How do ingrown nails occur?

Ingrown nail

Ingrown nail (Unguis incarnatus): Finger or toenail that has grown into the nail fold, with or without accompanying painful inflammation. The big toe is most commonly affected. Nail ingrowth is promoted by improper nail care and too tight shoes. The treatment consists of special bandages, plastic splints or nail braces; in pronounced cases, the nail has to be operated on.

Leading complaints

  • Ingrown nail
  • Strong pain
  • Possibly red, swollen, tender nail wall
  • Sometimes also purulent papules.

When to the doctor

In the next days

  • at the above signs.

The illness

The ingrowth of nail edges into the surrounding areas of the skin is most common on the big toes. In addition to ingrowth, there is often purulent inflammation with reddening, swelling, throbbing pain and pus discharge.

Younger people between the ages of 14 and 25 are particularly affected, men somewhat more often than women. Causes and facilitating factors are

  • wrong pedicure, round trimming of toenails
  • shoes that are too tight
  • Disposition
  • Nail disease.

Diagnostic assurance

The ingrown nail is a visual diagnosis.

Differential diagnoses. Depending on the extent of ingrowth and accompanying inflammation, an ingrown nail can resemble black skin cancer (malignant melanoma) or squamous cell carcinoma on the nail.

treatment

In the case of an ingrown nail, the doctor must both correct the nail position and contain the existing inflammation.

Nail correction

Tape bandage. In mild cases, the doctor applies a tape dressing that pulls the inflamed nail wall away from the nail with adhesive plaster strips.

Alternatively, he brings a small one Plastic split pin in the side fold of the nail to encourage normal nail growth.

Nail correction brace. The nail brace is a narrow wire that is individually adapted and - depending on the initial situation - glued to the nail for several weeks to a year. At the edge of the nail, a small hook is hooked under the nail edge so that the nail is easily lifted and the surrounding tissue is relieved. The nail braces regulate the nail position in a similar way to braces. An integrated loop allows the tensile force on the nail to be dosed and the direction of growth to be controlled until the nail grows straight again. The treatment with the nail correction brace can also be carried out by the medical podiatrist.

surgery. If the nail has grown deeply, surgical intervention is necessary. The doctor removes the overgrown flesh either with a scalpel, with cold (kyrotherapy) or with heat (electrocautery). This procedure is performed under local anesthesia. In the case of recurring complaints, a surgical procedure can be used Nail bed reduction (Emmert plastic, nail wedge excision), in which part of the nail including the nail root is removed. This makes the growing nail narrower. In newer surgical procedures, the nail plate is thinned and repeatedly ground down, which ultimately changes the appearance of the nail less than the reduction of the nail bed.

Treating inflammation

If there is an inflammation, the doctor treats it with antiseptic cotton rolls and loose bandages. He also often prescribes foot baths with potassium permanganate or quinolinol.

forecast

The earlier treatment begins, the easier it is to treat an ingrown nail. However, nail braces take time. In order to prevent the nail from growing in again, the patient must take care of suitable shoes and proper foot care (see your pharmacist recommends).

Your pharmacy recommends

What you can do yourself

If the nail is only slightly ingrown, a regular foot bath with curd soap, chamomile or 1% potassium permanganate solution is sufficient. After the footbath you can brush the excess "wild" meat with a silver nitrate pen (Höllenstein etching pen) and thus make it die off.

Prevention

  • Cut nails not round, but square and not too short
  • Avoid tight shoes
  • Regular medical foot care for elderly patients who cannot easily reach their own toes due to lack of mobility.

Authors

Dr. med. Arne Schäffler, Dr. Bernadette Andre-Wallis in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 09:40


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.