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November 25, 2009
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Ingrown Toenail
(Onychocryptosis)

Medical Author: Nili N. Alai, MD, FAAD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What are ingrown toenails? What are the symptoms?

Ingrown toenails are a very common problem affecting primarily the great toenail. They are caused by sideways growth of the nail edge into the skin of the toe. The abnormal extension of the toenail pushes into the surrounding skin causing discomfort. Normal toenail growth should be vertical or outward toward the tip of the toe. The medical term for ingrown toenail is onychocryptosis.

Symptoms of ingrown toenails are sore, often painful, nail folds with various degrees of redness, swelling, and sometimes clear or yellow drainage. Frequently, ingrown toenails resolve without medical treatment. Complicated cases may require treatment by a physician.

What causes ingrown toenails?

The sideways growing portion of nail acts like a foreign body and pokes into or pinches off a small piece of skin at the outer edge of the toe. This may cause a break in the skin, causing inflammation and possibly infection. The inflammation often causes more thickening of the nail skin fold, further exacerbating the problem. The protruding piece of nail keeps pushing into the skin, causing further injury and pain.

Are some people more prone to ingrown toenails?

Some people are simply more prone to ingrown toenails. Some risk factors include

  • athletic adolescents and children,


  • tight or narrow shoes (poorly fitted shoes),


  • repeat injury or trauma to feet,


  • poor foot hygiene,


  • poor posture and gait,


  • congenital foot deformity,


  • congenital toenail malformation,


  • very long toes,


  • naturally short nails,


  • obesity,


  • diabetes,


  • toenail infections,


  • fungal nail disease,


  • prior nail surgery,


  • abnormal nail growths,


  • arthritis, and


  • excessive foot sweating.


Next: Which nails are most commonly affected? »

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Ingrown Toenail

How is the foot designed?

The foot is an intricate structure of 24 bones that form two arches. The longitudinal arch runs the length of the foot, and the transverse arch runs the width. The ankle joint is the interaction of the foot and the lower leg, and the toes are on the far side of the foot. The bones of the foot are primarily held together by the shape that they fit with each other and by a fibrous tissue known as ligaments. The muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. The foot has internal muscles that originate and insert in the foot and external muscles that begin in the lower leg and attach in various places on the bones of the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact during weight-bearing.

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