Ingrown toenail (onychocryptosis)

Ingrown toenail (onychocryptosis): symptoms, causes, and diagnosis

Ingrown toenail (onychocryptosis): symptoms, causes, and diagnosis

Understanding ingrown toenail (onychocryptosis)

Ingrown toenail, medically known as onychocryptosis, is a condition in which the edge of the nail grows into the soft tissues surrounding it, causing pain, inflammation, and sometimes infection. This typically occurs due to improper footwear, incorrect nail trimming, or nail growth disorders. An ingrown toenail can lead to serious problems if left untreated and includes conservative treatment methods and, in some cases, surgical intervention to correct the issue.

Pathology leading to ingrown toenail

Ingrown toenail (onychocryptosis) is most often caused by improper nail care, but can also result from structural abnormalities of the nail bed itself. Orthopedic anomalies, injuries, genetic factors, narrow-toed shoes, and infections—all of these factors can contribute to the development of this condition. Excessive trimming of the nails, wearing uncomfortable shoes, or trauma resulting in damage to the surrounding tissues can lead to an ingrown toenail, causing pain and inflammation for the patient. If the problem is ignored for a long time, serious complications may arise, so early identification of the causes is important to prevent ingrown toenails.

  • Improper nail care: incorrect trimming of nails or too short cuts can contribute to an ingrown nail.
  • Orthopedic anomalies: foot or toe deformities can exert pressure on the nail bed, causing onychocryptosis.
  • Injuries: damage to the nail or surrounding tissues can provoke improper nail growth and ingrowth.
  • Wearing uncomfortable shoes: shoes with a tight toe box can press on the nail, leading to its ingrown condition.
  • Genetic factors: hereditary features can make a person more susceptible to ingrown nails due to the characteristics of the nail bed structure.

The main signs of an ingrown toenail

Symptoms of an ingrown toenail (onychocryptosis) may include pain, redness, swelling, and inflammation around the edge of the nail. Patients often experience discomfort when pressure is applied to the affected area, and may also notice the presence of purulent discharge. With prolonged presence of an ingrown toenail, there may be growth of hypergranulations – excess tissue covering the wound’s surface, which can increase pain sensations and complicate wound healing.

  • Pain and discomfort: patients may experience pain when pressure is applied to the ingrown nail, which can worsen when walking or wearing shoes.
  • Redness and inflammation: the skin around the ingrown nail may become red, inflamed, and tender to the touch.
  • Swelling and redness: inflammation and pressure from the incorrect shape of the nail can cause swelling of the tissues and discoloration of the skin around the nail.
  • Presence of purulent discharge: sometimes pus may accumulate in the pathological area, which may indicate the presence of an infection.
  • Increase in hypergranulation: with prolonged trauma and inflammation, excessive tissue may form, which can lead to additional pain and complicate the healing of the wound.

Expert opinion on the treatment methods for ingrown toenail

Experts in the field of dermatology and nail surgery highlight several main methods for treating ingrown nails (onychocryptosis), including conservative and surgical approaches. Conservative treatment involves the use of antiseptic therapy, anti-inflammatory medications, and antibiotics to reduce inflammation and pain. Experts also recommend that patients with an ingrown nail practice proper care of their nails and feet, as well as wear comfortable shoes with a wide toe box to prevent further injuries and deformities.

In the case of uncontrolled or chronic onychocryptosis, experts recommend surgical treatment, which involves the removal of the ingrown edge of the nail followed by plastic reconstructive surgery. Surgical correction can be performed if there is no positive dynamics after conservative treatment, as well as in the presence of complications such as purulent processes or recurrences. Successful treatment of an ingrown nail requires a competent approach and an individualized choice of method depending on the severity and nature of the condition.

Methods of diagnosing an ingrown toenail

Diagnosis of ingrown toenail (onychocryptosis) includes a visual examination of the affected nail and surrounding tissues to assess the presence of inflammation, swelling, or purulent discharge. Additional diagnostic methods may include X-rays to determine the possible presence of osteomyelitis or other complications, as well as a bacterial culture analysis of purulent material to identify the pathogen of the infection and select antibiotic therapy. Ultrasound examination may also be used to assess the depth of inflammation infiltration based on the impact on surrounding tissues.

  • Visual inspection: Assessment of inflammation, swelling, and purulent discharge on and around the affected nail.
  • X-ray: To identify complications such as osteomyelitis and to assess the condition of underlying bone structures.
  • Bacterial culture test: Identification of the infectious agent by analyzing purulent material, which helps choose the most effective treatment.
  • Ultrasound examination: Used to assess the depth of inflammation infiltration and its impact on surrounding tissues.
  • Clinical tests: Include a complete blood count to identify signs of inflammation and biochemical tests to assess the overall health status of the patient.

Methods of treating ingrown toenails

Treatment for ingrown toenail (onychocryptosis) may include conservative methods such as regular use of softening foot baths, the use of antiseptics to reduce inflammation, as well as recommendations for proper nail care. In cases with more serious symptoms or recurring cases, surgical intervention may be required, such as partial or complete removal of the nail or part of the nail bed, to prevent further ingrowth and ensure healing without complications. It is important to consult a qualified specialist to assess the condition of the ingrown nail and choose the optimal treatment method based on the individual characteristics of each patient.

  • Conservative methods: include the use of softening foot baths, antiseptic agents to reduce inflammation, and recommendations for proper nail care.
  • Surgical intervention: in cases with severe symptoms, partial or complete removal of the nail or part of the nail bed may be required to prevent further ingrowth.
  • Individualized approach: it is important to consult a professional to choose the optimal treatment method, taking into account the characteristics of each patient.
  • Preventive measures: after successful treatment of an ingrown nail, it is essential to adhere to precautions to prevent relapses and maintain nail health.
  • Consultation with a specialist: since treatment should be individualized, it is important to discuss all methods and possible therapy options with a nail problem specialist.

Preventive measures for ingrown toenails

Prevention of ingrown toenails (onychocryptosis) includes proper nail care, including regular and careful nail trimming, avoiding cutting them too short or in the wrong shape, which can contribute to ingrown nails. It is important to wear comfortable shoes with enough toe space, avoiding overly tight footwear that can put pressure on the nails and cause them to grow into the skin. If there is a nail pathology or an increased risk of developing an ingrown toenail, it is advisable to consult a specialist for regular monitoring and preventive recommendations.

  • Proper nail care: includes regular trimming of nails, preventing them from being cut too short or shaped incorrectly, which contributes to ingrown nails.
  • Choosing comfortable footwear: wearing comfortable shoes with enough room for the toes will help avoid pressure on the nails and prevent ingrown conditions.
  • Avoiding injuries and damage: preventing injuries to the nail plate and surrounding tissues will help prevent the development of ingrown nails.
  • Consulting a specialist: if there are nail abnormalities or an increased risk of ingrown nails, it is important to consult a doctor for regular monitoring and recommendations for prevention and care.
  • Proper shoe fitting: choosing shoes with the right shape that do not put pressure on the nail plates will help prevent the development of ingrown nails and ensure comfort for the feet.

Amazing features of an ingrown toenail

An interesting fact about onychocryptosis is that this condition can occur not only on the toenails but also on the fingernails, although this is much rarer. This phenomenon is the result of the similarity in the structure and function of the nails on the hands and feet, as well as their exposure to precise and frequent injuries in everyday life. Additionally, ingrown nails can occur in both men and women, regardless of age, although this condition is most commonly found in teenagers and young adults due to the peculiarities of nail plate growth and development.

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