An ingrown Toenail,
or onychocryptosis, is a condition that commonly affects the big toenail
although it can also occur in any of the other toes.
specific causative factors of onychocryptosis are still unknown. However, it is
known to be caused by pressure exerted by the in-growth of the Toenail edge
into the toe’s skin, resulting in inflammation.
the condition causes discomfort which soon develops into an infection (cellulites)
and then becomes a recurring
problem. It is associated with toe injuries and is common among athletes,
especially those participating in ‘stop and start’ sports such as tennis,
soccer and basket ball.
Some of the common causes of
ingrown Toenails include:
- Ill-fitting shoes
- Improper hygiene / lack of
trimming of Toenails
- Toe injury
- Picking of Toenail
Those who are obese, diabetic or
arthritic and those who have an abnormal gait or toe deformities such as
hammertoes or bunions are also likely to be at an increased risk of
onychocryptosis. Also at risk are those who have fungal infections
the toes or edema of the lower extremities.
Ingrown Toenails / Ingrowing Toenails
Symptoms of ingrown
Toenails include the following:
- Pus discharge, in case of
Usually the condition resolves on its own.
However, if it becomes infectious, or if it is persistent and recurrent, it has
to be treated medically. Infections occur when the feet are kept warm or moist
and caused by bacteria such as Staphylococcus or Pseudomonas or by the fungus
Candida. If there is a break in the skin close to where the nail has ingrown
these micro organisms enter and cause infection.
unresolved toenail can lead to severe consequences such as:
- Paronychia – Localized infection of
- Cellulitis – Paronychia can progress into
infection of the deeper soft tissues or cellulitis
- Osteomyelitis – Bone infection
- Scarring of
tissues surrounding the nails
- Onychodystrophy – Deformed
- Onychomycosis – Fungal
Diagnosis of Ingrown
Toenails / Ingrowing Toenails
The diagnosis of
onychocryptosis is rather simple and can be done with the help of the medical
history of the patient, tracing the causative factors and by observing the
A spicule or a nail growth may be detected along
with pain, swelling and tenderness in the area. If infected, it may have pus
drainage too. However, certain serious conditions such as tumors or even fungal
infections can look like an inward growing toenail to an untrained person and
hence the condition has to be carefully investigated.
Treatment for Ingrown Toenails / Ingrowing
Home Treatment for Ingrown
1. Soak the feet for 15-20 min in lukewarm water
containing any of the following:
- One part of white vinegar to four parts of water
- Two tbsp of Epsom salt in one quart of
2. Clean feet, keep nails
anti-inflammatory drugs (oral) to relieve pain
4. Change to
comfortable footwear that do not apply too much pressure on the
If there is pain and if the symptoms persist for over
a week, or if you have developed an infection, you must consult a podiatrist.
Although GPs, dermatologists and many other types of medical practitioners can
treat, podiatrists are specialists who are specifically qualified to manage
If the symptoms do not improve with
home-treatments then surgery will have to be carried out to remove the problematic
nail border. Surgical methods are based on two approaches:
- Narrowing or minimizing the nail
- Debulking the soft tissues
of the surgical techniques include:
- Avulsion – Detachment of
- Partial matrixectomy - Elimination of the affected
nail or the nail border.
- Permanent matrixectomy - Removal
of cells from nail base (nail matrix). This is usually done for chronic and
recurring conditions and can be done electrically, chemically or through
choice of procedure depends on the degree to which the person is affected and
also on the surgeon’s discretion. All the techniques have a high cure rate and
the outcome is dependent on the way it is carried out.