Main
- The big toe is most often affected: it bears the main load when walking, so the edge of the nail plate grows into the skin right there.
- The cause is cutting the nail too short or at an angle: a cut-off corner leaves the plate without support, and its edge begins to press on the lateral nail fold.
- Tight shoes with a narrow toe box increase the pressure: the toes are squeezed, the plate shifts and cuts into the soft tissues with every step.
- Purulent discharge and body temperature are a reason to see a doctor urgently: these signs indicate an added infection.
- The condition is managed by a surgeon or a podiatrist: in pronounced ingrowth, the part of the plate pressing on the soft tissues is removed.
What is an ingrown toenail
An ingrown toenail is a condition in which the edge of the nail plate grows into the soft tissues of the toe, causing pain and inflammation. The big toe is most often affected, and the problem can recur if the cause is not eliminated.
What happens in the body
The nail plate grows forward and normally slides over the soft nail fold without catching on it. When the corner is cut too deeply, the plate loses its support and begins to press on the lateral edge of the skin. The tissue under pressure responds with inflammation: swelling, redness and pain when walking appear. Gradually the edge of the nail cuts through the skin and remains in it, like a wedge, with every step. Shoes with a narrow toe increase the pressure and speed up this process. The inflamed fold prevents the nail from growing straight, and it curls even more. Therefore, without eliminating the cause, the condition returns again after a temporary lull.
What causes it to develop
- Improper trimming: cutting nails too short or at the corners deprives the plate of support, and its edge begins to press on the lateral fold.
- Tight shoes: a narrow toe squeezes the toes and shifts the nail plate, forcing its edge to cut into the soft tissues.
- Injury to the toe or nail: a blow or bruise changes the shape of the plate, and it begins to grow at the wrong angle to the skin.
- Fungal nail infection: the affected plate thickens and changes shape, causing its edges to press harder on the surrounding tissues.
- Hereditary predisposition: in some people the toes and nails are naturally structured in a way that makes ingrowth more common.
Who encounters this more often
An ingrown toenail is more common in people who wear tight shoes or trim their nails at the corners. The big toe is affected more often than the others because it bears the main load when walking. In people with increased foot sweating, the skin softens and is more easily injured by the edge of the plate. Sports shoes with a narrow toe and constant stress on the foot increase the risk. With a hereditary predisposition, the shape of the toes and nails itself creates the conditions for ingrowth. A fungal infection changes the structure of the plate and also contributes to the problem. If the cause is not eliminated, the condition returns after a temporary improvement.
What symptoms can occur?
An ingrown toenail is recognised by pain at the side edge of the nail and redness of the skin. These signs worsen when walking and when shoes press on the toe, and over time they may be joined by purulent discharge.
How it is noticed at the very beginning
At the beginning, an ingrown toenail makes itself known by pain at the side edge of the nail, which is easy to put down to tiredness after a long walk. The pain appears when pressing on the toe and when walking, and by the evening it becomes more noticeable. The skin at the edge of the nail reddens and swells, and the toe looks puffy compared with the neighbouring ones. The soft tissues around the nail gradually grow and begin to protrude above the edge of the plate. Because of this, shoes press harder, and every step causes more and more discomfort. A person often changes to looser shoes, but relief comes only for a short time. If these signs are not paid attention to, purulent discharge and a rise in body temperature are added to them.
Signs that occur most often
- Pain when pressing or walking: occurs at the side edge of the nail and worsens when shoes press on it, making it difficult to move normally.
- Redness and swelling of the skin: the skin at the edge of the nail becomes red and puffy, which indicates irritation and inflammation of the tissues.
- Overgrowth of soft tissues: a protruding ridge appears around the nail, which over time enlarges and presses on the plate.
- Discharge of pus: in advanced cases, purulent discharge comes out from under the edge of the nail, which indicates an added infection.
- Rise in body temperature: when an infection is added, the temperature rises, and this is a noticeable reason not to postpone a visit to the doctor.
When to seek help urgently
Examinations and tests
Examination for an ingrown toenail begins with a visual inspection, and additional tests are rarely ordered. They are needed when the doctor suspects a fungal infection or diabetes.
How the examination begins
Examination for an ingrown toenail begins with an inspection of the toe by a surgeon or podiatrist. The doctor assesses how the edge of the nail plate presses on the skin of the nail fold and how pronounced the inflammation around it is. They look for redness, swelling and overgrowth of soft tissue along the lateral edge. Separately, they check whether the plate itself has changed: its colour, thickness and shape say a lot. The doctor clarifies how long ago the complaints appeared and what the person has already tried on their own. They ask about diabetes, circulatory disorders and other conditions affecting healing. Based on the examination, it becomes clear whether local care is enough or a more serious intervention is needed. If the picture is atypical, the doctor decides which tests to add to the examination.
What is ordered and what it shows
What to prepare for the appointment
- Discharge summaries: bring records from other clinics where the toe has already been treated, so the doctor can see the whole picture.
- Results of previous scrapings: if the nail was previously tested for fungus, these data will help avoid repeating the test.
- Information about diabetes: report elevated sugar or follow-up with an endocrinologist, this changes the approach to the examination.
- List of medications taken: list everything you take regularly, including blood thinners, so the doctor can take this into account during the examination.
- Observations: note when the pain appeared, what makes it worse and how the appearance of the toe has changed over this time.
- Comfortable footwear: wear loose shoes so that after the examination you do not press on the inflamed toe on the way home.
Which doctor should I see?
The choice of specialist for an ingrown toenail depends on how pronounced the ingrowth is and whether there are signs of inflammation. Below — who manages this condition, what the care consists of, and which part of the result depends on the patient themselves.
Which specialist manages this condition
An ingrown toenail is managed by a surgeon, as well as a podiatrist — a specialist in foot and nail care. The surgeon assesses the depth of the ingrowth, the condition of the tissues around the nail, and decides whether conservative methods are sufficient. The podiatrist deals with treating the nail plate, correcting its shape, and selecting orthopaedic devices. If there is no specialist podiatrist nearby, the initial appointment is conducted by a surgeon at the polyclinic at the place of residence. During the examination, the doctor clarifies how long ago the unpleasant sensations appeared and how the patient cuts their nails. They examine the toe and check whether there is swelling, redness, or discharge from under the nail fold. With pronounced ingrowth, the doctor may refer for an additional consultation or immediately discuss the scope of intervention. If the toe hurts severely and makes walking difficult, the visit should not be postponed — this noticeably worsens the quality of life.
What the treatment consists of
- Correcting the way nails are cut: the doctor shows how to trim the plate evenly, without rounding the corners, so that the edge does not press on the fold.
- Wearing loose footwear: a tight last and narrow toe box squeeze the toe, so during treatment, models without pressure on the forefoot are chosen.
- Local treatment and dressings: regular procedures as prescribed by the doctor reduce inflammation around the nail fold and help the tissues heal.
- Fitting special braces or plates: the device gradually lifts the ingrown edge and changes the direction of nail plate growth without removal.
- Surgical removal of part of the nail: with pronounced ingrowth, the doctor removes the section of the plate that presses on the soft tissues and treats the growth zone.
What depends on the patient themselves
The result of treatment for an ingrown toenail largely depends on the regularity of follow-up and precise adherence to the doctor's recommendations. It is important for the patient to come for dressings and follow-up examinations at the appointed times, and not only when the pain worsens. If a brace or plate has been fitted, its position is checked by a specialist; the device must not be adjusted independently. At home, the toe should be examined to notice redness, swelling, or discharge from under the fold in time. It is better to choose loose footwear, and to cut nails evenly, without cutting the corners too short. If discomfort appears between visits, the doctor should be informed rather than waiting for the scheduled appointment. Such attentiveness to oneself helps to notice deterioration earlier and adjust the approach without unnecessary complications.
What helps prevent an exacerbation?
Everyday care and attention to detail help prevent the nail from growing back in. Below are habits, observations and regular visits that reduce the risk of an exacerbation.
What is changed in habits
Cutting the nails directly affects how the edge of the plate behaves in relation to the lateral nail fold. If the corners are cut too deeply, the nail begins to press on the soft tissues with every step. Shoes in the right size with a wide toe leave the toes the room that a tight last deprives them of. Dryness of the skin between the toes and around the plate reduces softening of the tissues and lowers friction. Nail fungus changes the shape and density of the plate, so its timely treatment keeps the edge in the correct position. Attempts to remove the ingrown edge on your own often end in damage to the fold and worsening of the inflammation. People with diabetes or impaired circulation should discuss care with a doctor, because a minor injury heals more slowly in them.
What should be kept under control
- Direction of the cuts: the nail is cut straight, without rounding the corners, so that the plate grows evenly and does not press on the fold.
- Fit of the shoes: the toe should be wide, and the size should match the length of the foot, otherwise the toes are squeezed when walking.
- Condition of the skin of the feet: regular examination helps to notice redness, chafing or excessive moisture between the toes in time.
- Signs of fungus: a change in the colour and thickness of the plate requires a visit to a doctor, since without treatment the shape of the nail changes.
- Own attempts: one should not trim the ingrown edge on one's own, as this often worsens the inflammation and pain.
- Special caution: in diabetes and impaired circulation, any changes in the feet are examined by a doctor, not by the patient themselves.
How often to see a doctor
A regular examination by a specialist is needed even when the nail does not bother you and looks calm outwardly. The doctor assesses how the plate is growing, whether there is hidden pressure on the fold and signs of fungus. In diabetes and impaired circulation, such visits are especially important, because the sensitivity of the feet is reduced and the onset of a problem is easy to miss. The specialist advises how to cut the nail correctly and what shoes to choose for the characteristics of the foot. If redness, swelling or pain appear, the visit should not be postponed, because it is easier to help at an early stage. Between examinations, it is useful to examine the feet yourself and note any changes in the skin or the plate. Such control does not replace the prescribed treatment, but it helps to notice an exacerbation earlier and seek help in time.
What is worth remembering
A conversation about an ingrown toenail comes down to a few simple things that are worth keeping in mind. Below is the main thing that determines how a person behaves with this problem.
Key takeaways
An ingrown toenail is a condition that does not go away on its own and usually worsens over time. The edge of the nail plate presses on the soft tissues, they become inflamed, pain and swelling appear, and with a prolonged course an infection joins them. This is most noticeable when walking and in tight shoes, when the pressure on the toe increases. Attempts to cut the corner deeper or to pick at the edge with improvised means often make the picture worse. If you delay the visit, the inflammation spreads to the neighbouring tissues, and it becomes harder to cope. Therefore, with an ingrown toenail it is sensible not to postpone seeing a specialist and not to undertake self-intervention. The support in solving this is a calm assessment of your condition and refraining from drastic actions.
