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What is an ingrown toenail - Onychocryptosis

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What is an ingrown toenail?

Ingrown toenail, medically termed as onychocryptosis or unguis incarnatus is a common painful nail disease. Onychocryptosis, often affects the great toenail (hallux).
Onychocryptosis can be defined as a condition in which the toenail grows cutting into one or both sides of the nail bed. Onychocryptosis may also occur due to overgrown skin fold around the toenail. Pain, swelling and discharge are the main clinical features of onychocryptosis.

Diagnosis is apparent with inflamed reddened toe characterized by nail-fold swelling, erythema, edema, and pain with pressure. The toenail disease can cause significant morbidity and hamper the quality of life by interfering with daily activities.

Several treatment options are available. If the onychocryptosis is in its initial stage conservative methods of treatment such as treatment with warm water and salt soaks,antibacterial ointment and using dental floss or a gutter splint to provide a track for the nail to grow can be opted. If the toenail is highly infected or recurrent, surgical correction is the treatment of choice.
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Onychocryptosis web definition
The definition of onychocryptosis according to collinsdictionary.com is "a form of nail disease in which nails are ingrown".
The lexbook.net defines as "Onychocryptosis, also known as an ingrown toenail, or unguis incarnatus is a common form of nail disease."

Several anatomic and behavioral factors contribute to onychocryptosis. Some of the factors are:
  • poor foot hygiene,
  • improper trimming of the nails,
  • ill-fitting shoes,
  • cutting the nail too short,
  • rounded off at the corners of toenail,
  • peeling off nails,
  • stubbing the toenail,
  • dropping things on the toe,
  • pressure on the skin around the nail,
  • footwear bunching the toes,
  • abnormally shaped nail beds,
  • overcurvature of the nail plate,
  • too much skin around the nail,
  • thick nail folds,
  • lower extremity edema,
  • pressure necrosis of tissue around the nail,
  • hyperhidrosis and softening of skin around the nail,
  • nail deformities caused by diseases,
  • bacterial or fungal infections,
  • genetic predisposition to onychocryptosis and
  • congenital onychocryptosis.
image of wounded infected toenail
wounded infected ingrown toenail

Treating ingrown toenail

There are several conservative as well as surgical options available for treating onychocryptosis. Some of the treatment options are:
  • soaking the foot in warm, soapy water,
  • applying topical antibiotic or steroid ointment,
  • placing cotton under the onychocryptosis corner,
  • inserting dental floss under the onychocryptosis edge,
  • placing gutter splint,
  • correcting the convexity of the nail by reducing its thickness,
  • using nail wire or brace to reduce convexity of onychocryptosis nail,
  • partial nail avulsion,
  • total nail excision,
  • phenolization,
  • electrocautery,
  • matricectomy and
  • laser ablation of the onychocryptosis nail matrix.
Following a regular foot and toenail care regimen will keep onychocryptosis at bay.
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References on ingrown toenail:
1.Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009 Feb 15;79(4):303-8.
2.Reyzelman AM, Trombello KA, Vayser DJ, Armstrong DG, Harkless LB. Are antibiotics necessary in the treatment of locally infected ingrown toenails? Arch Fam Med. 2000;9(9):930–932.
3.DeLauro NM, DeLauro TM. Onychocryptosis. Clin Podiatr Med Surg. 2004;21(4):617–630.
4.Khunger N, Kandhari R. Ingrown toenails. Indian J Dermatol Venereol Leprol. 2012 May-Jun;78(3):279-89.
5.Chapeskie H. Ingrown toenail or overgrown toe skin? Alternative treatment for onychocryptosis. Can Fam Physician 2008;54:1561-2.
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