Ingrown Toenails Trivia Quiz

Answer: Personal home regime

Although an established ingrowing nail can be too far gone for home treatment, the British National Health Service lays out a simple regime to reverse mild and initial stages. The simplest way is by cutting the nail to keep it clear around the edges, rigorous hygiene to avoid it becoming infected, soaking in warm water to soften the nails regularly, and possibly using material such as dental floss or packed cotton to free the skin from under the nail, and leaving it there to gradually train the nail away from it. If this does not work, then it will need the care of a chiropodist, who may be able to eventually reverse it rather than needing to relieve the damage on a regular basis as the nail grows. If not then the next level of treatment includes a V shape being cut in the front of the nail so it then grows back inwards, or a small slice on the edge being removed surgically in stubborn cases.

Answer: Paronychia

True ingrown toenails are just that. The nail curls inwards at an angle which penetrates the skin, while a paronychia is an infection of the nail bed which causes swelling and can cover part of the nail, but needs antibiotic treatment and possibly minor surgery to lance it.

A second similar condition occurs where the nail is a normal shape but the skin grows too far above it, needing quite different treatment. A direct injury will not simulate an ingrown toenail but can actually cause one if it happens in the required spot.

Answer: Genetics

As a natural design, toenails have a basic shape at birth. The tendency to curl under is inbuilt, much like the similar but much rarer ingrown eyelashes. But without a shoe which isn't the right shape to guide it further, a potentially deformed nail will not normally become ingrown. Improper cutting for long enough will also deform the toenail which may lead to ingrowing if it leaves enough nail to grow into the skin.

Answer: Removal by surgery

Surgery is the final weapon in the arsenal to deal with a stubborn nail, often one previously requiring monthly chiropody for some time without improvement, before deciding to give up and have the part of all of the nail removed. Being made of keratin, they do regenerate, and using the methods mentioned elsewhere should be able to prevent ingrowing in future.

Modern surgery is now often carried out by phenolisation, using phenol to destroy the offending tissue rather than a scalpel, and draining any infection before stitching back.

Answer: Do not wear shoes at all

The evidence shows people who normally have bare feet with no existing problems do not develop ingrown toenails. But as it is impractical for most people not to wear shoes the majority of the time, the other methods of care should be sufficient to avoid ingrown toenails in the future.

The bones of the foot are the only ones subjected to a daily squashing. Being small and vulnerable, the bones and nails will easily be damaged and distorted by squashing them regularly for very long. A similar slow adaptation process where body parts can be realigned is with the use of dental braces which take crooked teeth and apply pressure long enough to straighten them permanently.

Answer: True

Although it's not something you'd normally think of, biting your toenails (or presumably someone else's...) can also be a cause. How they discovered this is another thing but definitely genuine. I personally would be proud to have on my CV 'Undertook study to discover the diletarious effects of toenail biting'.

Answer: The big toes

Due to their exposure, the big toe and little toe are the most likely to be affected, with the big toe having by far the greatest risk. But if shoes press on any others, or the toes are damaged in other ways, the same cause will have the same effect on them.

It would be fascinating to discover if one foot was more susceptible to ingrown nails than the other, but I doubt it's even occurred to anyone to check.

Answer: True

Nails are nails, but as toenails are squashed daily by shoes in most cases any potential deformity will be exacerbated, while someone with potentially curved fingernails will probably never know about it. But the one common element is cutting the nails, and incorrect cutting is the likeliest cause of the fingernails ingrowing, which of course will have the same effect on both if carried out badly. Biting nails, which is very common on the fingers, is another cause.

Answer: True

Although normally the potential for ingrown toenails requires an additional outside force to complete, some babies are also born with them when either the nail wall is overgrown congenitally, or from a misalignment of the big toenail, and will be watched over time to see if it corrects itself while keeping it clean to avoid infection. About half will sort themselves out naturally, while the rest will require corrective surgery.

Answer: Infection

Although in the longest term toes can become deformed by a chronically ingrown nail, much like associated bunions also caused by ill fitting shoes and the like, the immediate threat is from infection. The vast colonies of bacteria on the feet, all incubated and multiplied by confining in shoes, makes any skin damage from the nails a perfect breeding ground for such delights as yeast, other fungi and the commonest cause of skin infection, staphylococcus. The pain of course is a given, but is a direct symptom treated by relieving the pressure and short term painkillers, while a complication is a secondary development of a primary disorder.

Firstly the infected area must be cleaned, cleared of any imposing nail, disinfected and then possibly treated with either a topical or oral antibiotic, and then long term treatment will follow to reverse the curvature or remove the offending nail. Gangrene is the end result of any long standing untreated skin infection, especially in the diabetic, elderly, or anyone else with circulatory restrictions, but should rarely happen if treatment is sought as soon as there is a problem.