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Wednesday, June 10

Ingrown toenail symptoms

Home › Ingrown toenail › Causes › Symptoms of ingrown toenails
An ingrown toenail, or onychocryptosis, is a common painful condition that most often affects the outer edge of the big toe.

However, ingrown toenail can occur on any toe and also on both sides of the toe. The initial symptoms of ingrown toenail are mild pain, reddened skin and swelling at the corner of the toenail.

The symptoms of onychocryptosis develop as a reaction to a foreign body, when the toenail pierces and enters the flesh (the ungual labia folds) surrounding it. Considering the progress of symptoms, Jonathan D. Mozena (Podiatr Med Assoc. 2002 Mar;92(3):131-5) had classified onychocryptosis into stages I, IIa, IIb and III. Martínez-Nova A et al. added a new stage IV.

Symptoms in early stage of ingrown toenail

Early stage is an inflammatory stage with the following symptoms:

Erythema (reddening of skin) is caused by the increase of blood flow to superficial capillaries, mostly as an immune reaction.

Abscess stage of ingrown toenail

There is increase in erythema, swelling and pain. Hyperesthesia (increased sensitivity) is experienced by the patient.
The patient may experience continuous throbbing, stabbing pain.
There is hypertrophy of toenail fold. It extends over the ungual plate, but measures less than 3 mm.
Clear, thin, watery serous drainage may begin.
Next, it may progress into serosanguineous exudate, which is thin, watery, and pale red to pink in color. The pink tinge is due red blood cells leaking from damaged capillaries.
In this stage, infection may set in, causing seropurulent exudate of thin, watery, cloudy, and yellow to tan in color.

Infected ingrown toenail

Advanced abscess stage of ingrown toenail

There is further increase in erythema, swelling, excruciating pain and hyperesthesia.
The hypertrophy of toenail fold extends over the ungual plate and measures more than 3 mm.
Paronychia, an infection of the paronychium (soft tissue surrounding the border of the toenail), caused by Staphylococcus, Pseudomonas, Candida or superficial dermatophytes occurs.
Thick, opaque, purulent, foul smelling exudate of tan, yellow, green, or brown in color may discharge from the infected wound.
The affected area may feel hot to touch.

Symptoms in hypertrophic stage of ingrown toenail

In hypertrophic stage, the earlier symptoms like erythema, swelling, excruciating pain, hyperesthesia and pus discharge continue.
The hypertrophy becomes chronic with the increase in the volume of lateral fold tissue due to the enlargement of its component cells.
The hypertrophic fold tissue widely covers the lateral ungual plate.
Granulation tissue composed of new connective tissue and tiny blood vessels forms on the surfaces of the wound.

Symptoms in distal hypertrophic stage of ingrown toenail

The hypertrophic tissue completely covers the lateral, medial and distal ungual plate.
The toenail and the lateral and distal skin folds undergo chronic deformity.
If untreated cellulitis and osteomyelitis can occur.

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What is an ingrown toenail - Onychocryptosis

Home › What is ingrown hair? › What is an ingrown toenail - Onychocryptosis definition.

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.

Causes of ingrown toenail

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.

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.