Ingrown Toenails
Einstein Health Glossary
ICD 10 - L600
What are ingrown toenails?
Ingrown toenails occur when the corner of the nail, which slides into a small fold of skin on both sides of the nail, becomes surrounded by an excessive amount of inflammatory tissue. This tissue prevents the nail from growing without causing further damage to the area, which is usually enlarged due to a secondary infectious process.
Is there any “classification”?
An ingrown toenail can be chronic or acute, when there is active infection and a more intense inflammatory condition.
Causes
The cause is improper nail trimming, usually of the toenails, especially the big toe.
When we cut the corners of the nail too short, they remain inside the skin fold on the sides of the nail, causing traumatic injury to this skin (because it is pushed upward when we walk and place weight on the big toe), which then suffers a secondary infection caused by bacteria that normally live on our skin.
This infectious process causes local swelling, which hinders nail growth, significant pain, and difficulty wearing regular shoes. Pointed shoes and high heels can also contribute to this condition.
Some nail shapes may make this more likely to occur.
Symptoms
Pain, swelling, discharge, and redness of the toe folds.
Diagnosis
The diagnosis is clinical, based on these findings.
Treatment: measures to relieve pain? Measures to prevent it?
We usually treat the infection and local inflammation to reduce the volume of skin in front of the nail and allow it to exit the fold it occupies. It may be necessary to lift the edge of the ingrown nail, which can be done under local anesthesia.
In cases where conservative or minimally invasive treatments fail, a surgical procedure may be needed to remove a portion of the nail and the hypertrophied skin covering it, and to reestablish the relationship between the nail and the skin at the corners.
Risk factors
Certain nail shapes, pointed shoes and high heels, excessive manipulation, and improper nail trimming.
Prognosis. Living with the problem.
It is important to guide patients to keep the nail corner out of the skin fold, avoid excessive cuticle manipulation, and treat any changes early.
Possible complications?
The infection may reach the joint between the toe bones or the bone itself, causing difficult-to-control and treat problems. In patients with circulation issues or diabetes, this can lead to serious complications, potentially resulting in the need for amputation of the affected area.