is severe, surgical treatmt may be required.
A "gutter splint" may be improvised by slicing a cotton-tipped wood applicator diagonally to form a bevel and using this to insert a wisp of cotton from the applicator head under the nail to lift it from the underlying skin after a foot soak.
Nail bracing is more conservative than surgery, but less widely used. Nail braces work by gtly lifting the sides of the toail and evtually retraining the nail to grow to a flatter shape over time. The total time needed for the nail to be reshaped is one full nail growth or about 18 months.
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There are two main types of nail braces: adhesive and hooked. Adhesive nail braces are gerally made of a thin strip of composite material that is glued to the top of the nail. The strip naturally tries to return to a flat state and lifts the edges of the nails in the process. Hooked nail braces consist of a hook (usually made of dtal wire) placed under either side of the nail with some type of tsioning system pulling the hooks together.
Because of the curved shape of the nail, the tsioning device rests on the higher middle of the nail by applying upward pressure to the
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