Ingrown Toenail (Onychocryptosis)

What it is

An ingrown toenail happens when the edge of the nail, usually on the big toe, grows into the surrounding skin, causing pain, redness, swelling and, often, infection with pus and reddish tissue that bleeds easily (granuloma). The most common causes are cutting the nails incorrectly, rounding the corners, tight shoes, repeated trauma, naturally curved nails and excessive sweating. In early cases, warm soaks, open shoes, correcting how the nail is cut and, if there is infection, medication usually resolve it. When the problem keeps recurring or there is intense inflammation, treatment is cantoplasty, which removes the ingrown edge and treats the matrix so that side no longer grows in — performed in the office, under local anesthesia, at Femi Saúde with a CO₂ laser.

Most common symptoms

• Pain at the corner of the nail, usually the big toe
• Redness and swelling of the skin around the nail
• Pain when wearing shoes and walking
• Pus and signs of infection
• Reddish tissue that bleeds easily (granuloma)
• A condition that recurs after temporary relief

Causes and risk factors

• Incorrect nail trimming, rounding the corners
• Tight or narrow-toed shoes
• Repeated trauma, such as in sports and kicking
• Naturally curved or very wide nails
• Excess sweating and moisture in the feet
• Diabetes and circulation problems, which worsen infection

How it is diagnosed

Diagnosis is made by examining the toe, where the surgeon looks at the nail edge penetrating the skin, the degree of inflammation, the presence of pus and granuloma, and the curvature of the nail. Imaging is not needed in most cases; an X-ray is reserved for suspected bone involvement in prolonged infections. The consultation also identifies factors that favor the problem, such as nail trimming, footwear and conditions like diabetes, which are important for planning treatment.

How we treat it at Femi Saúde

In early cases, warm soaks, open-toed shoes, correcting how the nail is trimmed and, if there is infection, antibiotics and local care usually resolve the problem. When the nail keeps becoming ingrown, there is intense inflammation or a granuloma, the general surgery team at Femi Saúde performs cantoplasty in the office, under local anesthesia: the ingrown edge is removed and the corresponding nail matrix is treated with CO₂ laser, so the nail does not grow back on that side. Recovery involves simple dressing changes and, generally, a quick return to activities. The plan is individualized, taking into account recurrence, infection and the patient's health condition.

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