Governed by genetics, nails can vary in size and shape in people. Trimming nails is a weekly ritual for most of us, and a key part of a healthy nail care routine. Trimming — keeping it short or long — is a matter of preference. However, some people trim their nails too short and too close to the skin, causing them to curve at the corners as they grow. Such nails eventually cut into the surrounding skin, leading to ingrown nails — and the related pain.
How the nail is trimmed is just one factor. Ingrown nails can also happen when the tissue surrounding the nail is too thick and soft, which is particularly seen among overweight people or those with obesity.
“Ingrown nails happen when the nail turns inwards and grows into the skin or soft tissue,” says Dr Poonam Wadhwani, a Mumbai-based dermatologist and cosmetologist. “It causes pain, swelling and redness of the skin.”
The experience is painful as the nail digs into the soft tissue. In severe cases, the pain escalates and can be felt even while walking or wearing footwear.
Ingrown nails: More common in toes
The inward curving of nails is usually seen in toes, especially the big toe, and only rarely in fingers.
“In the beginning stage, it’s just the corners of the nails that start piercing the skin,” says Dr Sarika Jambhulkar, podiatry practitioner, FootImpact Podiatry Clinic, Mumbai. “After the piercing, the corner of the nail rolls inwards, forming a pincer nail which is usually very painful because the skin and soft tissue surrounding the nail get trapped. In severe stages, it can cause infection and pus formation.”
The pus occurs when there is bacterial infection in the soft skin around the nail. Sometimes there can also be a fungal nail infection which makes the nails look dry.
Other causes of ingrown nails
The type of footwear also influences the shape and curving of the toenails. Wearing narrow-fitting and pointed shoes can result in ingrown nails.
“Constantly wearing closed or ill-fitting or too-tight shoes that cause compression and constriction of the blood flow, having diabetes (which hinders blood circulation) or any underlying bacterial or fungal infection are some factors that cause ingrown nails,” says Dr Wadhwani. “Excessive perspiration and improper foot care are some other reasons.”
Dr Sarika adds: “Apart from footwear, another main reason is foot alignment issues. For example, if one has flat feet, the toe shape changes, and eventually the shape of the nail also changes, resulting in ingrown nails.”
Preventing and healing the nail
Wearing footwear of the correct size —in terms of both length and width — helps prevent ingrown nails. How, and how often, you trim your nails makes a difference, too.
“Not trimming the nails too short helps,” says Dr Wadhwani. “Home remedies include soaking the infected toe or foot in lukewarm water and then applying antibiotic creams.”
Dr Sarika adds: “The frequency at which the nails are trimmed is also important. One should trim the toenails at least once every 15 days, especially while wearing closed shoes. Trim the toenail straight and do not go very deep in the corners.”
Complete removal of nail not recommended
The discomfort and pain caused by an ingrown nail requires medical intervention in advanced stages.
In severe cases, where there might be infections too, placing a cotton pad below the edge of the nail and taking oral antibiotics might be required.
“Partial trimming of the nail or, if there is severe abscess, drainage [of liquid or pus] is required,” suggest Dr Wadhwani. “And if there is recurrence of ingrown nails, surgical excision of the entire nail is advised.”
But such surgical removal should be the last resort.
“We should always try to avoid it, because if anyone tries to remove the entire toenail, there is no control over how the new nail will grow,” points out Dr Sarika.
Also, the ingrown nails can reoccur despite complete removal too if the problem is not resolved completely.
“For this reason, non-surgical nail trimming can show effective and amazing results,” says Dr Vilas Jambhulkar, FootImpact Podiatry Clinic, Mumbai. “In this process, only the corner of the nail which is causing pain is trimmed. This is followed by corrective footwear and other correction methods. Frequent trimming and footwear changes will facilitate proper nail growth.”
Takeaways
- Ingrown nails occur when there is an inward curving of the nail into the skin and surrounding soft tissue region. They are mostly seen in toenails.
- An ingrown nail begins with a slight swelling, redness and pain. In severe stages, it also can lead to infections with pus formation.
- Trimming the nails straight and not curved or deep in the edges or too close to the skin helps prevent them from growing into the skin.
- Full removal of an ingrown nail should be the last resort. It is not commonly advised as there is always a chance of recurrence.
