ingrown fingernail

Introduction

An ingrown fingernail is a painful condition in which the edge of a nail grows into the surrounding skin. While we often hear about ingrown toenails, fingernails can also become ingrown. This article will explore what an ingrown fingernail is, its causes, symptoms, treatment options, and prevention strategies. Whether you're dealing with this issue yourself or simply want to learn more, this comprehensive guide will provide you with the information you need to understand and manage ingrown fingernails.

What Is an Ingrown Fingernail?

An ingrown fingernail, also known as onychocryptosis when it affects toenails, is a condition where the edge or corner of a nail grows into the surrounding skin. 1,2 This can cause pain, inflammation, and in some cases, infection. While ingrown nails are more common in toes, especially the big toe, fingernails can also become ingrown. 1,2

To understand ingrown fingernails better, it's helpful to know the anatomy of a nail:

• Nail plate: This is the hard, visible part of the nail that we typically call the "nail."
• Nail fold: The skin surrounding the nail plate.
• Nail bed: The skin underneath the nail plate.

When a fingernail becomes ingrown, the edge of the nail plate pierces the nail fold, causing irritation and potentially infection.

Compared to ingrown toenails, ingrown fingernails are less common but can be just as painful and troublesome. The fingers are more exposed and used often, which can make an ingrown fingernail a daily frustration.

If left untreated, an ingrown fingernail can lead to complications such as:

• Paronychia: This is an infection of the skin around the nail. It can be acute (short-term) or chronic (long-term).
• Chronic paronychia: A long-lasting inflammation of the nail fold that can cause changes in nail shape and texture.
• Abscess formation: In severe cases, pus may collect under the skin, forming a painful abscess.

While ingrown fingernails can be painful and annoying, they are generally not as prone to severe complications as ingrown toenails. This is partly because our hands are typically cleaner and drier than our feet, so the risk of infection is lower. However, proper care and attention are still important to prevent potential complications.

Causes of Ingrown Nails

Understanding the causes of ingrown nails can help you prevent them. While these causes are for fingernails, many of them also apply to toenails. Let's explore the various factors that can cause ingrown nails:

• Improper nail trimming: One of the most common causes of ingrown nails is cutting them too short or rounding the edges instead of cutting straight across. 3,8 When nails are cut too short, the surrounding skin can fold over the nail as it grows, leading to an ingrown nail.
• Nail biting and other habits: Biting your nails can damage their shape and increase the risk of ingrown nails. 11 Similarly, picking at your nails or pushing back the cuticles too aggressively can create irregularities that lead to ingrown nails.
• Trauma to the nail: Injuries to the finger or nail can change the nail's shape and cause an ingrown nail. 11 This could include accidents like slamming your finger in a door or dropping something heavy on it.
• Genetic factors: Some people may be more susceptible to ingrown nails because of their natural nail shape or curvature. 10 If your nails are naturally more curved or wide, you might be at a higher risk of developing ingrown nails.
• Medical conditions: Certain health issues can raise the risk of ingrown nails. 2,5 For example:
• Diabetes: This condition can affect blood circulation and nerve function in the extremities, making it harder to heal from minor nail injuries.
• Psoriasis: This skin condition can affect nail growth and increase the risk of ingrown nails.
• Fungal infections: These can cause the nail to thicken and become distorted, potentially leading to ingrowth.
• Occupational factors: Certain jobs or activities that put repeated pressure on the fingertips can increase the risk of ingrown nails. For example:
• Musicians who play string instruments
• Typists or people who spend a lot of time typing on keyboards
• Workers who use their hands extensively, especially if they wear tight gloves
• Tight-fitting gloves or frequent hand washing: These can cause the skin around the nail to soften and be more prone to ingrown nails. 12 When the skin is soft and puffy, it's easier for the nail edge to pierce and grow into it.
• Hormonal changes: Hormonal fluctuations, such as during pregnancy or menopause, can affect nail growth and increase the risk of ingrown nails.
• Poor nutrition: A diet lacking in important nutrients for nail health, such as biotin, protein, and omega-3 fatty acids, can lead to weakened nails that are more prone to damage and irregular growth.
• Age-related changes: As we age, our nails may become thicker and more brittle, which can raise the risk of irregular growth and ingrown nails.

While some of these factors, like genetics or certain medical conditions, are beyond our control, many causes of ingrown nails can be prevented through proper nail care and lifestyle adjustments.

Understanding these causes can help you identify your personal risk factors and take steps to prevent ingrown nails. For example, if you know you have naturally curved nails, you might be extra careful when trimming them. Or if your job requires frequent hand washing, you might pay special attention to keeping the skin around your nails moisturized and healthy.

Symptoms of an Ingrown Nail

Recognizing the symptoms of an ingrown nail early can help you address the problem before it becomes more severe. Here are the signs and symptoms of an ingrown nail, from early stages to more advanced conditions:

Early Signs and Symptoms:

• Pain and tenderness along the edge of the nail, especially when pressure is applied 1,2
• Redness around the nail 1,2
• Slight swelling around the nail
• Warmth in the affected area 4

Progressive Symptoms:

As the condition worsens, you may experience:

• More intense and consistent pain 1,2
• More pronounced swelling 1,2
• The skin next to the nail may start to grow over the edge of the nail
• Difficulty using the affected finger because of pain and swelling

Signs of Infection:

If the ingrown nail becomes infected, you may notice:

• A clear or yellowish pus or drainage 1,2
• Increased redness and swelling 1,2
• Throbbing pain
• Warmth or hot sensation 4
• In rare cases of severe infection, you might develop a fever.

Differences Between Fingernail and Toenail Symptoms:

While many symptoms are similar, there are some differences between ingrown fingernails and toenails:

• Visibility: Ingrown fingernails are more visible and easier to monitor than toenails.
• Pain intensity: Ingrown toenails might cause more intense pain from the pressure from shoes and walking.
• Infection risk: Ingrown toenails are generally at higher risk of infection because of the warm, moist environment inside shoes.
• Impact on daily activities: While ingrown toenails can affect walking and wearing shoes, ingrown fingernails might interfere more with tasks that need dexterity.

Pay attention to these symptoms and seek treatment if they persist or worsen. Treating early can prevent more serious complications and provide relief faster.

If you have diabetes or a condition that affects blood circulation or your immune system, it's especially important to monitor for these symptoms and seek medical attention quickly if you suspect an ingrown nail. 6,7 These conditions can increase the risk of complications.

Treating Ingrown Nails

Treating an ingrown nail promptly can help relieve pain, prevent infection, and avoid more serious complications. The treatment approach depends on the severity of the condition and whether there's an infection. Let's explore various treatment options, from home remedies to medical interventions:

Home Remedies:

For mild cases of ingrown nails, these home treatments may be effective:

• Warm water soaks: Soak the affected finger in warm water for 10-15 minutes, 3-4 times a day. 2,4 This helps reduce swelling and ease pain. Adding Epsom salt to the water can enhance the soothing effect.
• Gentle massage: After soaking, gently massage the affected area to reduce swelling. 9
• Apply antibiotic ointment: Use an over-the-counter antibiotic ointment to help prevent infection. 2,4
• Use a cotton wedge: Gently lift the edge of the nail and place a small piece of cotton or dental floss underneath to encourage proper growth. 4 Be careful not to force the nail, as this could cause further irritation.
• Pain relief: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain and reduce inflammation.
• Proper nail trimming: Cut nails straight across and avoid cutting them too short. 3,13 This can help prevent the problem from coming back.

Over-the-Counter Treatments:

Several products are available at pharmacies to help treat ingrown nails:

• Antiseptic solutions: These can help prevent infection.
• Nail softening products: These can make the nail more pliable and ease the pressure on the surrounding skin.
• Protective pads: These can help cushion the affected area and reduce pressure.

When To Seek Medical Help:

While many ingrown nails can be treated at home, you should seek medical attention if:

• You have diabetes or poor circulation 6,7
• There are signs of infection (increased pain, swelling, redness, or pus) 1,2
• Home remedies haven't improved the condition after a few days 2
• You experience severe pain or discomfort 1,2

Medical Treatments:

If home remedies aren't effective or if the ingrown nail is severe, a healthcare provider may recommend:

• Lifting the nail: A healthcare provider may carefully lift the ingrown edge and place cotton, dental floss, or a splint under it to separate the nail from the skin. 14
• Partial nail removal (partial nail avulsion): For more severe cases, a portion of the nail may be removed. 14 This is typically done under local anesthesia.
• Nail matrix procedure: In cases of recurring ingrown nails, a procedure may be performed to prevent the problematic part of the nail from growing back. This can be done using chemicals (like phenol) or through surgical methods. 19
• Antibiotics: If the nail is infected, oral or topical antibiotics may be prescribed. 2

Surgical Options for Severe Cases:

In rare cases, more extensive surgery might be needed to correct the problem. 1,2 This could involve:

• Complete nail removal: The entire nail may be removed if the problem is severe or recurring.
• Nail bed alteration: The nail bed might be surgically altered to change the way the nail grows.

Recovery and Aftercare:

After any medical or surgical treatment for an ingrown nail, proper aftercare is necessary:

• Keep the area clean and dry.
• Apply antibiotic ointment as directed by your healthcare provider.
• Wear loose-fitting gloves or finger protectors if necessary.
• Avoid activities that could irritate the treated nail until it heals.
• Follow up with your healthcare provider as recommended.

It's important to note that while these treatments can be effective, prevention is always better than cure. By keeping good nail care habits and addressing ingrown nails early, you can often prevent more serious complications and promote faster healing.

Preventing Ingrown Nails

Preventing ingrown nails is easier and less painful than treating them. By following some simple guidelines, you can significantly reduce your risk of developing this uncomfortable condition:

• Proper nail trimming: One of the most effective ways to prevent ingrown nails is to trim them correctly. Cut your nails straight across, avoiding rounding the corners. 15,15 Don't cut them too short. Leave them long enough so that the corners are visible above the skin. 15,15 This technique helps prevent the nail from growing into the surrounding skin.
• Protect your nails: If your job or activities put you at risk of nail injuries, wear protective gloves. 15,15
• Regular inspections: Make it a habit to check your nails regularly, especially if you have diabetes or poor circulation. 22,23 Early detection of potential problems can help you address them before they become more serious.
• Moisturize: Keep the skin around your nails moisturized to prevent it from becoming dry and brittle. However, avoid getting lotion between your toes, as this can create a moist environment that promotes fungal growth.
• Address underlying conditions: Certain medical conditions, such as fungal infections or diabetes, can raise your risk of developing ingrown nails. Managing these conditions can help reduce your risk. 6,18
• Avoid nail biting and picking: These habits can damage the shape of your nails and increase the risk of ingrown nails. 24,25 If you find yourself biting or picking at your nails, try to break the habit or seek help if you’re having trouble.
• Be cautious with nail accessories: If you enjoy using nail polish or artificial nails, be mindful of how these products might affect your nail health. Avoid using them constantly, and give your nails breaks to breathe and grow naturally.
• Proper nail filing: When filing your nails, always file in one direction rather than using a back-and-forth sawing motion. This helps prevent weakening and splitting of the nail, which can contribute to ingrown nails.
• Nutrition for nail health: A balanced diet rich in vitamins and minerals can contribute to overall nail health. Foods high in biotin, protein, and omega-3 fatty acids can help promote strong, healthy nails. 26,27

By using these preventive measures, you can reduce your risk of developing ingrown nails. Remember, prevention is always better than cure when it comes to nail health. If you do notice early signs of an ingrown nail despite these precautions, address it promptly to prevent it from getting worse.

Conclusion

Ingrown fingernails can cause significant discomfort and complications if left untreated. By understanding what an ingrown fingernail is, recognizing its causes and symptoms, and knowing how to treat and prevent them, you can maintain healthier nails and avoid the pain of an ingrown nail.

Remember that proper nail care is key to prevention. Trimming your nails correctly, wearing well-fitting shoes and gloves, and maintaining good hygiene are simple yet effective steps you can take to reduce your risk of ingrown nails. For those with underlying health conditions like diabetes or poor circulation, check your nails more frequently and thoroughly.

If you do develop an ingrown nail, don't ignore it. Early intervention with home remedies can often help mild cases. However, if you experience severe pain, signs of infection, or if home treatments aren't effective, talk to a healthcare provider. Healthcare providers can offer more advanced treatments and help prevent complications.

Citations:

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