Ingrown Toenails

What are the other Names for this Condition? (Also known as/Synonyms)

• Nail Avulsion
• Onychocryptosis
• Unguis Incarnatus

What are Ingrown Toenails? (Definition/Background Information)

• An Ingrown Toenail is a common painful condition that occurs, when the nail edge grows down, into the soft tissue (usually the nail bed) of the toe
• A majority of such conditions involve the big toe. It may be caused by a repeated trauma to the toe, usually due to participation in certain type of sports. Studies have indicated that the condition may have a genetic component
• Ingrown Toenails are commonly seen in teenagers and older individuals. It is also observed that this condition is generally present in a population that wears shoes. Individuals, who mostly walk barefoot, do not seem to get the condition
• Both nonsurgical and surgical methods are available to treat the condition

Who gets Ingrown Toenails? (Age and Sex Distribution)

• Ingrown Toenails may occur in individuals of all ages, race, ethnic groups, and gender
• Teenagers and older individuals have the highest occurrence rate

What are the Risk Factors for Ingrown Toenails? (Predisposing Factors)

Common risk factors for Ingrown Toenails include:

• Physically-active individuals, who participate in certain sports
• Some studies have shown that Ingrown Toenails may have a genetic component
• Individuals, who regularly wear shoes for prolonged periods on a continuous basis, may be at risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ingrown Toenails? (Etiology)

Some common causes of Ingrown Toenail include:

• Improper cutting of toenails, such as rounding-off (shaping) the edge nails, as opposed to cutting nails straight across
• Recurring injury to the toe, due to participation in certain sports activities
• Wearing tight shoes, which put abnormal pressure on the nails
• Abnormal curvature of the toenails, caused due to genetic defects
• Infection of the nail
• Poor foot hygiene
• Excessive sweating
• Individuals, who have a family history of Ingrown Toenails may have an increased risk of the condition

What are the Signs and Symptoms of Ingrown Toenails?

The signs and symptoms of Ingrown Toenails include:

• Pain and tenderness felt in the toe
• Inflammation of the nail bed
• Swelling and redness around the toenail
• Infection of the tissue surrounding the toenail

How are Ingrown Toenails Diagnosed?

Common diagnostic methods that a physician may use to help diagnose Ingrown Toenails include:

• Physical examination: A physician can usually diagnose an Ingrown Toenail, based upon its location, appearance, and the symptoms presented
• In addition to this, a complete medical history may aid in arriving at a definitive diagnosis
• This toenail condition should not be confused with corns, calluses, or involution of nails

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ingrown Toenails?

A few complications associated with Ingrown Toenails include:

• Infection of the bone (osteomyelitis)
• Infection and ulceration of the affected toe(s) causing a swelling of the toe, drainage of pus, and redness
• Improper or delayed healing of the toenail

How are Ingrown Toenails Treated?

Treatments associated with Ingrown Toenails include both nonsurgical and surgical methods. Individuals in whom there is excessive bleeding or an infection, surgery may be necessary.

Nonsurgical treatment measures include:

• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to treat Ingrown Toenails. These medications can help decrease the pain and swelling
• Soaking the foot in warm water on a regular basis can help relieve some pain
• Application of an antibiotic cream to the affected area

Surgical treatment measures include:

• Adhesive nail bracing and hooked nail bracing: It is a common method to treat the condition. In this procedure, the nail is lifted-up for a period of time so that the nail grows back into its natural shape
• A partial nail avulsion, called wedge resection of lateral nail plate, is a surgical approach that involves a partial removal of the nail plate
• A complete nail avulsion is a surgical approach that involves the complete removal of the toenail
• A partial nail removal can be performed either as a partial nail extraction with phenolisation, or as a partial excision of the nail matrix

A few other surgical procedure types include:

• Chemical matriectomy (such as phenol matriectomy)
• Ablative matriectomy (using electrodissection and curettage method)
• Radical matriectomy (also called syme procedure)

The healthcare provider shall decide and recommend the kind of procedure that is best-suited for each specific individual.

How can Ingrown Toenails be Prevented?

A few preventative methods for Ingrown Toenails include:

• Regularly wear appropriate footwear (such as the proper shoe size); especially so, while participating in sports
• Keep the toenails trimmed to proper shape; do ensure that the nails are cut straight across
• Keep your feet clean and dry and protect them from any infection

What is the Prognosis of Ingrown Toenails? (Outcomes/Resolutions)

• In a majority of the individuals, the prognosis with Ingrown Toenails is usually good
• However, long-term complications may occur in individuals, who have diabetes, poor blood circulation (peripheral vascular disease - PVD), and peripheral neuropathies (nerve damage)

Additional and Relevant Useful Information for Ingrown Toenails:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/orthopedc-disorders/