What Causes Ingrown Toenails? Understanding the Root of the Problem

Ingrowing Toe Nails Can be Very Painful

An ingrown toenail might seem like a small annoyance at first, but anyone who has had one knows how quickly it can turn painful! Redness, swelling, and tenderness around the nail can make even walking uncomfortable. Ingrown toenails are extremely common, and while they can happen on any toe, they most often affect the big toe. Understanding what causes them is the first step in preventing this painful issue.

Below are the most common causes of ingrown toenails and how they work together to create discomfort.

1. Improper Nail Trimming

One of the most frequent causes of ingrown toenails is cutting toenails too short or rounding the edges. When nails are trimmed this way, the surrounding skin can fold over the nail as it grows. As the nail continues to grow outward, it may curve into the skin instead of above it, creating the perfect conditions for an ingrown nail.

The safest approach is to trim toenails straight across, leaving the corners visible and not tapered. Nails should also be kept at a moderate length not so short that they expose too much skin, and not so long that they’re prone to breakage or pressure.

2. Tight or Ill-Fitting Footwear

Shoes that squeeze your toes together can slowly push the nail into the skin. High heels, narrow-toe shoes, and tight socks are common culprits. When pressure is applied repeatedly, the nail has less space to grow naturally, causing it to grow downward or sideways.

Athletes especially runners are particularly susceptible because their toes repeatedly hit the inside of their shoes. Sweat can also soften both nails and skin, making it easier for the nail to cut into the flesh.

3. Natural Nail Shape and Genetics

Some people naturally have toenails that curve more than others. A naturally rounded or “pincer-shaped” nail is more likely to grow inward. Likewise, genetics may influence nail thickness, curvature, or even the amount of soft tissue around the nail all of which can affect susceptibility.

If ingrown toenails seem to “run in the family,” the cause may be inherited nail shape or structural foot characteristics.

4. Toenail Injury

Stubbing your toe, dropping something heavy on your foot, or repeated trauma (like kicking a ball) can cause the nail to grow irregularly. When the nail is damaged, it may begin to grow crooked, which can lead directly into the skin.

Even a minor injury can cause inflammation, which makes the surrounding skin swell and press against the nail.

5. Poor Foot Hygiene

Feet that stay moist for long periods whether from sweat, improper drying, or damp environments are more prone to ingrown nails. Moisture softens the nail and skin, making it easier for the nail to penetrate the skin. Fungal infections can also cause nails to become thick, brittle, or misshapen, increasing the chance of ingrowth.

Keeping feet clean, dry, and properly moisturized (without over-hydration) can help support healthy nail growth.

6. Structural Foot Issues

The shape of your feet and the way you walk can influence toenail health. Conditions such as:

• Flat feet

• Bunions

• Hammertoes

• Overpronation

can alter how pressure is distributed across the toes. Uneven pressure may force the nail edge into the skin over time. This is especially true if you’re on your feet for long hours or participate in sports.

7. Improper Pedicure Techniques

Cuticle cutting, aggressive filing, or digging into the sides of the nail during pedicures can damage the nail bed. When the nail re-grows after such trauma, it may grow inward. Tools that aren’t sanitized can also lead to infections, causing swelling and making ingrown nails more likely.

8. Age-Related Changes

As we age, toenails tend to become thicker and harder, which can make them more challenging to trim correctly. Older adults may also have reduced mobility, making it harder to maintain proper nail care. This combination often contributes to ingrown toenail formation.

Final Thoughts

Ingrown toenails are rarely caused by a single factor more often, they’re the result of multiple influences like incorrect trimming, tight shoes, moisture, or genetic predisposition. The good news is that many of these triggers are preventable with small changes in foot care habits. By giving your toenails space, trimming them properly, and wearing supportive footwear, you can significantly reduce your chances of developing this painful problem.

If pain persists or signs of infection appear, consulting a podiatrist about ingrowing toe nail surgery is always a good idea.