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Involuted toenails

What is an involuted toenail?

An involuted toenail is a nail that is a curved shape meaning that the centre of the nail is often quite raised and the edges pinch the skin at the sides. The skin can get red, painful and swollen and easily infected.

Nail problems are often caused by poor cutting technique, trauma, picking your nails, or badly fitting footwear.

Some people appear to be genetically predisposed to involuted nails, or the deformity can occur over a long period of time from prolonged trauma such as in runners or people who wear steel toe cap boots for work.

The term ingrowing toe nail is often used to describe them too, but a true involuted and true ingrowing toe nail are different.

How can I help myself?

It may be possible to prevent pain from involuted nails with good cutting and nail care techniques, including filing the nails and good footwear selection.

If you start to get pain from an involuted toenail, bathing the foot in lukewarm salt water for 5 minutes 1-2 times a day may help. We will be posting a video on this soon.

You need to also address any aggravating footwear or socks that are causing pressure on the nail(s).

Although it is tempting to pick or cut down the side of the toe nail, it can make the problem worse or introduce an infection.

If the symptoms are mild, gently brushing down the side of the nail with a clean, soft toothbrush whilst salt water bathing may help keep the skin and nail apart but do not do this is it is painful.

When to see a Podiatrist?

Involuted nails probably need professional treatment. If you see a Podiatrist, they may be able to help encourage the nail grow out and they may be able to thin the nail to reduce pressure from footwear. Most Podiatrists can also supply antibiotics if there is an infection.

If the nail cannot be managed conservatively, it may be worth considering a partial or total nail removal. This is carried out under local anaesthetic by your podiatrist. Once the nail is removed, the nail matrix is usually treated with a chemical called phenol which helps to prevent nail regrowth. It is only minor surgery but will take usually 6-10 weeks to heal depending on your health and lifestyle.

In the case of partial nail avulsion (removal o one or both of the sides of a nail), the nail should look quite normal after, depending on its thickness, and it will look slightly narrower. The skin at the side of the toe will just grow up to the side of the nail. In the case of full nail removal (total nail avulsion), the nail bed will harden. Regrowth of the nail after its removal can occur and a repeat procedure may be required later on.

It is important to discuss specific options available to you and the risks and benefits of each with a Podiatrist.

Involuted nail