Ingrown toenail
Dr. med. Julia Schwarz is a freelance writer in the medical department.
More about the experts All content is checked by medical journalists.An ingrown toenail (Unguis incarnatus) is usually found on the big toe. It presses itself into the nail bed and causes pain. Often an ingrown toenail becomes infected too. Possible causes for ingrowth are, for example, shoes that are too tight and incorrect nail clipping. Read more here about the causes and symptoms and what treatment options are available if a toenail has grown in.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. L60
Ingrown toenail: description
Ingrown toenails usually press into the surrounding tissue. This pressure often causes inflammation with painful swelling. The irritated tissue is more susceptible to bacteria entering, making inflammation worse. As a result of the inflammation, so-called "wild flesh" (granulation tissue) forms, which begins to proliferate as the wound heals.
Ingrown nails cause uncomfortable pain, which is why those affected often cut the nails even shorter, in many cases oval. Even light pressure through the shoes pushes the edge of the nail into the tissue - an ingrown toenail is created again. It is difficult for those affected to break free from this vicious circle on their own. An ingrown toenail therefore deserves professional treatment. A doctor or medical foot care provider should be the first point of contact.
Ingrown toenail: symptoms
An ingrown toenail usually affects the big toe, less often the remaining toenails or fingernails. It can cause severe local pain. The accompanying inflammation causes swelling, the tissue is often red and feels warm. Wearing stockings or lying on a duvet can sometimes be a torture for those affected. At an advanced stage, the tissues can begin to bleed. In addition, in many cases an ingrown toenail brings pus with it.
Ingrown toenail: causes and risk factors
An ingrown nail can have a number of causes. Ingrown toenails can be promoted by using the wrong nail cutting technique. If the toenail is cut too far down at the edges (i.e. cut oval), the edges then grow more easily into the surrounding nail bed.
Tight footwear - especially worn by women - can also be the reason for an ingrown toenail. In tight shoes, sustained increased pressure between the skin and toenail can easily lead to nail ingrowth. Profuse sweating on the feet also softens the skin around the nail and also increases the risk of ingrown toenails.
In addition, an ingrown toenail occurs in families. Some people naturally have wider nail beds than others. The innate anatomical features of the nail bed also play a role.
Ingrown toenail: exams and diagnosis
Patients can usually tell for themselves what is causing the pain and inflammation in the foot: an ingrown toenail. But which doctor or which specialist can help with such a problem? In milder cases, the help of a medical podiatrist (podiatrist) is usually sufficient. If an ingrown toenail is more advanced and associated with considerable discomfort, you should consult a dermatologist or foot surgeon.
Ingrown toenail: treatment
If a nail has grown in, prompt treatment is required. There are different options:
Ingrown toenail: conservative treatment
As a first measure, it is recommended to tape the ingrown toenail to relieve the surrounding tissue from the nail. To do this, a padded plaster strip is pushed between the nail and the inflamed nail wall. The plaster is then pulled around the toe so that there is more air between the skin and the nail. Patients usually find this measure to be an immediate relief and the pain is alleviated.
An ingrown toenail can also be treated with anti-inflammatory iodine ointment. Foot baths are often useful in advance: they soften the tissue so that an ingrown toenail can then be better treated with ointments and plasters.
Sometimes an ingrown toenail is treated with a nail correction brace if the nail is too rounded on the side edges. A medical podiatrist (podiatrist) attaches the plastic or steel wire brace in such a way that it is attached to the edges of the nail and is fixed in the middle of the nail. It is worn for a period of around six to twelve months. This will slowly pull an ingrown toenail back up from the depths of the nail bed. The nail grows from scratch into a new shape, which is why this process takes so long.
Ingrown toenail: OP
If conservative measures are not sufficient, an ingrown toenail should be treated surgically: the ingrown nail corners and the surrounding granulation tissue are removed under local anesthesia. The wound is then covered with a plaster or a small bandage. Regular checks are carried out to check whether the inflammation has healed and whether the toenail has grown in again.
If there is a risk of a toenail growing in again and again, an operation to reduce the size of the nail bed (Emmert plastic or nail wedge excision) can be useful. The affected nail part and the lateral nail wall are removed in a wedge shape. The nail becomes narrower overall, which reduces the risk of re-ingrowth.
After the operation, the tissue is still very sensitive for a while. The patch should be changed regularly after the first two to three days.
Ingrown toenail: disease course and prognosis
An ingrown toenail can usually be treated well:
- With early treatment, conservative methods are usually sufficient. However, they require reliable cooperation and a lot of patience from the patient.
- If the disease progresses worse, an ingrown toenail often has to be operated on. The procedure brings quick success - the symptoms disappear.
Following any conservative or surgical treatment, the patient should ensure that the nails are trimmed correctly (straight and not oval) and that they do not wear shoes that are too tight. Otherwise, an ingrown toenail will quickly develop again.
An ingrown toenail often occurs without realizing it, especially in older people. Due to a lack of mobility, many older people are no longer able to properly and adequately care for their feet and nails. Medical foot care may then be necessary.
In addition, wearing sufficiently large and breathable footwear can prevent an ingrown toenail from developing (again).
Tags: nourishment skin first aid
