An ingrown toenail (Unguis incarnatus) usually affects the big toe. The ingrown toenail presses into the nail bed and causes pain or inflammation. Possible causes are, for example, too tight footwear or wrong nail cutting. Read more about the causes and symptoms and what treatment options are available when a toenail is ingrown.
Ingrown toenail: description
Ingrown toenails usually press into the surrounding tissue. This pressure often causes inflammation with painful swelling. The irritated tissue is more susceptible to the entry of bacteria, which aggravates the inflammation. When an ingrown toenail inflames, so-called “wild flesh” (granulation tissue) is formed, which begins to proliferate when the wound is healed.
Ingrown nails cause uncomfortable pain, which is why people often cut their nails even shorter, in many cases oval. Even slight pressure through the shoes then pushes the nail edge into the tissue – again an ingrown toenail is created. Alone affected people can hardly escape from this vicious circle. An ingrown toenail belongs to professional treatment. A doctor or a medical pedicure should be the first port of call.
Ingrown toenail: symptoms
An ingrown toenail usually affects the big toe, more rarely the remaining toenails or fingernails. He can cause severe local pain. The concomitant inflammation causes swelling, the tissue is often reddened and feels warm. Wearing stockings or lying on a comforter can sometimes be a torment. In the advanced stage, the tissue may start to bleed. In addition, in many cases an ingrown toenail causes pus.
Ingrown Toenail: Causes and Risk Factors
An ingrown nail can have various causes. Ingrown toenails can be promoted by the wrong nail cutting technique. If the toenail is cut too far down at the edges (ie oval cut), then they grow more easily into the surrounding nail bed.
Especially women often wear tight footwear. Due to the permanently increased pressure between the skin and the toenail, an ingrown toenail can easily develop. Heavy sweating on the feet also softens the skin around the nail and also increases the risk of ingrown toenails.
In addition, a ingrown toenail occurs familial heaped up. Some people naturally have wider nail beds than others. The innate anatomical conditions of the nail bed also play a role.
Ingrown toenail: examinations and diagnosis
Patients can usually see for themselves what causes the pain and inflammation of the foot: an ingrown toenail. Which doctor or specialist can help with such a problem? In mild cases, the help of a medical pedicurist (podiatrist) is usually sufficient. If an ingrown toenail is already advanced and associated with significant discomfort, a dermatologist or foot surgeon should be consulted.
Ingrown Toenail: Treatment
If a nail has grown, it needs a timely treatment. There are several possibilities:
Ingrown Toenail: Conservative Treatment
As a first measure it is recommended to tap the ingrown toenail to relieve the surrounding tissue from the nail. A padded plaster strip is pushed between the nail and the inflamed nail wall. The patch is then pulled around the toe so that more air between the skin and nail is. The patients usually experience this measure immediately as relief, and the pain is alleviated.
An ingrown toenail can also be treated with anti-inflammatory iodine ointments. In advance, footbaths can make sense: they soften the tissue, so that an ingrown toenail can then be better supplied with ointments and patches.
An ingrown toenail can still be treated by another non-surgical (conservative) method – the nail correction clip. It is attached by a medical podiatrist if the nail is too round at the lateral margins. The nail clip can be made of plastic or wire. The nail clip is applied over a period of approximately six to twelve months. It is attached to the nail edges and fixed in the middle of the nail. Thus, an ingrown toenail is slowly pulled up again from the depths of the nail bed. The nail grows from scratch into a new shape, which is why this process takes so long.
Ingrown Toenail – OP
If the conservative measures are not sufficient, an ingrown toenail should be treated surgically: under local anesthesia, the ingrown nails and the surrounding granulation tissue are removed. The wound is then treated with a patch or a small bandage. However, it is important to check the wound regularly to see if the inflammation heals and the toenail has not regrown.
If there is a risk of an ingrown toenail recurring, a nail bed reduction surgery (Emmert plastic or nail wedge excision) may be useful. Here, the affected nail part and the lateral nail wall are removed wedge-shaped. The nail thus becomes narrower overall, which reduces the risk of re-ingrowth.
After the operation, the tissue is still very sensitive for a while. The attached patch should be changed regularly after the first two to three days.
Ingrown toenail: Disease course and prognosis
An ingrown toenail can usually be treated well:
With early treatment conservative methods are usually sufficient. However, they require a reliable cooperation of the patient. Since it is a longer-lasting treatment, the patient should be patient.
In worse cases, an ingrown toenail often needs surgery. The procedure brings rapid success – the symptoms disappear.
Following any conservative and surgical treatment, the patient should be careful to cut the nails correctly (straight and not oval) and not wear too tight footwear. Otherwise, an ingrown toenail quickly develops again.
Especially in the elderly, an ingrown toenail often occurs without them realizing it. Due to the lack of mobility, many older people are no longer able to perform adequate pedicure. Then medical foot care may be necessary. In addition, wearing sufficiently large and breathable footwear can prevent (re) entry ingrown toenail arises.