The Ingrown nail is a common problem affecting especially the big toe. It is favored by a bad cut of the nail and repeated traumas (shoes too narrow…) It translates into a bead around the nail, painful and red which can become infected in the absence of treatment.
What is the Ingrown nail?
A nail is incarnated when it penetrates the tissues that limit its lateral edges. This is the result of a conflict between the nail tablet and the peri-nail tissue. The edge of the nail sinks into the flesh and causes an inflammatory reaction of the peri-nail tissue, then, in the absence of early treatment, an infection.
This problem preferentially touches the toenails: the Ingrown nail is particularly frequent at the level of the big toe.
What is a nail for?
The nail is made of keratin, forming a nail tablet that rests on the nail bed. The fixed edges of the nail are surrounded by a peri-nail fabric called “full nail” or “nail bead”.
The nail has several important functions:
- It protects the distal phalanges;
- It increases tactile discrimination (touch);
- It is an instrument of scraping or even defending;
- It ensures the aesthetics of the foot and/or the hand;
- Toenails have a role in running and walking.
The factors that promote the appearance of the nail incarnate.
There are factors that promote the appearance of an ingrown nail. Among them:
- The wrong cut of the nail: this is the most important factor in the occurrence of an incarnate nail. The cut nail should exceed the free edge of the toe by two to three millimeters. If the nail is cut in a semicircle, too short on the edges, the skin will cover the edge of the
- nail and it shall grow by sinking into the dermis;
- The forgetting of a fragment of fingernail, practically invisible, in the furrow peri-nail;
- Poorly fitting, too narrow shoes, exerting pressure points;
- Significant perspiration (sweating);
- Secondary bone modifications to osteoarthritis (e.g. valgus);
- Disturbances of the static of the foot with a bad progression of the step;
- Defects in shape or thickness of the nail (e.g. onychomycosis);
- Hypertrophy of peri-nail tissue;
- A conflict between the first and second toes;
- A trauma to the nail and fingertips: A nail can be incarnated as a result of a violent shock (impact on the toe, kick in a ball, etc.). It then creates a trauma of the nail with a break and a piece of nail penetrates into the flesh;
- Some diseases can lead to the modification of nails or a decrease of peripheral vascularization (diabetes…)
The symptoms of the nail incarnate.
The main symptoms of the ingrown nail are as follows:
-A pain around the nail, especially at the pressure;
-redness and swelling, or sometimes a cut of the skin and then the appearance of a bead around the nail.
In the absence of treatment, the ingrown nail becomes progressively worse:
- First, the pain around the nail is moderate, intermittent and felt during footwear or sporting activity. The Ingrown nail is enshrined in the peri-nail and the pressure of the ribs is sensitive.
- Then the pain of the toe is more vivid, almost permanent, and increased by the shoeing. It can hinder walking. The peri-nail bead, around the nail, becomes inflammatory (red, warm and swollen). There is no flow. The pain is acute when the bead is pressed.
- Then the Ingrown nail is infected and the pain is intense and pulsate. A purulent flow appears in the peri-nail retreat.
- Finally, in the absence of treatment of the ingrown nail, the peri-nail becomes hypertrophy. A granulation tissue in the form of a large red raspberry bud, called Botryomycome, appears.
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