Ingrown Toenail
This condition also receives the name of onicocriptosis (unguis incarnatus), it is very common and as a general rule it attacks the nail of the big toe, although any other toe can also be affected by this condition. An ingrown toenail can be the result of having curved nails, tight shoes, nails trimmed improperly, or an injured toe. The skin that surrounds the ingrown toenail can get infected. If this condition is not treated on time on diabetic persons, it can become severe.
The disease involves the nail as the triggering of irritation of tissues
Therefore it is not the nail the element that is affected, but the cause of the problem. The nail plate is projected over the folds of skin that are framing it, and then the nail plate is introduced deeply inside the tissues producing inflammation on them.
The ingrown toenail can happen in an isolated way or be recurrent in patients which have a predisposition to be affected by it. Some patients have family backgrounds of the disease. Pain is a common symptom and it is not rare on the periods of increased inflammation to observe detachment of fluids as suppuration from the affected area.
However the suppuration does not imply necessary the presence of an infection. The disease does not require of an infection to emerge. The infection can be observed in some circumstances as a process which is clearly secondary.
Signs and exams
The exam of the foot made by a chiropodist is enough to diagnose the presence of the condition. It is pathology of traumatic etiology which consists of a spicule or splinter of the lateral border of the nail which is inserted on the soft tissue of the groove. It can compromise only one border (one-sided) or it can compromise both sides of the nail (two-sided).
Although there are a lot of causes that trigger the emergence of this disease, the main factor is the presence of the spicule, without it there is no presence of onicocriptosis or ingrown toenail. It is very important to make this clarification since many times different inflammations of the groove of the toenail are mistakenly called ad onicocriptosis.
In the mechanism of the emergence of this condition we can find as predisposing factors the following:
- The morphology of the nail, for instance a curled nail.
- A very long toenail, which is compressed on its lateral side by the shoe.
- An inadequate structure of the shoe, which can be too tight, too short or too pointed.
- The hyperhidrosis or the excessive abuse of hot water which decreases the vitality of the groove of the skin.
- The exuberance of the periungual impeller which pushes the lateral border of the nail.
- Orthopedic pathologies which alter the dynamic and alienation of the toes.
- Traumas affecting the nail which produce the rupture of the nail plate, with a subsequent distortion.
- Infections, such as the onychomycosis (an infection that affects the nails caused by funguses).
- And the cause which is the most common among people, a bad cut of the nails.
These causes together or separated help on the emergence of onicocriptosis, but it is important to point out that they alone cannot cause the emergence of onychomycosis, the presence of the spicule is required for the emergence of the disease since that is the triggering of the process.
In certain occasions on which the nail becomes fragile and brittle, it is forced by the pressure exerted by the shoe, tends up to break spontaneously, although the spontaneous generation of the disease is not frequent, but in general can obey to an incorrect cut of the nail, which could have be done by the patient itself or by an unfortunate intervention of an inexpert professional.
Habitually, the person who for any of the mentioned causes feels an annoyance on the groove tries to relief the displeasure by cutting the angle of the nail in such a way that leaves a sharp corner on the lateral border. If the nail groove is resilient enough and the shoe has no more incidences over it, it could happen that the cut of the nail may not cause further consequences.
On the contrary, a few days later the pain will increase and the patient will try to cut the nail again but the inflamed tissue will not allow a deep cut, therefore only a superficial cut can be done, leaving on the bottom of the furrow the spicule whose sharp point is directed downwards and forwards.
With the pass of the days the growth of the nail grinds the spicule into the skin of the toe, until a septic focus is produced due to the big quantity of opportunists germs that are placed over the skin, this infectious process generates a tissue of granulation known as pyogenic granuloma, which is considered as a benign tumor of the infectious type, which progressively keeps growing and complicating the case. The granuloma is a spongy tissue which is highly vascular, exudative and painful that in some cases can even get to cover the nail plate.
Once you learn the adequate technique to cut your nails, you may not need to pass through this painful process, if the problem advances at a point where the removal of a vertical strip will be required, it will take several months to replace that side of nail. Generally the new nail will not be affected by this condition again. In many cases the best thing is to prevent the emergence of the condition, it can be done by avoiding the practices that increase the tendency for the emergence of the ingrown toenail, cut your nails properly.
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