A toenail is ingrown when it grows into the soft skin of the big toe or the surrounding skin. Michael Wilding from the Podiatry Department at Singapore General Hospital shares the causes.
Changes to the normal shape and appearance of nails, particularly fingernails, can indicate general health conditions, while injury to the nails or the nail fold can cause problems with the nails themselves that can be painful and often require treatment. Ingrown nails are one example.
What are the types of ingrown nails?
The only true type of ingrown nail is caused by a nail spike piercing the skin at one or both edges. The spike is caused by trauma or, usually, poor nail cutting.
The other condition often called an ingrown nail is caused by the nail being excessively curved from side to side. This causes the nail to pinch into the skin.
The vast majority of ingrown nails affect the big toes. The first signs are usually pain accompanied by slight swelling and redness.
Ingrown nails are actually a very minor problem at origin. Unfortunately, they often don’t heal and can get worse because the nail spike, once embedded in the skin, stays there, keeping the wound open and becoming a site for infection, swelling and pain.
If left untreated, a specialised kind of skin, called hypergranulation, can grow at the site. This can look alarming but it does no harm and is simply the body’s Plan B attempt to heal the area. It regresses once the nail is treated.
What causes ingrown toenails?
The primary cause of ingrown toenails is anatomical (genetic), where the nail is wider than normal and the skin is stretched and folded up around it. In some cases the nail can appear to be buried in the skin (see picture below). All that is needed is a small trauma or poor nail cutting to produce a spike that can break through the skin.
Who gets ingrown toenails?
Younger people under 40 are the main sufferers as they are generally more active, their feet can get hot and sweaty, and they often wear footwear more for their looks than their practicality. Combined with the anatomical factors the ingredients for an ingrown toenail are there.
Learn how to treat and prevent ingrown toenails in the next page.