A curved toenail or a pincer nail is a condition where the sides of the toe nail curve inwards causing it to dig into the skin surrounding it. This results in what is known as an “ingrown toenail”; because it’s growth is directed towards the skin rather than outside in a straight line, effectively embedding itself inside it.
This brings with it a lot of pain, accompanied by swelling and redness. There is also a high possibility of infections, if it is left untreated. Individuals may notice that the skin becomes hard at first, followed by the formation of pus or fluid in the adjoining area.
The reasons for developing an curved toenails inward can be hereditary or acquired. Let us look in detail at some of the potential causes of this condition.
Curved Toenails – Causes
One of the most common reasons this happens is if the toe has suffered some kind of damage. For example, if it collided head on with a blunt object. This can effectively change the overall course of nail growth, causing it to grow in an unfavorable direction.
This is one of the reasons the big toe is the most likely candidate for inner growth, owing to the fact that it is the first one to make impact in such a situation and therefore absorbs nearly all of the shock.
it doesn’t necessarily have to be a one-time incident. People who engage in a lot of athletic activities that put a lot of pressure on the toe end of their feet may also experience this. For example, the repeated trauma from kicking a football or a ballet dancer balancing their entire body weight on their toes.
When wearing shoes that are smaller than the appropriate size, your toes typically compensate for the lack of space by getting scrunched close together.
If you wear smaller shoes for a long enough time, you will notice your nails naturally start to curve inwards because of the constant pressure on them. This is most likely to happen with the big toe.
This is why we recommend buying properly sized shoes. You must be especially careful when it comes to buying shoes for your kids as it can be difficult to keep up with their growth spurts. Don’t rely on predetermined sizes or intuitive guesswork. Have them personally try out every new pair before you purchase it.
Don’t just focus on the length. Your toes may have plenty of room up-front, but shoes that are too narrow are equally likely to contribute to the development of downward curved toenails.
In some cases, the size of the toe is not large enough to accommodate the size of the nail, causing the nail to curve uncharacteristically, which often leads to in-grown toenails.
This is by far the most common reason for an ingrown toenail. Most people cut their nails by following the curve of the toe; which is okay, to an extent. However, this often encourages the edge of the nail to curve and dig into the skin.
It is advised that you cut in straight lines to avoid potential in-growth. Do not cut the nails too short either.
Sweaty feet that are not regularly cleaned and dried are more likely to develop this condition. It is advised you thoroughly wash your feet everyday and trim your nails every few weeks.
It will also prevent infections: The reason being that a moist environment like this stimulates bacterial growth. Do not share footgear and wear shoes at public places to avoid acquiring infections.
Some people are genetically predisposed to have nails that gravitate inwards. These people must be extra cautious with their care.
Individuals like this may experience ingrown nails on nearly all toes and may suffer from chronic pain due these issues. Frequent visits to the doctor often become a norm and surgeries are not uncommon.
Researches show that a diet deficient in iron and zinc tends to cause nails to curve upwards which makes them more prone to injury.
B12 deficiency is also thought to play a role in the curvature of toenails.
Curved Toenails – Symptoms
The very early signs you will notice are tenderness and swelling in the area. Applying pressure will most likely result in a sharp stab of pain.
If nothing is done about it, the condition will gradually worsen, starting with fluid build-up and an increase in the swelling.
The skin swelling up and becoming red is a sure sign of infection. There will be consistent pain even if no pressure is applied, especially when you’re standing up. You might notice pus oozing out of the area and constant bleeding. The infected area generally feels warmer than the rest.
The skin around an infected wound will become fairly thick, due to the formation of granulation tissue whose purpose is the healing of wounds. However, since the nail has pierced the skin and is lodged inside it like a knife, the healing process cannot happen.
If you notice these symptoms, refer to a doctor immediately. The kind of doctor that specializes in study of the foot, ankle and lower extremities is known as podiatrist.
The infection can lead to open sores and foot ulcers, if not handled right away. This can further complicate and delay your treatment. For people with diabetes, an ingrown toenail poses an even greater threat of infection.
The podiatrist will first perform a physical examination to determine the cause of the ingrown toenail; whether there is an underlying cause that might need to be treated first. If the extent of the in-growth is unknown, the podiatric physician might recommend an X-ray as well.
You must acquaint yourself with possible signs of infection in your feet such as discoloration, cracked nails and peeling skin between the toes as any one of these things could signal a potential fungal infection.
Curved Toenails – Treatment
If you’re positive that your nail isn’t infected, then you are not obligated to go to a doctor, if you know how to fix curved toenails at home. But it is advised, all the same, to let a doctor handle it for optimum results.
This home treatment involves soaking your feet in warm water a couple of times a day, for up to half an hour each time.
Next you need to place a cotton ball or a dental floss under the ingrown edge by lifting it, in order to separate it from the skin, thereby allowing it to grow freely. The material needs to be replaced daily by first soaking the feet in warm water as previously mentioned.
Medication such as Tylenol or Advil can help in managing the pain, if there is any. It is readily available over-the-counter (does not require a prescription). In order to prevent infection in the affected area, apply a steroid cream or a topical antibiotic (cream or ointment).
If the home treatment fails to have a positive effect, see a doctor.
Partial nail removal
This involves cutting away the side edges of the nail and treating it with phenol to prevent the nail from growing back. Cotton is placed under the remaining part in order to prevent further inner growth.
Do not try this yourself. Only a qualified professional should undertake this task.
If thickening is the cause of your ingrown nail, rather than curvature, the doctor might remove your entire nail. This procedure is called Matrixectomy. The person is injected with a local anesthetic and then the nail is removed.