Why Does My Ingrown Toenail Keep Coming Back?

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Fool me once, they say, shame on me. Fool me twice, shame on you.

Get an ingrown toenail more than twice in a short period of time and… well, there isn’t really anything to be ashamed about. However, it is a good sign that something needs to change to get some much-needed relief.

An ingrown toenail once in a great while can just be part of life sometimes. If you have never had one in your lifetime, you’re either quite lucky or just forgot you ever had it—and in either case, that’s pretty fortunate.

However, having ingrown toenails return over and over again is not normal, and in many cases isn’t just a case of “bad luck.” Conducting a simple investigation into potential causes can help take care of the problem for good.

What Causes an Ingrown Toenail, Anyway?
Under standard conditions, a toenail grows straight at a slow pace (a little over 1.5 mm per month on average, in case you were curious).

In the case of an ingrown toenail, the nail is not growing in the proper direction. Instead, the edge or corner of the nail is digging into the soft flesh along the side of the nail, leading to pain, swelling, and redness. An infection might also sometimes happen, since the environments your feet regularly face are not always the most sterile.

But if an ingrown toenail is caused by the nails growing incorrectly, what causes them to do that in the first place?

The Factors that Make Ingrown Nails—And What You Can Do About Them

When it comes to the influences on ingrown toenails, pressure, injury, and abnormalities are the keys to be looking for. Let’s take on the most frequent causes we see, one by one.

Wearing Shoes that Are Too Tight

Toenails do not grow with the force of a rampaging elephant. Even a relatively small amount of pressure against them can cause them to start growing inward, especially if that pressure is fairly consistent throughout your day.

Enter ill-flitting shoes.

Shoes that have a tight or narrow toe box will cram the toes together, providing a substantial amount of consistent pressure on the sides. This can cause toenails to become ingrown quite easily (and also just feels terrible). Shoes that force weight to the front of the foot, such as high heels, can also place excess pressure on the toes against the front of the shoe, causing similar problems.

When looking into purchasing new shoes for yourself, consider not only the toe box and general fit of the shoe, but your own foot shape as well.

In some cases, the structure of the foot itself can be such that weight is being distributed improperly against the toes. High arches, flat feet, hammertoes, and other structural problems can all play a role. This can sometimes be accommodated for simply by choice in footwear. Other times, however, custom orthotic inserts may be necessary to provide substantial enough relief.

Improperly Trimming Your Toenails

It doesn’t seem like clipping your toenails is something that can be done “wrong,” but there is a way to complicate just about everything in this world.

The way you cut your toenails can have an influence on how they regrow. Cutting your nails too short, for example, can risk damage to the underlying nail bed. Not only does this hurt, but it can cause the nails to grow back in a non-standard way.

Similarly, rounding the corners of your toenails too much can cause their growth to start to curve downward, into the flesh.

When trimming your toenails, leave some white at the ends, even with the tips of your toes. Also trim straight across the nail, without rounding the corners. If you end up with sharp corners, pare them down a bit with a nail file or emery board.

Damaging Your Toenails

In addition to errant clipping, you can damage your toenails through everyday tasks as well. This ranges from jobs where you frequently stub your toe (or even drop things on your foot—yikes!) to running and other activities that might cause your toes to repeatedly ram against the front of your shoe.

When toenails become damaged, they may bruise, blacken, and even fall off. Regardless of what happens, their recovery can increase the risk of ingrown toenails.

The best course of action to take is preventative action. Avoid toenail trauma in the first place by wearing protective shoes, or footwear that is more accommodating to the stresses of running.

But Nothing Seems to Help!

So you have changed your shoe game, protect your toes, and trim like a pro. But you are still getting ingrown toenails! What gives?

Perhaps the problem is not something you can account for.

Sometimes, ingrown toenails can be a genetic problem. Some people are just born having toenails that tend to grow curved. There was never anything you could do to prevent it, and making external changes isn’t going to help much, either.

But that doesn’t mean nothing can be done!

In situations where we have determined the cause is not being influenced by outside factors, we may recommend partially or fully removing the affected nail. The underlying nail bed can be treated in a way that prevents the nail from ever growing back, stopping ingrown toenails for good. It may sound slightly extreme, but is a relatively simple in-office procedure that can be well worth an end to recurring pain.

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