An ingrown fingernail, technically known as onychocryptosis, occurs when the edge of the nail plate penetrates the surrounding soft skin fold, causing inflammation and pain. While ingrown nails are far more common in the toes due to pressure from footwear, the condition can affect the fingers, making simple daily tasks uncomfortable. The condition is generally manageable, requiring understanding of its causes, prevention, and treatment. Addressing an ingrown fingernail early can prevent minor irritation from progressing into a painful infection.
The Primary Causes of Ingrown Fingernails
The development of an ingrown fingernail is often a mechanical issue resulting from external forces or improper grooming. A frequent cause is improper nail trimming, such as cutting the nail too short or rounding the corners deeply. When the nail edge is cut into a curved shape, the nail is encouraged to grow downward into the lateral skin fold rather than straight out.
Physical trauma is another common trigger, ranging from a single injury to repeated pressure. Activities involving constant friction, such as frequent typing or playing musical instruments, can push the nail plate into the surrounding tissue. Nail biting or picking at the edges can also tear the nail, leaving a sharp spicule that grows into the skin.
The cause can also relate to the natural shape of the nail, as some individuals have an excessively curved nail plate. This curvature places constant pressure on the nail grooves, making them susceptible to ingrowth. Additionally, wearing tight-fitting gloves can exert external force on the sides of the fingers, squeezing the soft tissue up against the rigid nail.
Essential Steps for Prevention
The most effective strategy for avoiding ingrown fingernails is adopting a precise trimming technique. Nails should be cut relatively straight across, ensuring the free edge extends slightly beyond the fingertip. Avoid trimming the corners at an angle or curving the sides of the nail into the skin.
After trimming, sharp edges should be smoothed gently with a file to prevent irritation. The nail should never be cut too short; cutting too short allows pressure from the fingertip pulp to push the skin up over the nail plate, encouraging ingrowth. The goal is to leave a small amount of white nail visible at the tip.
Protecting the hands from repetitive trauma is also important, especially for those whose work involves manual labor or constant friction. Use well-fitted protective gloves during tasks like gardening or woodworking to shield the fingertips from impact and pressure. Avoid nail biting or picking at the skin, as this creates micro-traumas that can introduce bacteria and lead to inflammation. Maintaining clean, dry hands prevents the skin from becoming overly softened, which contributes to the nail digging in.
Immediate At-Home Care for Mild Cases
When an ingrown fingernail is noticed early and is not showing signs of infection, several at-home methods can alleviate discomfort and encourage proper growth. Soaking the affected finger in warm water is a fundamental step. Soak for 15 to 20 minutes, three to four times daily, to reduce swelling and soften the skin around the nail.
Adding a few tablespoons of Epsom salt to the water can enhance the soaking effect, helping to draw out fluid and decrease inflammation. After each soak, gently pat the finger completely dry with a clean towel. Following the soak, apply a small amount of over-the-counter antibiotic ointment to the irritated area to protect against bacterial entry.
For temporary relief, a small, clean piece of cotton or a thin sliver of dental floss can be carefully inserted under the ingrown nail edge. This technique gently lifts the nail away from the inflamed skin, repositioning it to grow over the skin rather than into it. This material should be changed daily for sanitation.
If pain is present, over-the-counter pain relievers such as acetaminophen or ibuprofen can manage discomfort and reduce localized swelling. Avoid attempting to cut out the ingrown portion of the nail at home, as this often leads to further injury, increased pain, and a higher risk of severe infection. Home treatment should be discontinued if the condition worsens after a few days.
Recognizing When to Seek Professional Treatment
While many ingrown fingernails resolve with diligent at-home care, certain signs indicate that a medical professional should be consulted immediately. The clearest indication that professional treatment is necessary is the presence of an infection. Symptoms include increasing redness, swelling, warmth to the touch, and throbbing pain that does not subside.
The presence of pus or yellowish drainage around the nail fold is a definite sign that an infection requires prescription treatment. If redness begins to spread away from the finger toward the hand (red streaking), this suggests the infection is advancing and requires urgent medical attention. Untreated infections can lead to serious complications, including cellulitis or an abscess.
Individuals with underlying health conditions should seek medical care at the first sign of an ingrown nail, rather than attempting home remedies. Those with diabetes, poor circulation, or nerve damage are at a higher risk for complications and delayed healing. A healthcare provider may prescribe oral antibiotics or perform a minor in-office procedure to remove the portion of the nail embedded in the skin.