What is an Ingrowing Toenail and How is it caused ?
An ingrowing toenail develops when the side(s) of the toenail pierces and grows into the surrounding skin. The adjacent skin becomes red, swolled and tender.
If allowed to continue to grow over a period of weeks or months, the area often becomes infected with the formation of hypergranulation tissue.
Hypergranulation tissue often dissociates itself from normal skin and forms in response to the embedded nail growing into the flesh and if left, becomes organised both underneath and around the ingrowing toenail.
This tissue is highly vascular and it is at this point that even the slightess tap to the toe can result in extreme pain and bleeding.
In more severe cases, the toenail can become infected, producing pus from the area.
Patients are commonly prescribed repeated courses of antibiotics e.g. Flucloxacillin to reduce the infection and inflammation.
This serves no other purpose than reducing the infection, it has no effect on the offending ingrowing toenail.
Ingrowing toenails are commonly caused by the following
Incorrect nail cutting
Cutting your toenails too short, or the edges too deep, will encourage the skin to fold over your nail and cause the nail to grow into the flesh.
Tight footwear and hosiery
This places increased pressure on the skin around your toenail, this will cause friction and irritation of the skin over the toenail which will result in the nail piercing the skinfold.
Commonly stubbing your toe or dropping a heavy object on your toenail can result in injury to the nail plate and form an ingrowing toenail.
Sweaty feet and poor hygiene
If the skin around your toenails is soft, it is easier for your toenail to pierce and embed into the skinfold.
Natural shape of the nail
Some people inherit foot shapes from their parents. Certain foot shapes can cause the nail bed to grow with an increased curve at either one or both sides to form an involuted nail which are more likely to be subjected to increased pressure and trauma which can result in a painfully infected toe similar to an ingrowing toenail.
How to try and prevent ingrowing toenails
Correct nail cutting
Trim, file or cut toenails following the natural curve of the end of your toe, the corner of the nail should be visible above the skin. Cutting your toenails straight across does not prevent ingrown toenails it only serves to make them worse.
Do not probe down the edges of your toenails, use nippers with a small curve opposed to scissors or straight clippers.
Young children and teenagers should be advised not to pick their toenails.
Cut your toenails after a bath or shower when they are soft.
Change your hosiery regularly
Ingrowing toenails are common amongst teenagers, ensure they change their socks/stockings regularly and rotate their footwear.
Choose socks with a material that will breath.
Choose footwear with a slightly deeper or broader toe box if you are prone to ingrowing toenails and of a material that will breathe and style that will not place increased pressure on your toes.
Avoid wearing old, wet training shoes which will cause moist, soggy feet. Always rotate your footwear so each pair has a chance to dry out thoroughly.
Diabetes and poor circulation
For those people who are Diabetic, suffer with a neuropathy (reduced sensation in your toes) and whom are taking anticoagulant and / or steroid therapy, should never attempt to cut their own ingrowing toenails, always eek professional help and advice from a Podiatrist.