An ingrown toenail is a condition in which the end of the nail curves inward on the toe.

Most ingrown toenails occur on the thumb nail. As the condition progresses, the nail digs into the skin, causing pain.

Inflammation can occur, and swelling can cause the nail to dig in even more, making the inflammation more severe. In rare cases, however, the nail may be curved so severely that it does not cause pain or inflammation. In many cases, the patient's posture and gait may deteriorate in an attempt to avoid pain, causing knee pain, joint pain, and back pain. It is important to heal quickly while symptoms are mild.

There are three main causes of ingrown toenails.

Insufficient force to stop the nail from curling.

Nails have a natural tendency to try to curl so that they do not peel off from the fingers. When the toes are used to walk, the force of repulsion from the ground balances the force of the nail trying to curl, and the nail flattens out. However, if the time spent walking is too short or the toes are not used properly, the force of the nail trying to curl becomes stronger, resulting in an ingrown toenail.

Pressure on the nail due to ill-fitting shoes

Wearing shoes that are too small or too narrow will put pressure on the nail and cause ingrown toenails. High heels or shoes that are too large can also cause the foot to move forward in the shoe as you walk, putting pressure on the tip of the nail each time you walk.

Deep Nails

When a nail is cut too short, the force of the nail curling becomes stronger due to the principle of leverage. In addition, the exposed skin, which has lost the nail, rises up to cover the nail due to the repulsive force from the ground, preventing force from being transmitted to the nail in the direction of spreading.

Other causes include
Bad posture and habitual walking
Weak finger muscles
Stiff ankles and toes, etc.

When the nail becomes ingrown, the nail digs into the skin, causing inflammation around the nail, which leads to redness, swelling, and pain, and then to the suppuration phase, when the nail sinks into the skin and pus accumulates. If left untreated, the nail reacts to irritation and a red flesh rises up, which is called the granulation phase.

Pyogenic periungual infection

The skin is damaged and bacteria enter, causing a secondary infection. The skin around the nail becomes red, pus accumulates and appears yellowish, and the finger swells severely, resulting in severe pain. In severe cases, the patient may be unable to put weight on the toes and may even be unable to wear shoes, walking on his or her heels.

Granuloma telangiectaticum

A benign skin tumor. It is triggered by a minor scratch or infection caused by a fingernail, which has caused the capillaries to react and dilate. There are no symptoms such as pain or itching, but because it is a mass of blood vessels, it bleeds easily when injured, and the bleeding does not stop easily.

It rarely heals spontaneously and requires some form of treatment.

There are two types of treatment for ingrown toenails: conservative treatment and surgical treatment.

Conservative therapy

・Taping method

Taping is a method of creating a gap between the ingrown nail and the skin that is in contact with the nail.
The pain is reduced because the nail is kept from digging in, and mild granulations shrink in size.
It is a simple method that requires daily reapplication of tape.
However, it does not eliminate the cause of the ingrown toenail, so it is not a fundamental solution, but only a stopgap symptomatic treatment.

・Cotton packing

Cotton packing is a method of inserting a cotton pad to create a gap between the skin and the area where the nail is ingrown. As with the taping method, this is not a fundamental solution and is a symptomatic treatment.
It is necessary to be careful because it may become painful if the position is not appropriate or if the cotton is packed too much.

・Shape Memory Plate Therapy

A plate is attached to the surface of the nail, and the nail is corrected by the force of the plate trying to return to its original shape.
It is a treatment method that does not cause pain, but as a disadvantage, the force is weak, so the initial stage of ingrown toenails, the effect is not seen unless the nail is relatively thin.

・Wire therapy

This is the most effective of the conservative therapies and uses the principle of traction to correct the nail by hooking a wire to either end of the nail or to one side of the nail.
There are several types of wires, some of which correct only one side of the nail and some of which correct both sides at the same time.
Wire therapy has a moderate to strong corrective force, and too much force may cause the nails to detach.

Surgical Therapy

・Inclusion Nail Surgery

Surgery is performed to remove the nail matrix (the base of the nail) and narrow the width of the nail to prevent the growth of deformed nails.

・Phenol method

In this treatment, the nail that is cutting into the skin is partially removed, and the nail matrix cells are killed or denatured by a chemical (phenol) at the base of the nail to prevent the nail from growing in that part of the body.
Surgical therapy is covered by insurance, which reduces co-payments and often requires fewer hospital visits.
Although the pain of ingrown toenails disappears, the probability of recurrence is not small: the nail width becomes narrower, there is postoperative pain from the surgical procedure, the narrowing of the nail width causes more pressure than before, and the nail may begin to curl again or become thicker, resulting in severe deformity.
In addition, if bleeding or festering occurs, minimal surgical treatment is necessary, if not surgery.

Treatment at our clinic

Our clinic employs a German ingrown toenail care system, a wire therapy called ORA Spange. It adjusts the wire according to the shape of the person's ingrown toenail and hooks the wire to the edge of the nail without pain, and gently and firmly corrects the entire nail to a healthy state with traction and corrective force without stress to the nail.

It is effective for various types of ingrown nails, and there is little risk of flattening or peeling the nail more than necessary. It can be used for both right and left ingrown toenails, and can also be used for both types of ingrown toenails by adjusting the wire.