Ingrown Toenail
(Onychocryptosis)

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Medical Author:

Nili N. Alai, MD, FAAD

Nili N. Alai, MD, FAAD

Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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.

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.

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.