An ingrown toenail, clinically referred to as onychocryptosis, is a common and often painful condition where the side of the nail grows into the surrounding skin. While it can affect anyone, adults in the United Kingdom frequently encounter this issue due to a combination of daily grooming habits, footwear choices, and physical activities that put repetitive pressure on the toes.
What We’ll Discuss in This Article
- The impact of incorrect nail trimming techniques
- How footwear and hosiery contribute to nail pressure
- The role of physical trauma and repetitive sports activities
- Genetic factors and natural nail shapes
- Identifying the signs of an ingrown toenail
- Simple preventative measures for daily foot care
- When to seek professional clinical advice for a painful nail
What causes ingrown toenails in adults living in the UK?
The primary cause of ingrown toenails in adults is incorrect nail trimming, where cutting the nails too short or rounding the corners allows the skin to fold over the edge of the nail as it grows. Other significant factors include wearing tight or ill-fitting footwear that compresses the toes and repetitive trauma from activities like running or football, which can push the nail plate into the nail fold.
Incorrect Trimming Techniques
The most frequent reason adults develop ingrown toenails is the way they cut their nails. Many people mistakenly believe that rounding the corners of the toenail to follow the shape of the toe is the correct method. However, this often encourages the nail to grow into the skin at the sides. When the corners are cut back too far, the skin can be pushed over the edge of the nail by the pressure of walking or wearing shoes.
To maintain healthy growth, nails should be trimmed straight across. It is also important not to cut the nails too short. A nail that is trimmed to the point where the nail bed is exposed is much more likely to become ingrown as it tries to grow back. Using proper, sharp nail clippers rather than scissors or picking at the nails can also prevent the jagged edges that frequently lead to irritation.
Impact of Footwear and Hosiery
The shoes and socks we wear in the UK play a major role in the health of our toenails. Footwear with a narrow or pointed toe box compresses the toes together, forcing the side of the nail into the surrounding soft tissue. Over several hours of wear, this constant pressure can cause the nail to pierce the skin, leading to pain and inflammation.
Similarly, tight hosiery or socks can put enough pressure on the toes to contribute to the problem. For individuals who spend long hours on their feet, such as healthcare workers or retail staff, the cumulative effect of even slightly tight shoes can be significant. Choosing footwear with adequate room for the toes to move and breathe is a fundamental step in preventing recurring ingrown nail issues.
Physical Trauma and Exercise
Repetitive trauma is a common cause for active adults. Sports that involve frequent stopping, starting, or kicking—such as football, rugby, or distance running—subject the toenails to constant impact against the front of the shoe. This can cause the nail to shift or become damaged, eventually leading it to grow into the nail fold.
Sudden trauma, such as stubbing a toe or dropping a heavy object on the foot, can also alter the way the nail grows. If the nail plate is damaged or partially detached, the new nail emerging from the base may follow a different path, increasing the risk of it becoming ingrown. Maintaining short, straight-trimmed nails is especially important for those who engage in high-impact physical activities.
Genetic Factors and Nail Shape
For some individuals, the tendency to develop ingrown toenails is hereditary. The natural shape of the nail can influence how likely it is to grow into the skin. Nails that are naturally curved or fan-shaped, sometimes called involuted nails, are more prone to pressing into the nail folds. In these cases, even with perfect trimming habits, the nail may still become ingrown due to its structural anatomy.
Ageing also plays a role in nail shape. As adults grow older, the nails may become thicker or more curved, which can increase the risk of the edges irritating the surrounding skin. People with naturally fleshy toe folds also have less space for the nail to grow, making them more susceptible to the nail edge becoming embedded in the tissue.
Identifying the Signs of an Ingrown Nail
Recognising the early signs of an ingrown toenail allows for quicker intervention before an infection develops. The first symptom is usually pain or tenderness when pressure is applied to the side of the toe. You may also notice slight swelling and redness where the nail meets the skin.
If the nail has actually pierced the skin, you might see a small amount of clear fluid or even pus, which indicates that bacteria have entered the area. The skin may also begin to grow over the nail as a protective response, a condition known as granulation tissue. It is important to monitor these signs closely, as an unmanaged ingrown nail can lead to a more serious bacterial infection.
Conclusion
Ingrown toenails in adults are primarily caused by improper trimming, tight footwear, and repetitive physical trauma. By cutting nails straight across and ensuring shoes provide enough space for the toes, most people can avoid the discomfort associated with this condition. Understanding your natural nail shape and maintaining good foot hygiene are essential for long term prevention. If you experience severe, sudden, or worsening symptoms, call 999 immediately.
Why does my toenail hurt more when I wear shoes?
Shoes put pressure on the toe, which pushes the edge of the ingrown nail further into the inflamed skin, causing acute pain.
Can I fix an ingrown toenail at home?
Minor cases can sometimes be managed by soaking the foot and wearing wider shoes, but you should never attempt to perform home surgery or cut the nail out yourself.
Is it better to cut my nails when they are wet or dry?
Trimming nails after a bath or shower when they are softer can be easier, but you must still ensure you cut them straight across.
How do I know if my ingrown toenail is infected?
Signs of infection include increased redness, heat, throbbing pain, and the presence of pus or a discharge from the side of the nail.
Why do I keep getting ingrown nails on the same toe?
This may be due to a naturally curved nail shape or a habit of wearing shoes that are too tight on that specific foot.
Should I wear a plaster on an ingrown toenail?
A plaster can protect the area from friction, but it should be changed regularly to keep the site clean and dry.
Do ingrown toenails happen on fingers too?
While much less common, ingrown fingernails can occur, usually due to nail-biting or picking at the cuticles.
Authority Snapshot (E-E-A-T)
This article is designed to provide clear and factual information regarding skin health for the general public. The content is written by the Medical Content Team and has been reviewed by Dr. Stefan Petrov. He is a UK-trained physician with an MBBS and postgraduate certifications including Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and the UK Medical Licensing Assessment (PLAB 1 & 2). He has hands-on experience in general medicine, surgery, anaesthesia, ophthalmology, and emergency care. Dr. Petrov has worked in both hospital wards and intensive care units, performing diagnostic and therapeutic procedures, and has contributed to medical education by creating patient-focused health content and teaching clinical skills to junior doctors.
