Ingrown Toenail / Ingrown Nail

Ingrown nail (also known as an " Onychocryptosis ,") is a common form of nail disease. It is an often painful condition in which the nail grows so that it cuts into one or both sides of the nail bed. While ingrown nails can occur in both the nails of the hand and feet, they occur most commonly with the toenails, generall known as Ingrown Toenail Infection.

The main cause for Ingrown nail ( Onychocryptosis ) is improper footwear including shoes with inadequate toe-box room and tight stockings that apply top and or side pressures; next is the damp wet atmosphere toes are subjected to all day in enclosed shoes, softening the nail-plate and swelling the epidermis keratin, which eventually increases the convex arch permanently; next is genetics; and last are trauma and disease.

Improper cutting of any nail may cause the nail to cut into the side-fold skin from growth and impact, whether or not the nail is "ingrown" ( Onychocryptosis ). The nail bends inwards or upwards depending on the angle with which it has been cut. A shorter cut will bend the nail more, unless the cut is even on both top and bottom of the nail.

Causes include:

• Bad maintenance, including cutting the nail too short, rounded off at the tip or peeled off at the edges instead of being cut straight across
• ill-fitting shoes, as those that are too narrow or too short can cause bunching of the toes in the developmental stages of the foot (frequently in those under 21), causing the nail to curl and dig into the skin
• Trauma to the nail plate or toe, which can occur by stubbing the toenail, dropping things on the toe or going through the end of the shoes (as during sports or other vigorous activity), can cause the flesh to become injured and the nail to grow irregularly and press into the flesh
• Predisposition, such as abnormally shaped nail beds, nail deformities caused by diseases, or a genetic susceptibility to nail problems like ingrowth

" Ingrown Toenails " is actually a problem where there is too much skin around the nail ("Overgrown Toeskin") - the nail is not the problem.

Symptoms of an ingrown nail include pain along the margins of the nail (caused by hypergranulation that occurs around the aforementioned region), worsening of pain when wearing shoes or other tight articles, and sensitivity to pressure of any kind, even the weight of bed sheets or a duvet. Bumping of an affected toe with objects can produce sharp, even excruciating, pain as the tissue is punctured further by the ingrown nail . By the very nature of the condition, ingrown nails become easily infected unless special care is taken to treat the condition early on and keep the area as clean as possible. Signs of infection include redness and swelling of the area around the nail, drainage of pus and watery discharge tinged with blood. The main symptom is swelling at the base of the nail on whichever side (if not both sides) the ingrowing nail is forming.

The most common place for ingrown nails is in the big toe, but ingrowth can occur on any nail. Ingrown nails can be avoided by cutting nails straight across; nails should not be cut along a curve, nor should they be cut too short. In both cases, the important thing to avoid is cutting the nail shorter than the flesh around it. Footwear which is too small, either in size or width, or those with too shallow a 'toe box' will exacerbate any underlying problem with a toenail.

Ingrown toenail can be caused by injury, commonly blunt trauma where the flesh is pressed against the nail causing a small cut that swells. Also, injury to the nail can cause it to grow abnormally, making it thicker or wider than normal or even bulged or crooked. Stubbing the toenail, dropping things on the toe and 'going through the end of your shoes' in sports are common injuries to the digits. Injuries to the toes can be prevented by wearing properly fitting shoes, especially when working or playing.

Treatment of ingrown nails ranges from soaking the afflicted area to surgery. The appropriate method is dictated by the severity of the condition. In nearly all cases, drainage of blood or watery discharge should mean a trip to the doctor, usually a podiatrist, a specialist trained explicitly to treat these conditions. Most practitioners agree that trying to outwait the condition is nearly always fruitless, as well as agonizing, but it can be done as long as the condition is not too severe and if the individual has a high pain threshold.

In mild cases, doctors recommend daily soaking of the affected digit in a mixture of warm water and Epsom salts and applying an over-the-counter antiseptic. This might allow the nail to grow out so it may be trimmed properly and the flesh to heal. Note that infection may be somewhat difficult to prevent in cleaning and treating ingrown nails owing to the warm, dark, and damp environment in shoes.

Peroxide is immediately effective to help clean minor infections but iodine is more effective in the long term as it continues to prevent bacterial growth even after it is dry. However, iodine should not be used on deep wounds. In such cases a physician or podiatrist should be consulted. Also, although bandages can help keep out bacteria, one should never apply any of the new types of spray-on bandages to ingrown nails that show any discharge - preventing drainage will likely cause intense swelling and pain. Removal of spray-on bandages can be achieved with common rubbing alcohol.

Another effective method is to use a toothpick or other small pointed object to stuff a very small piece of cotton under the nail, specifically the affected area or as close to it as possible. In mild or moderate cases this may help the nail to grow back out from underneath the skin.

Never ever attempt to alleviate the swelling using a needle, doing so can lead to an infection.

These home remedies are, in serious cases, ineffective: when the flesh is too swollen and infected these procedures (purple skin around natural skin tone) will not work. Thus, these more severe cases, such as when the area around the nail becomes infected or the nail will not grow back properly, must be treated by a Podiatrist.

If you think you may have an ingrown toenail, toenail fungus or any other nail infeciton seek professional help from a Podiatrist as soon as possible.

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