Ingrown, curved, deformed toenails--onychogryposis--accounts for 20 percent of patients seeking family medical attention for a foot problem 1. The curved nail punctures and digs into the skin at the sides of the nail, introducing bacterial infection and inflammation. Untreated, this condition leads to a red, swollen, painful condition often characterized by malodorous drainage.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.


The nail edges penetrate deeply into the skin along the nail’s sides. Sometimes, a small spike or corner of the nail embeds into the skin like a knife. The resultant infection causes granulation tissue (thickening skin around a healing wound) to develop.

The causes of ingrown toenails include trauma, such as a stubbed toe or repetitive injury caused by rubbing or kicking; poorly fitting footwear, when either socks or shoes are too small or too tight 1. Nail conditions, such as:

  • fungal infections,
  • the most common cause
  • improper trimming
  • encourages skin to fold over the nail

The tendency for ingrown toenails may be heredity or health-related 1. Another natural cause is simply aging.

Iron and zinc deficiencies or thyroid problems may cause nails to curve upward, exposing them to trauma. Nails that curve downward may indicate heart and liver problems, respiratory problems or a deficiency in Vitamin B12.

Home Care

Patients may perform some treatment to relieve ingrown toenails 1. If an infection is suspected, or if the patient has high risk foot issues, such as diabetes, nerve damage or circulations problems, they should seek professional care.

It is recommended that people with this condition soak feet in room temperature water with Epsom salts, gently massaging the side of the nail to reduce inflammation. However, they should not repeatedly cut the nail, cut notches in the nail, trim nail borders or place cotton under the nail. Contrary to popular belief, these practices do not change the growth pattern of the nail and may introduce bacteria, worsening the condition.

Physician Care

After examination, a physician likely will prescribe an oral antibiotic for the infection and an anti-inflammatory for the inflammation. Minor in-office surgery to remove the nail’s side border eases pain and inflammation and allows the infection to heal. Some recurring ingrown nails require removal of the nail root.


Careful care of nails prevents most ingrown nail occurrences. Proper trimming involves cutting nails in a straight line, and leaving a portion of the white tip. Make that sure shoes fit. If the toe is short or tight, it puts pressure on the toenail. Loose shoes cause the foot to push into the toe area, causing the same effect as if the shoe were too tight.

Serious Conditions

Clubbed toenails--where the ends of the toes are enlarged, and the nails are abnormally curved and shiny--signifies more serious medical conditions. According to the American Academy of Family Physicians, some illnesses associated with clubbing include heart and lung problems, inflammatory bowel disorders, such as Crohn’s disease or ulcerative colitis. Cirrhosis of the liver and thyroid problems also result in clubbing in some cases. Seek professional medical advice for any of these conditions.