Ingrown nails
This condition commonly affects the big toe, but it can occur in any toenail. If not properly treated, ingrown nails can lead to complications and may require medical attention, such as nail avulsion or surgical procedures to remove the ingrown portion of the nail.
The medical term for ingrown nails is "onychocryptosis." The term "onychocryptosis" has its roots in Greek. The word is derived from two Greek components:
Onycho- (ὄνυξ): This prefix is related to the Greek word for "nail" or "claw."
Crypt- (κρυπτός): This component means "hidden" or "concealed."
Combining these elements, "onychocryptosis" essentially refers to a condition where the nail is hidden or buried, which accurately describes the nature of ingrown nails, where the edge or corner of the nail grows into the surrounding skin.
Ingrown toenails can cause a range of symptoms, and the severity of symptoms can vary depending on the extent of the ingrowth and the presence of infection. Common symptoms of ingrown toenails include:
Pain and Tenderness:
Pain is one of the most common symptoms of an ingrown toenail. Discomfort is often felt along the side of the affected toenail, especially when pressure is applied.
Swelling:
The skin around the ingrown toenail may become swollen, red, and inflamed.
Redness:
The skin near the ingrown toenail may appear red, indicating inflammation and irritation.
Warmth:
The affected area may feel warm to the touch due to inflammation.
Pus or Drainage:
In cases where an ingrown toenail becomes infected, pus may accumulate, and there may be drainage of yellow or white fluid.
Difficulty Wearing Shoes:
Due to pain and swelling, wearing shoes, especially those that press on the toes, may become uncomfortable.
Overgrowth of Tissue:
In response to chronic irritation, the skin along the side of the ingrown toenail may overgrow, forming a swollen and tender mass known as a "granuloma."
Infection:
If bacteria enter the broken skin around the ingrown toenail, an infection can occur. Signs of infection may include increased redness, swelling, warmth, and the presence of pus.
Foul Odor:
In cases of infection, there may be a foul odor associated with the drainage from the ingrown toenail.
If an ingrown toenail is causing significant pain, signs of infection, or recurrent issues, seeking professional medical attention is advisable. Attempting to self-treat severe cases or ignoring signs of infection can lead to complications. Healthcare providers, such as podiatrists or dermatologists, can provide appropriate evaluation and treatment, including minor surgical procedures if necessary.
Causes
Ingrown toenails can be caused by a variety of factors, and they often result from the interaction of multiple contributing factors. Common causes include:
Improper Nail Trimming:
Trimming toenails too short or rounding them instead of cutting straight across can encourage the nail to grow into the surrounding skin.
Ill-Fitting Footwear:
Wearing shoes that are too tight or narrow can compress the toes, putting pressure on the toenails and leading to ingrowth.
Toe Injuries:
Trauma or injury to the toe, such as stubbing it, can cause the nail to grow abnormally and contribute to ingrown toenails.
Genetics:
Some people may be genetically predisposed to developing ingrown toenails. If family members have a history of ingrown toenails, an individual may be more susceptible.
Abnormal Nail Shape:
Certain nail shapes, such as curved or involuted nails, may increase the likelihood of ingrown toenails.
Excessive Sweating:
Prolonged exposure to moisture, such as sweaty feet, can soften the skin around the nails, making it easier for the nail to penetrate the skin.
Poor Foot Hygiene:
Inadequate foot hygiene, such as not keeping the feet clean and dry, can contribute to the development of ingrown toenails.
Health Conditions:
Certain health conditions, such as fungal infections or nail disorders, may affect the growth and structure of the toenails, increasing the risk of ingrown nails.
Heredity:
A family history of ingrown toenails may increase an individual's likelihood of experiencing the condition.
Toe Deformities:
Structural abnormalities of the toes, such as bunions or hammertoes, can alter the pressure distribution on the toenails, contributing to ingrown toenails.
Babies are not more likely to have ingrown nails but some may be genetically predisposed
It is best to address the underlying causes to prevent the recurrence of ingrown toenails. Proper nail care, wearing well-fitting shoes, and maintaining good foot hygiene are essential preventive measures. In cases where ingrown toenails are persistent or causing significant discomfort, it's advisable to see a doctor.
Treatments
The treatment for an ingrown toenail depends on the severity of the condition and whether there is an associated infection. Here are some common treatments for ingrown toenails:
Warm Water Soaks:
Soaking the affected foot in warm water for 15-20 minutes, a few times a day, can help reduce pain and inflammation. Adding Epsom salt to the water may provide additional relief.
Cotton Under the Nail:
After soaking, placing a small piece of cotton or dental floss under the ingrown edge of the toenail can help lift the nail and encourage it to grow over the skin.
Proper Nail Trimming:
Trim the toenails straight across, avoiding rounding the edges. This can help prevent the nail from growing into the surrounding skin.
Foot Elevation:
Elevate the affected foot to reduce swelling, especially when resting or sleeping.
Antibiotic Ointment:
Applying over-the-counter antibiotic ointment to the affected area can help prevent infection.
Wearing Comfortable Shoes:
Choose footwear that provides enough room for the toes, avoiding tight or narrow shoes that can squeeze the toes.
Over-the-Counter Pain Medications:
Non-prescription pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation.
Avoid Aggravating Activities:
Limit activities that put excessive pressure on the toes, such as running or activities that involve repetitive impact.
Professional Nail Trimming:
A healthcare provider, such as a podiatrist, may trim the ingrown portion of the nail in a sterile environment.
Partial Nail Removal (Partial Nail Avulsion):
In cases where conservative measures are ineffective, a healthcare provider may partially remove the ingrown portion of the nail, often under local anesthesia.
Matrixectomy:
This procedure involves removing or destroying a part of the nail matrix to prevent regrowth of the ingrown portion. It is typically reserved for recurrent cases.
Total Nail Removal (Total Nail Avulsion):
In severe or recurrent cases, the entire toenail may need to be removed. This is done under local anesthesia.
Avoid rounding the edges
Straight cut is better
If signs of infection, such as increased redness, swelling, warmth, or the presence of pus, are present, seek medical attention promptly.
Surgical Treatments
When conservative or home treatments are ineffective or if an ingrown toenail becomes a recurrent or severe problem, surgical intervention may be recommended. There are a few different surgical procedures that healthcare providers may use to address ingrown toenails:
Partial Nail Avulsion (PNA):
This is a common and relatively simple surgical procedure. It involves the removal of a portion of the toenail, particularly the ingrown or affected part. The healthcare provider may use a local anesthetic to numb the toe before removing the nail. This procedure is often performed in an outpatient setting.
Total Nail Avulsion:
In more severe cases, or when ingrown toenails are recurrent, the entire toenail may need to be removed. This procedure is known as total nail avulsion. It involves the complete removal of the toenail, including the matrix (the area where the nail grows from). This is typically done using a local anesthetic.
Matrixectomy:
A matrixectomy involves the removal or destruction of a part of the nail matrix to prevent regrowth of the ingrown portion. This procedure is more involved than partial or total nail avulsion and is typically reserved for cases with persistent ingrown toenails.
Laser Therapy:
Some healthcare providers may use laser therapy to treat ingrown toenails. Laser treatment can help destroy the cells responsible for nail growth, preventing the regrowth of the ingrown portion. This method may be less common and is not widely adopted in all settings.
After the surgical procedure, the toe is typically dressed, and postoperative care instructions are provided. Recovery time varies depending on the extent of the procedure, but patients can usually resume normal activities relatively quickly.
