An ingrown toenail —onychocryptosis— is an edge of the nail plate that, instead of growing over the skin, grows into it. The skin reacts as it would to any foreign body: it becomes inflamed, hurts against the shoe and, if it continues, can form red raised tissue around it or become infected. It usually starts on the big toe and almost always on the same side.
It is hardly ever one single thing. Several add up: the shape of the nail —a strongly curved plate digs in by itself—, a cut that is too short or rounded at the corners, footwear that presses across the foot, moisture that softens the skin of the groove and, in some cases, a toe pushing against its neighbour. Working out which of those dominates in your case is what decides whether changing the cut and the shoe is enough, or whether something more is needed.
What is looked at, and what NOT to do
- The shape of the nail plate and the groove, to see whether the nail digs in by design.
- Signs of infection: growing pain, heat, redness or discharge.
- Footwear and the way you cut the nail — the two causes you can change today.
- Do not cut a V or a point: it relieves nothing and leaves a spike that digs in again.
- Do not dig in the groove with scissors or pins: it is the quickest route to an infection.
Is the edge of your nail digging in and hurting in your shoe?
Book an appointmentFrequently asked questions
- Why is it nearly always the big toe?
- Because three things come together in that toe that do not in the others. Its nail is the widest and the most curved, so its edges sit deeper in the groove; it is the toe that takes most pressure as the foot pushes off; and it is the first to meet the front of the shoe, especially if the shape ends in a point. On top of that, if the toe is deviated towards the others — as in a bunion — its nail no longer points straight ahead and one of the edges sits deeper still. That is why, when it keeps happening on that toe, the appointment also looks at the shape of the foot and not only at the nail.
- Do gel polish or gel nails have anything to do with it?
- They do not make a nail dig in on their own, but they can add to it. In two ways: through what is done when applying them — filing the surface of the plate and, above all, removing or pushing back the skin of the groove, which is the barrier protecting that area — and through what they prevent you seeing, because a layer of colour covers the edge exactly where it should be looked at. Also, a plate reinforced with rigid material loses flexibility and responds worse to pressure from footwear. You do not have to give them up: what helps is not touching the groove, not filing into the corners, and removing them from time to time to see the nail as it is.
