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Ingrown toenails Causes, Symptoms and Treatment

An ingrown nail appears when one of the upper corners of the nail enters the flesh around it. This causes redness and swelling ( inflammation ), pain and sometimes an infection. This problem, referred to as onychocryptosis in medical language, most often affects the toenail of the big toe.

To prevent the wound from becoming infected and the condition getting worse, it is important to treatan ingrown toenail as soon as possible.

Causes of Ingrown toenails

The most common causes of this condition are too short a nail and wearing too tight shoes . However, in many cases, there is no obvious cause for the occurrence of an ingrown toenail.

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If left untreated, an ingrown toenail can lead to infection of the tissues around the fingernail (paronychia), or even more serious infection of the foot or bones of the foot.

People with diabetes for several years are at higher risk of complications. In the long term, diabetes impairs blood flow, which interferes with wound healing. In addition, diabetes decreases the ability to fight infections. It is important for diabetics to check their feet regularly for any injuries or ingrown toenails because the condition reduces pain sensitivity. In case of a wound, it is important to quickly consult a chiropodist or a doctor to avoid infection and get a quick healing.

Symptoms of Ingrown toenails

  • Pain around a fingernail, usually amplified by wearing shoes;
  • Redness and swelling of the skin surrounding the painful nail;
  • If there is infection, the pain is greater and there may be pus;
  • If the infection persists, a bead of flesh may form on the edge of the nail and deform. Called botryomycoma, this bead is usually painful and bleeds at the slightest touch.

Ingrown nails can evolve into 3 stages :

  • In the early stage, there is a slight inflammation and pain on the pressure;
  • In the second stage, a purulent infection appears, swelling and pain worsen. The wound becomes more apparent;
  • The third stage is chronic inflammation and bulky bulging . An ulcer may even form, especially in people with diabetes who notice late that they have an ingrown toenail.

 People at risk  for Ingrown toenails

  • People who have  thick or curved nails , shaped like “tile” or pliers (that is to say, very curved);
  • The  elderly , because their nails tend to thicken and they manage to cut them less easily;
  • The  teenagers  as they often exhibit excessive sweating of the feet, which softens fabrics. Nails are also more friable and tend to incarnate more easily;
  • People whose close relatives had ingrown toenails ( hereditary factor );
  • People with bone deformities related to osteoarthritis on the toes.

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 Risk factors

  • Cut too short his toenails or round the corners;
  • Wear shoes that are too tight, especially if they have high heels. With age, the size of the foot increases from ½ cm to 1 cm;
  • Have a damaged nail.

The prevention of ingrown toenails

Basic prevention

  • Cut the toenails straight and leave the corners slightly longer. File rough nails
  • Use scissors designed for cutting nails; avoid the nail clipper;
  • Wear shoes that are wide enough to not compress the toes. If necessary, buy shoes suitable for people with foot conditions;
  • Wear shoes that are suitable for work and activities to avoid damaging the nails;
  • Older people, those with circulation problems or who have diabetes should be very careful about caring for their feet. They should have their feet examined by a doctor or foot specialist (podiatrist or chiropodist) twice a year, in addition to having good foot hygiene and examining them every day.
Measures to avoid aggravation
If one of your nails is incarnated, several steps must be taken to avoid infection:

  • Clean the wound with an antiseptic product as soon as redness appears and wear wide shoes to limit friction;
  • If necessary, make footbaths with an antiseptic (eg, chlorhexidine).



Exercises to stimulate blood circulation in the feet

In people with diabetes , the prevention of complications requires a daily inspection of the feet and immediate care in case of injury. However, it is important to improve the overall health of the foot and boost the blood circulation. Several exercises can contribute to it:

  • While standing, lift on tiptoe and bring the weight of the body back on the heels;
  • Pick up balls or crumpled napkin with toes;
  • Regularly self-massage the feet, or even better, receive massages.

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Medical treatments of Ingrown toenails

Note . Consult a physician if there are signs of wound infection . On the other hand, people with diabetes , those with blood circulation problems or neurological problems in their feet (peripheral neuropathy) should seek immediate medical attention if they have an ingrown toenail instead of home care. Similarly, an ingrown toenail in a child requires a medical consultation.

Home Care

Most ingrown toenails can be treated at home by providing the following care:

  • To soak the foot for 15 minutes in warm water to which is added a little salt or antibacterial soap;
  • Dry the foot, then gently lift the sill of the softened nail by placing a small piece of clean cottonbetween the skin and the nail, which will help the nail to grow above the skin. Flossing, finer, can replace cotton if necessary;
  • Apply an antibiotic ointment on the painful area;
  • Wear open-toed sandals or comfortable soft shoes until pain and inflammation disappear.

Take a foot bath and put a new cotton under the nail at least 2 times a day. At this point, it is important not to try to cut the nail. The nail should be cut straight when it has grown a few millimeters and the inflammation will be gone.

Medical care

If the ingrown nail is infected or there is a large bead around the nail, an operation is necessary. It removes the edge of the nail that fits into the skin (partial onyxectomy). The toe is previously numb by anesthesia. Antibiotics may be prescribed (in ointment or orally). Several studies have shown that, in the majority of cases, healing is very good without oral antibiotics and the ointment is sufficient .

In case of frequent recurrence, the doctor also removes the matrix which is under the lateral part of the nail (surgical extraction of the root). The matrix is ​​the root that makes the nail and it can help to “produce” ingrown toenails if left in place. The destruction of the matrix is ​​generally done chemically, by applying phenol under local anesthesia. We are talking about phenolization . The best results are obtained by combining phenolization and surgery. Other techniques can be used to destroy the matrix, such as laser, radio frequency or electrocautery (“burning” tissue by an electric current) treatment. These techniques are however more expensive than phenolization and are not accessible everywhere.

Complementary approaches

According to our research (October 2010), there are no unconventional treatments supported by evidence-based studies to relieve the symptoms of ingrown toenails.

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