An ingrown toenail occurs when the edge of a toenail grows into the surrounding skin, most commonly affecting the big toe. This condition can lead to discomfort and inflammation as the nail presses against or pierces the soft tissue. Understanding what happens beneath the surface is helpful for early identification.
The Initial Visual Signs
The early stages of an ingrown toenail often present with distinct, observable signs around the affected nail. Individuals may notice redness along the border of the toenail, indicating initial irritation and inflammation. This is often accompanied by mild swelling of the skin adjacent to the nail plate. The area might also feel tender or painful to the touch, especially when pressure is applied, and could be slightly warm.
How the Nail Penetrates the Skin
Beneath the surface, an ingrown toenail involves a physical mechanism where the nail plate, typically a corner or edge, curves abnormally and pierces the soft flesh of the nail groove. This penetration creates a microscopic wound within the skin, leading to a foreign body reaction and an inflammatory response. The presence of the nail material within the dermal tissue triggers the body’s immune system, resulting in localized inflammation and discomfort. This internal irritation can be caused by factors such as improper nail trimming, which leaves sharp edges, or tight footwear that constantly presses the nail into the skin.
Progressive Visual Changes
As an ingrown toenail progresses, particularly if left unaddressed, the visual signs become more pronounced and indicate worsening irritation or infection beneath the skin. The initial redness and swelling intensify, often spreading beyond the immediate nail border. A common development is the appearance of pus or clear fluid drainage from the affected area, signaling a bacterial infection.
The skin around the nail may also become visibly hardened or show an overgrowth of tissue, known as granulation tissue, which is a red, fleshy mass that forms in response to chronic inflammation. This excess tissue can cover part of the nail, further contributing to the problem. Increased pain, throbbing, and warmth in the toe are also common as the condition advances.
When Professional Assessment is Needed
If there are clear signs of infection, such as pus or liquid drainage, spreading redness, a foul odor, or persistent, severe throbbing pain, medical attention is advisable. Difficulty walking or wearing shoes comfortably due to intense pain also warrants a visit to a healthcare provider. Individuals with underlying health conditions like diabetes, poor circulation, or nerve damage should seek prompt medical care at the first sign of an ingrown toenail, as these conditions can increase the risk of serious complications. Ignoring these signs can lead to more extensive infections, including those affecting the bone.