Ingrowing Toenail

An ingrowing toenail is where a piece of nail pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too. A nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn't an ingrowing toenail but can feel very painful and can also appear red and inflamed.

There are many genetic factors that can make you prone to ingrowing toenails, including your posture (the way you stand), your gait (the way you walk) and any foot deformity such as a bunion, hammer toes or excessive pronation of the feet (when your foot rolls inward excessively). Your nails may also have a natural tendency to splay or curl out instead of growing straight, encouraging your nail to grow outwards or inwards into the flesh.

One of the most common causes is not cutting your toenails properly, such as cutting nails too low in order to relieve the pressure and discomfort of an involuted nail.

Tight footwear, hosiery and socks can also push your toe flesh onto the nail so that it pierces the skin. Also, if you sweat excessively or don’t rotate your footwear, this makes the skin moist and weak so that it is easily penetrated by the nail. If you have brittle nails with sharp edges or are in the habit of breaking off bits of nail that are sticking out, you are also more likely to get an ingrowing toenail. 

Less common is a fungal infection or in some cases particular types of medication, for example isotretinoin.

Active, sporty people are particularly prone, because they sweat more. Younger people are more likely to get it (as they pick their nails more, compared to older people who may not be able to reach their toes!).

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