An ingrown toenail, or onychocryptosis, is a common condition in which the edge of the nail plate grows into the soft tissue of the toe, causing pain, inflammation, and the risk of secondary bacterial infection. This condition usually affects the big toes, but can also occur on other toes. The most common causes of ingrown toenails are improper nail trimming, wearing ill-fitting shoes, and injury. If left untreated, an ingrown toenail can lead to chronic inflammation, granulation tissue formation, and, in severe cases, even osteomyelitis.
History of the disease and interesting historical facts
Onychocryptosis has been known to mankind for many centuries. The first mentions of this pathology date back to Ancient Egypt, where doctors tried to treat ingrown nails with poultices and herbal extracts. Ancient Greek medical texts also describe methods for eliminating ingrown nails. Throughout history, medicine has sought to find effective methods for treating this condition, and in the 20th century, surgical interventions were developed that significantly improved outcomes for patients. Interesting fact: in the 18th century in France, the famous surgeon A. Bonnet created a method that involved using a special tool to correct the shape of the nail and reduce the risk of its ingrowth.
Epidemiology
According to statistics, ingrown toenails affect approximately 2-5% of the population. Men suffer from this condition more often than women, and the age group of 15 to 25 years is most susceptible to this condition. Research shows that the incidence of ingrown toenails increases in the summer months, when the pressure on the nail plates from shoes increases. Geographical features and the level of hygiene of the population are also important factors influencing the prevalence of the disease.
Genetic predisposition to this disease
Some studies point to a genetic predisposition to ingrown nails. It is likely that certain mutations in the genes responsible for nail formation and growth may affect their shape and structure. Currently, genes such as KRT17 and KRT14, which are responsible for keratinization and morphogenesis of the nail plate, are being studied. It is assumed that hereditary predisposition may determine the peculiarities of nail growth, which increases the risk of ingrown nails.
Risk factors for the development of this disease
Risk factors for ingrown toenails can be classified into physical and chemical:
- Incorrect nail cutting – too short or the wrong shape can contribute to ingrowth.
- Shoes that don't fit properly - tight or narrow shoes put pressure on the nail plate, increasing the risk of ingrowth.
- Trauma – significant mechanical damage to the nails can cause their deformation and growth disorders.
- Conditions that affect nail formation, such as diabetes, psoriasis or fungal infections, can significantly increase the risk.
- Poor hygiene – Not taking proper care of your feet can lead to infection developing around the nail.
Diagnosis of this disease
Diagnosis of an ingrown nail is based on a clinical examination. The main symptoms include:
- Pain and discomfort in the nail area.
- Inflammation and redness of the skin around the nail.
- Discharge of pus or serous exudate.
- Enlargement of the nail fold and formation of granulation tissue.
Laboratory tests may include microbiological testing to detect possible infection. Radiological tests, such as X-rays, can help rule out bone damage. Differential diagnosis is important to rule out other conditions, such as nail tumors or trauma.
Treatment
Treatment of an ingrown nail can be either conservative or surgical:
- General treatment. Includes shoe style correction, nail care and the use of antiseptics.
- Pharmacological treatment. Use of anti-inflammatory drugs and antibiotics in case of infection.
- Surgical treatment. In complex cases, partial or complete removal of the nail plate may be required.
- Other types of treatment. Use of orthopedic devices for correct correction of nail growth.
List of medications used to treat this disease
- Nonsteroidal anti-inflammatory drugs (eg, Ibuprofen)
- Topical antibiotics (eg, gentamicin).
- Keratolytic agents (eg, salicylic acid).
- Antifungal medications (if there is a fungal infection).
Disease monitoring
Control stages of treatment and monitoring of ingrown nails include regular specialist examinations, especially after surgery. The prognosis with adequate treatment is usually positive, but complications such as re-ingrowth of the nail or formation of abscesses are possible. It is important to educate the patient on proper nail care for prevention.
Age-related features of the disease
Ingrown nails can present differently depending on the age of the patient. Teenagers are more likely to develop ingrown nails due to improper cutting and intense physical activity. Older people are more likely to develop ingrown nails due to decreased skin elasticity and age-related changes in nail structure.
Questions and Answers
- How to prevent ingrown toenails? To prevent the disease, it is important to trim your nails correctly, avoid tight shoes and maintain foot hygiene.
- When should you see a doctor? It is recommended to consult a doctor if you experience pain, redness or pus around the nail.
- What are the complications of an ingrown toenail? Possible complications include bacterial infections, abscesses, and regrowth of the nail.
- Are there any home remedies? Some home remedies, such as using warm salt baths, may help relieve symptoms but should not replace professional treatment.
- Can an ingrown toenail come back after treatment? Yes, there is a possibility of re-ingrowth, especially if there are risk factors.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov recommends paying attention to the following:
- Visit a qualified professional for regular nail checks, especially if you have had an ingrown toenail in the past.
- Choose shoes that provide adequate room for your toes.
- Do not try to cut your nail yourself if it is ingrown – this may worsen the condition.
- Keep your feet clean and healthy to prevent infections that can complicate matters.
- Perform regular foot exercises to improve circulation and normal nail growth.
These tips will help you maintain healthy nails and prevent the condition from becoming more common.
