The term “ingrown toenail” or “onychocryptosis” describes a condition in which the side edge of the nail grows downward and penetrates the surrounding skin.
It is one of the most common nail disorders.
It most frequently occurs in the toenails, especially the big toe.
In cases of ingrown nails, the affected nail may grow into the skin on the right side, the left side, or both sides of the nail fold.
In the majority of cases, this leads to damage of the tissue beneath the nail and, in some instances, to permanent nail deformity.
Finally, it can affect both men and women and occur at any age.
Initially, when the nail penetrates the skin, it causes mild inflammation, accompanied by pain, redness, and swelling. If left untreated, the pain may intensify, and pus accumulation or discharge may be observed. If still not addressed at this stage, both inflammation and pain become more severe, and granulation tissue may develop. In rare cases, bleeding may occur at the site of injury.
If the problem is neglected and proper treatment is not initiated, then the infection may spread to adjacent tissues, such as the bone, requiring immediate treatment. Especially in vulnerable individuals suffering from diabetes mellitus or vascular disorders of the lower extremities, the complications and consequences of not treating the condition may be greater.
There are several factors that may predispose someone to develop this condition. Improper trimming of the nails—especially cutting them too short—is the most common cause of ingrown toenails. Wearing tight-fitting shoes can also contribute. Women who frequently wear high heels or individuals who use very rigid footwear (e.g., combat boots) are generally more prone to this issue.
Other contributing factors include nail disorders caused by underlying conditions (e.g., fungal infections), which can increase nail hardness, hereditary predisposition (such as excessive nail curvature), as well as trauma to the area.
Lastly, intense physical activity that puts pressure on the toes can also lead to the nail growing into the skin.
The specialized dermatologist–dermatologic surgeon is the one who will determine the appropriate therapeutic intervention based on the patient's clinical presentation.
In the early stages of ingrown toenail with mild inflammation, topical treatment may be applied along with other conservative measures, such as foot soaks, wearing comfortable shoes, regular cleaning of the area, and more.
In cases of recurrence or failure of conservative treatment, surgical management may be recommended by the treating dermatologist. In some cases, oral antibiotic therapy may also be necessary.
The procedure is safe, performed under local anesthesia, involves a relatively short recovery time, and provides a permanent solution to the problem.
At the dermatology clinic Skin and Hair Medical Care, Dr. Sotiris Theocharis will determine the most appropriate treatment for you following a clinical examination.
To reduce the risk of developing onychocryptosis (ingrown toenails), it is recommended that you trim your nails without rounding the corners. The nail length should extend slightly beyond where the skin ends. If you are unable to trim your nails properly, seek assistance from a certified and specialized professional. Additionally:
Do not pick at or pull your nails with your fingers.
Make sure your shoes and socks are not too tight.
Maintain good hygiene in the area.
This depends on the severity of each individual case. First-degree ingrown toenail (mild inflammation) is usually managed conservatively, and in a significant number of patients, the problem resolves without the need for surgical intervention. A key factor in success is the strict adherence to all medical instructions provided by the treating dermatologist.
However, when the ingrown toenail is at a second or third degree of severity, the chances of success with conservative treatment are lower, as there are usually signs of chronicity (e.g., inflammation, granulation tissue) that hinder or delay wound healing. In such cases, surgical treatment is generally necessary to provide a permanent solution to the problem.