Causes

Causes of ingrown toenails:

1. Incorrect cutting of toenails. People often tend to cut right down the sides of their toenails regularly. This habit can lead to toenails digging into the skin, with a resultant painful ingrown toenail. At times a piece of nail, commonly referred to as a nail spike, can easily be left behind as "the bathroom surgeon" has difficulty in seeing/reaching and /or is using make-do nail cutters and other objects. The nail spike grows forward and pierces the skin at the side of the toenail. This often becomes very tender, red, inflamed and pus may be present, indicating infection. Pus pockets then cause an increase in pain, and if left untreated some tissue may form at the side of the toenail. This granulation tissue is the body's response to a "foreign body" and may later increase in size and become hypergranulation tissue. Hypergranulation tissue develops its own vascular and nerve supply and becomes even more tender and bleeds easily/constantly.

1. Repeated minor trauma to toenail - for example constant pressure from ill-fitting footwear/shoes too small.

1. Single major trauma to toenail. This could happen in the form of stubbing your toe, dropping a heavy object on your toe or from someone standing on your toe.

1. Pressure on toenail from adjacent overlapping/overcrowded toes

An ingrown toenail (onychocryptosis) can occur at any age, and is a condition that often becomes infected, requiring a more permanent surgical procedure.

Often one or both of the nail edges (medial/lateral) of an incurved toenail may press into what is called the sulcus, causing a painful lesion. If the nail penetrates through the skin, hypergranulation tissue may form on the side. This may become very vascular and tender may result in an infection, and bleed often. In most cases an ingrown toenail may be managed conservatively, but if this is not possible or if they recur, then toenail surgery is recommended.

According to the 2012 National Health Assessment conducted by NPD Group of Preventive Foot Health, 18% of US adults age 21 and older have experienced an ingrown toenail.

Kindly note that this clinic may refer a patient who is considered high risk, to an alternative organisation for management, if the clinic deems it necessary. An example of a person, who is considered high risk, could include one with poor peripheral circulation, neuropathy and multiple comorbidities. Additional vascular assessments may be required, and in some cases these individuals may not be suitable for a surgical procedure and may have to continue with regular conservative management and constant monitoring.

(Comorbidities = presence of additional conditions/illnesses occurring in the same person at the same time)