Onychocryptosis more commonly known as ingrown toenails commonly affects the nail plate of the first phalanx (big toe).

The nail plate creates trauma to the surrounding skin (skin sulcus or cuticle), which causes inflammation, pain and opens the skin to bacteria. This may result in infection. A “spicule” is created that becomes anchored to the nail sulcus tissue. The growth of the nail plate causes the spicule to penetrate deeper into the tissue. In addition to this, the force from walking, pressure from tight footwear and/or nail shape increase the severity.

Ingrown toenails have multiple causes, such as incorrectly trimming the toenail. Incorrect trimming includes cutting the corners of the nail, shortening the nail edge to the nail bed, and rounding the edge of the nail. Other causes are trauma, hyperhidrosis, and poor foot hygiene. Conditions that may predispose the foot to oedema such as diabetes, and thyroid and renal disorders can increase the risk of ingrown toenails.

They can be common at all ages although we tend to see a relationship with teenagers growth spurts and the aging nails. As a result of the aging process the toenails texture changes, becomes less elastic, it also thicken. This increases the likelihood of pressure being placed on the lateral sides of the nail plate. Also, thicker toenails are can be more difficult to cut. This becomes a greater issue when there is a loss of mobility and vision, which subsequently results in a reduction in the ability to look after and care for toenails.

Ingrown toenails are painful and if left untreated may become very inflamed and infected. Walking, wearing tight shoes and/or incorrect cutting of the nail can make it worse.

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