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Ingrown nail

life science Maturity 9-11 Next article →

An ingrown nail, or onychocryptosis, is a common condition involving the nails.

Ingrown nail in hallux toe
Ingrown nail in hallux toe

The term comes from Ancient Greek, where "onux" means nail and "kruptos" means hidden. This condition occurs when a nail grows into the sides of the paronychium, which is the skin surrounding the nail, or the nail bed. While it can affect fingernails, it is most frequently seen in toenails.

Onychocryptosisdiagram
Onychocryptosisdiagram

It is often a very painful experience for the person affected.

There is a distinction between different types of nail issues. A true ingrown nail involves an actual sliver of the nail penetrating the flesh. However, the condition can also be caused by overgrown skin. In some cases, microbial inflammation of the paronychium leads to a granuloma, which is a mass of tissue that buries the nail. It is important not to confuse onychocryptosis with other growth patterns. These include convex nails, involuted nails, or pincer nails. It also differs from having calluses, corns, or debris in the nail sulci, which are the grooves at the sides of the nail.

Many factors can trigger the development of an ingrown nail. Footwear is a primary contributor, especially ill-fitting shoes with a narrow toe box. Tight stockings can also apply unwanted pressure to the sides of the foot. A damp environment inside a shoe can soften the nail plate. This softening can lead to swelling in the epidermal keratin, which may permanently increase the convex arch of the nail. Other causes include genetics, disease, or physical trauma. For example, dropping a heavy object on a toe or stubbing it can cause the nail to grow irregularly.

Onychocryptosisdiagram
Onychocryptosisdiagram

How a person manages their nail care can directly impact their health. Cutting nails too short or rounding the edges can cause them to dig into the skin. The angle of the cutting tool, such as scissors, is also critical. If the lower blade is closer to the toe than the upper blade, the nail may grow upward from its base. Conversely, if the angle is different, it may grow downward. This creates a warp that moves toward the end of the nail as it grows. To prevent this, nails should be cut straight across and should not be shorter than the surrounding flesh.

Symptoms of onychocryptosis can range from mild to severe. Common signs include pain along the margins of the nail caused by hypergranulation. This pain often worsens when wearing tight shoes or when any pressure is applied. In some cases, even the weight of bedsheets can cause sensitivity. If the condition is not treated early, it can lead to infection. Signs of infection include redness, swelling at the base of the nail, and the drainage of pus or blood-tinged fluid.

Ingrown nail in hallux toe
Ingrown nail in hallux toe

Treatment options depend heavily on the severity of the case. Mild to moderate cases might be managed with conservative methods. These include soaking the foot in warm water with Epsom salt, using antibacterial ointment, or using dental floss. Another option is nail bracing, which is less invasive than surgery.

Nagelspange
Nagelspange

There are adhesive braces, which are composite strips glued to the nail, and hooked braces, which use dental wire to lift the nail edges. Bracing aims to retrain the nail to grow in a flatter shape. This process typically requires one full nail growth cycle, which lasts about 18 months.

For more serious or recurring cases, a podiatrist may perform surgery. A podiatrist is a specialist who focuses on the feet and ankles. One common procedure is a wedge resection, where the offending part of the nail plate is removed.

Reene ingrown nail postop
Reene ingrown nail postop

If the nail continues to grow inward despite this, a doctor might perform a matrixectomy. This involves the excision or chemical destruction of the sides of the nail to prevent regrowth. Surgical treatments are generally more effective at preventing the condition from returning than non-surgical methods.

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File:Ingrown_nail_in_hallux_toe.jpg
Ingrown_nail_in_hallux_toe.jpg
File:Onychocryptosisdiagram.png
Onychocryptosisdiagram.png
File:Nagelspange.jpg
Nagelspange.jpg
File:Reene ingrown nail postop.jpg
Reene ingrown nail postop.jpg
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