11 Mar What Causes Ingrown Toenail and What Can be Done to Fix it?
What Causes Ingrown Toenail and What Can be Done to Fix it?
Ingrown toenails can be a frustrating problem often resulting in recurrent infection and pain. The medical term for an ingrown toenail is onychocryptosis which, by definition describes the condition being onycho – nail, crypto – buried/hidden, and sis – condition. Basically, the side/s of the toenail become embedded into the flesh (the nail folds) resulting in inflammation and often infection as the body identifies the nail edge as a foreign body, similar to a very nasty splinter. When the ingrown nail has been occurring for a long time there may also be a very red and tender lump on the affected side of the toe called hyper granular tissue, resulting from prolonged inflammation, that further engulfs the nail There are several causes of ingrown toenails from common issues such as footwear to the less common like nail bed deformities. Below is a list of some of the reasons why nails become ingrown:
- Incorrect nail cutting
- Tight or ill-fitting footwear
- Trauma to the nail resulting in abnormal nail shape
- Congenital nail deformity (in toddlers this may be due to enlargement (hypertrophy) of the nail folds that engulf the nail)
- Systemic diseases such as Psoriasis and localised diseases such as Fungal nail infections that result in changed nail shape
- Bone growths interfere with the nail bed and therefore the shape of the nail eg. subungual exostosis
- Inherited or hereditary nail shape such as Pincer nail where the excessive curvature of the nail edges
- Gait and biomechanical causes like flat feet or clawed toes that result in increased pressure and changed nail shape
How can an Ingrown nail be treated?
The most conservative approach to treating an ingrown toenail is to just cut away the edge of the nail that’s digging in. This is useful for those nails that have only recently become painful and where the nail is only curled inwards towards the end of the toe. Additionally, this treatment approach may be used in those where surgery is not indicated due to underlying medical conditions.
When the nail is aggressively and persistently ingrowing, with recurrent infections and hyper granular tissue, surgical removal of the nail edge is indicated. This is done in the clinic with a local anesthetic and is very effective for the permanent removal of the nail edge. The surgical removal of a nail edge is called a ‘Partial Nail Avulsion” procedure.
A newer treatment called ‘Onyfix nail bracing system” is also available and can be useful for those where surgery is not suitable or not wanted. It is as the name suggested, a strip of acrylic that is placed across the base of the nail to reduce the curvature of the nail as it grows.