Ingrown Toenails - Part 1

A very common picture of a very unhappy toenail.

A very common picture of a very unhappy toenail.

This is part one of a two-part blog post on that age-old problem that we podiatrists see all the time in our clinics – ingrown toenails. It’s an important post for me for two main reasons; firstly, this is the website’s very first blog post! And secondly, it’s a problem I experience myself from time-to-time and can definitely relate to the pain and nuisance it can cause! So let’s get started…

Ingrown toenails (known in medicine as Onychocryptosis) are an extremely common (and often very painful) problem for people of all ages and levels of activity. It occurs when a portion of the nail plate digs in or punctures the surrounding skin. Left untreated, ingrown toenails will often become even more painful and can become infected. In this blog post we will talk over the common features of this problem and the treatment options we offer in our clinic to manage or cure this painful condition.

Two of the most common factors when combined that increase the likelihood of an ingrown toenail are involution (the curvature of the nail plate which we’ll talk about further) and poor self-care of your nails in terms of how they are cut (or torn, ripped, bitten, whatever floats your boat). Although it’s really important to underscore the fact that the aetiology (cause) behind ingrown toenails can be diverse and can even include factors related to genetics and other systemic health problems.

Involution is the term we use to describe the curved edges on either side of the nail plate. Some degree of involution is quite normal and wouldn’t typically cause any problems. However, this curvature of the nail plate can become quite extreme for several reasons including damage to the nail plate (common with tight footwear or through sporting activity), genetic factors (as already mentioned; there may be a family history of this nail shape), even systemic factors linked to medications or hormonal changes have been suggested to influence the rate of growth in different parts of the nail (which might partly explain why this is very common in adolescents).

Yep, couldn't find a better picture so made my own on MS Paint.

Yep, couldn't find a better picture so made my own on MS Paint.

As already mentioned, poor self-care of nails can also be a factor. Cutting too deeply into the sulcus (the fold of skin that the side of the nail sits in) can often mistakenly leave sharp edges or spicules of nail behind that, as they grow forward, can damage and inflame the surrounding skin and thus become ingrown. As a rule of thumb, it is normally a sensible idea to cut nails straight across and use a file or emery board to carefully round off the edges. And just to dispel a common myth – cutting a ‘V’ in the top of the nail plate will not help!

Beyond carefully looking after your own nails, in part 2 we will talk about what to do when things go wrong. Starting with the first steps you can take to ease the problem and going on to discuss the various options your podiatrist to get you back on your feet, pain free!

Until then, thanks for reading and please do get in touch if you have any further questions.


~ Robert

Ingrown ToenailsMary Philip