Ingrown nails, or onychocryptosis, typically affect the big toe and occur when a nail grows into the surrounding skin, causing pain, swelling, and possible infection. Clinically, this can be caused by incorrect nail trimming, tight or ill-fitting footwear, toe injuries, and certain nail conditions like fungal infections. Non-clinical causes include inherited traits, age (as toenails thicken over time), poor posture, and inadequate foot hygiene. Treatment ranges from home remedies like warm foot soaks and proper footwear to medical interventions such as nail removal or surgery for recurrent cases. Always consult with a healthcare provider if an ingrown nail causes severe discomfort or shows signs of infection.


Clinical Causal Factors

  1. Improper Trimming of Nails: The most common cause of ingrown nails is improper trimming. Cutting your nails too short or not straight across encourages the surrounding skin to fold over the nail, which can cause the nail to grow into the skin.
  2. Footwear: Wearing shoes or socks that don’t fit well can also cause an ingrown nail. Tight shoes and socks can press the skin against the nail, forcing it to grow into the skin.
  3. Nail Injuries: Another common cause is injury, including stubbing the toe, dropping something heavy on the foot, or engaging in activities that involve repeated pressure on the toes such as kicking or running.
  4. Nail Conditions: Certain nail conditions, such as fungal infections or losing a nail due to trauma, can cause irregular, thickened, or widened nails that are more likely to become ingrown.

Non-Clinical Causal Factors

  1. Genetics: Some people are more prone to ingrown nails due to inherited traits like nail shape and thickness.
  2. Age: Older adults may be more at risk because toenails thicken with age.
  3. Poor Posture: Walking posture and gait abnormalities can exert undue pressure on the toes, leading to ingrown nails.
  4. Improper Foot Hygiene: Lack of proper foot hygiene, such as keeping the feet clean and dry, can make the skin soft and easy for the nail to pierce.

The treatment of an ingrown nail can range from at-home remedies like soaking the foot in warm water, using over-the-counter treatments, and wearing comfortable shoes, to medical treatments like partial nail removal, total nail removal, or surgery, especially in the case of recurrent ingrown nails. It’s important to consult with a healthcare provider if an ingrown nail causes severe discomfort or becomes infected.



Symptoms of Ingrown Nails:

  1. Pain and Tenderness: One of the most common symptoms is pain along the margins of the nail, especially when pressure is applied.
  2. Redness: The skin around the ingrown nail often becomes red and irritated.
  3. Swelling: There might be noticeable swelling of the skin along the edge of the nail.
  4. Infection: In some cases, an infection can develop, which may cause increased pain, pus discharge, overgrowth of skin around the nail (also known as granulation tissue), and sometimes a fever.


Diagnosis of Ingrown Nails:

Diagnosis of an ingrown nail is typically straightforward and usually based on the appearance of the toe and the symptoms described. A healthcare provider or a dermatologist can usually diagnose an ingrown nail during a physical examination.

The doctor may also ask about your medical history, lifestyle, and footwear habits to identify any contributing factors. In severe or recurring cases, an X-ray might be ordered to assess the depth of the ingrowth and to rule out bone infection.

If you’re experiencing symptoms of an ingrown nail, it’s important to consult with a healthcare provider for appropriate diagnosis and treatment. In some cases, if left untreated, an ingrown toenail can lead to a serious bone infection or cause a skin ulcer, which could potentially be a risk for people with poor circulation or diabetes.

Prognosis and Impact


Prognosis of Ingrown Nails:

Generally, the prognosis for ingrown nails is quite good, especially when they are treated promptly. In many cases, home remedies and proper nail care can solve the issue. When these measures aren’t enough, medical treatment is usually very effective. However, if left untreated, an ingrown nail can lead to complications like infection or an abscess, which might require surgical intervention.

Recurring ingrown nails may require a minor surgical procedure to remove a portion of the nail and potentially the underlying nail bed to prevent the problematic section of the nail from growing back. After such a procedure, the nail usually regrows narrower than before.


Impact of Ingrown Nails:

Ingrown nails can significantly impact an individual’s quality of life. They can cause substantial discomfort, making walking or wearing certain types of shoes painful. This can interfere with daily activities, work, or exercise routines.

In addition, they can lead to psychological stress, particularly if the condition is recurrent or if complications occur. A severe or infected ingrown nail might require time off work or school and limit participation in social or recreational activities due to pain or self-consciousness about the appearance of the foot.

People with underlying health conditions, such as diabetes or peripheral arterial disease, need to be particularly careful, as their healing process might be slower and they are at higher risk for complications like infections.

Treatment Options

Home Care: For mild cases, home treatment can often be effective:

  1. Soak in Warm Water: Soak the affected foot in warm water three to four times a day. This can help to reduce swelling and tenderness.
  2. Cotton Wedge Under the Nail: After each soak, you can place a small cotton wedge or dental floss under the ingrown edge to help the nail grow above the skin edge.
  3. Topical Antibiotics: Over-the-counter antibiotic creams can be applied to reduce the risk of infection.
  4. Proper Footwear: Wear comfortable shoes with ample room for your toes. This can help to relieve pressure on the ingrown toenail.

Medical Treatment: If home treatments are not effective or if the ingrown nail is severe or infected, medical treatment may be necessary:

  1. Partial Nail Removal: For an ingrown nail with a minor infection or inflammation, the doctor may remove the ingrown portion of the nail.
  2. Total Nail Removal: For a recurring ingrown nail problem, the doctor may suggest removing the entire nail along with the underlying tissue (nail bed) to prevent the problematic part of the nail from growing back. This is often done under local anesthesia.
  3. Oral or Topical Antibiotics: If there’s an infection, antibiotics may be prescribed.
  4. Surgery: In some cases, surgery might be needed to remove the segment of overgrown skin (granulation tissue) or to treat a deeper underlying issue.

Risks and Side Effects

Home Care:

  1. Soaking and Lifting the Nail: These methods are generally safe but they may not always be effective, especially in more severe cases. Overzealous lifting of the nail can cause further irritation and even injury.
  2. Topical Antibiotics: Some people may have an allergic reaction to the active ingredients in over-the-counter antibiotic creams. Signs of an allergic reaction can include rash, itching, swelling, severe dizziness, and trouble breathing.
  3. Footwear: Ill-fitting footwear can actually exacerbate the condition and cause more pain.

Medical Treatments:

  1. Partial or Total Nail Removal: These procedures can sometimes cause significant discomfort during and after the procedure. There’s also a risk of the nail becoming ingrown again, infection, and changes in the appearance of the nail. After total nail removal, the nail may grow back thickened or deformed.
  2. Antibiotics: Antibiotics can cause side effects, such as nausea, diarrhea, and allergic reactions. They can also lead to antibiotic resistance if used frequently.
  3. Surgery: Risks associated with surgery include pain, infection, nerve damage, and reactions to anesthesia. There’s also the chance that the nail or surrounding tissue will not heal correctly, leading to further problems.

FAQ Section

An ingrown nail occurs when the corner or side of a nail grows into the soft flesh of the toe, leading to pain, redness, and swelling, and potentially infection.

Improper trimming of nails, tight or ill-fitting footwear, toe injuries, and certain nail conditions can cause ingrown nails. Non-clinical causes include inherited traits, age, poor posture, and inadequate foot hygiene.

To prevent an ingrown nail, cut your nails straight across and not too short, wear comfortable shoes with sufficient room for your toes, and maintain proper foot hygiene.

Symptoms include pain and tenderness in your toe along the nail, redness around your toenail, swelling of your toe around the nail, and infection of the tissue around your toenail.

For minor ingrown nails, home treatments like soaking your foot in warm water and proper foot care may help. If the pain is severe, or if redness, swelling, and pus occur, it’s important to see a healthcare provider.

Mild cases may be managed with home treatments. Severe or recurrent cases may require medical treatment, including partial or total nail removal, antibiotics, or even surgery in some cases.

Most treatments carry minimal risks. However, nail removal can lead to post-procedure pain and potential changes in nail appearance. Antibiotics might cause side effects like nausea or allergic reactions. Surgical risks include infection, nerve damage, or reactions to anesthesia.