What is the pathophysiology of ingrown nails?

Updated: Nov 06, 2020
  • Author: Amira M Elbendary, MBBCh, MSc; Chief Editor: William D James, MD  more...
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Ingrown nails result from an alteration in the proper fit of the nail plate in the usual nail groove. Sharp spicules of the lateral nail margin develop and are gradually driven into the dermis of the nail groove. The nail acts as a foreign body. An inflammatory response occurs in the area of penetration, leading to erythema, edema, purulence, and development of granulation tissue.

The normal distance between the nail groove and the border of the nail is 1 mm. A thin epithelial layer covers the nail groove and protects it from irritation. With an increase in pressure on the nail bed and nail groove, an epidermal breakage occurs, with subsequent inflammation, pain, and infection. [2]

Ingrown nails generally occur as the result of poorly fitted footgear. However, this may be caused by prior trauma to or abnormal shape of the nail margin. [3]

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