In-growing nails are medically termed as ‘onychocryptosis’. It is one of commonest toe/foot complaints, but it can also occur on the fingers. It is a painful condition due to the piercing nature of the nail edges against the adjacent skin during growth. The growth of the nails usually depends on the status of the health and care for it. Nail matrix is the most important part determining the shape and thickness of the nail. The proper growth of nail is guided by the nail bed and the adjacent skin. Nails tend to coil after you let them grow long. This is due to loss of stability and support. But in case of in-growing nails, occurrence of crumbling is due to hindrance in growth or support or texture or disease.
- Uneven trimming/cutting of nails or biting nails
- Cutting nails deeply in a straight manner
- Nail Injury ending in deformity of nails
- Diseases of nails (fungal infection, rheumatoid arthritis involving finger joints, etc., can cause crumbling or deformity of nail or nail plate)
- Excessive thickening of nail will drive its lower edge inward (in psoriasis, lichen planus) causing in-growing nail
- Wearing ill-fitting and tight shoes for a prolonged time may restrict free nail growth and can cause in-growing nail
- Very sensitive and painful nail edges
- Throbbing or stabbing or pricking type of pain in nail/tip of fingers
- Red, swollen and inflamed skin, adjacent to in-growing nail edges
- Occasional discharge/oozing of fluid from inflamed part with pus/blood
- Brittleness or cracking or flaking of nails due to bending of growing nail with hindrance.
of in-growing nails are usually an extremely painful condition with sepsis and fever. It will often lead to emergency surgical procedure of partial or total nail removal. Usually, complaints of in-growing nails get aggravated by wearing ill fitting and tight shoes. Neglected or left-over untreated in-grown nails can produce complications as follows:
- Occurrence of nail bed infection & deformity of nail
- Infection that can spread into the deep spaces of foot
- Serious, life threatening circumstances can occur in people who suffer from diabetes and circulatory disorders
Prevention and management
- Proper cutting of the nails can surely avoid in-growing nails and its recurrence.
- Do not tamper skin, while cutting away the nails, since this may cause thickening of skin as a barrier against growing nails.
- Don’t trim nail very deeply, i.e. leave some free edges over the end of the nail.
- If it is very painful, in-growing edge of nail can be excised after being softened with any softeners or moisturiser or by soaking in water for a while.
- Trim in-grown nail from edge-to-edge in semi-lunar manner to avoid getting wound and infection or trim it straight and leave some free edges over skin to keep nail free from skin penetration
- Remove hanging nails, if any
- Wear proper fitting shoes with comfortable toe room.
- Prevent infection with anti-septic cream
In-growing nails are usually a recurring problem causing repeated infection. It will not resolve on its own as like other diseases that get resolved after the development of natural resistance in due course of suffering. So, treatment procedure is a must. In Allopathy, for in-growing nails, the first and foremost measure or treatment is excising the piercing edge or border of the nail, sometimes with partial or total nail removal. These measures give only temporary relief, but still the advantage of immediate shut down of pain is always admired. The next commonest prescription is anti-septic cream to control infection.
In-growing nail developed as/with a structural hindrance needs to be