SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (21)

Ingrown toenail - Nail and Distal Digit
Other Resources UpToDate PubMed

Ingrown toenail - Nail and Distal Digit

Contributors: Shari Lipner MD, PhD, Bertrand Richert MD, Robert Baran MD, Susan Burgin MD
Other Resources UpToDate PubMed


Ingrown toenails (onychocryptosis) are common nail complaints and may occur at any age. They result from the penetration of the nail plate into the skin. There are 2 types of ingrown toenails: lateral and distal.

Lateral ingrown toenails are the most common type, especially in children and young adults. The nail becomes embedded into one or both lateral nail folds, with a nail spicule that breaks the epidermis of the lateral groove with subsequent inflammatory reaction and pain. Cutting the spicule aggravates the condition by causing a new, more proximal spicule to form. In time, granulation tissue may develop with concomitant oozing, bleeding, and secondary infection. The condition may be precipitated by improper nail cutting, plantar hyperhidrosis, trauma, and anatomical foot abnormalities.

The second, and much less common, type of ingrown toenail occurs distally. Normally, there is a natural counter pressure from the nail plate to the underlying tissue. Nail plate avulsion or traumatic nail shedding cause a loss of counter pressure, causing a bulbous extremity. The newly formed nail abuts this distal wall, which interferes with its normal growth. A deep transversal horn fills the distal groove and results in the ingrown nail and pain.


L60.0 – Ingrowing nail

400200009 – Ingrown toenail

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Lobular capillary hemangioma (pyogenic granuloma)
  • Paronychia (Chronic paronychia, Bacterial paronychia)
  • Squamous cell carcinoma in situ
  • Pincer nail deformity

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required


Subscription Required

Last Reviewed:04/09/2017
Last Updated:02/14/2022
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Ingrown toenail - Nail and Distal Digit
Print E-Mail Images (21)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Ingrown toenail - Nail and Distal Digit
A medical illustration showing key findings of Ingrown toenail : Nail fold erythema and edema, Periungual toes, Solitary nail or digit, Toe pain
Clinical image of Ingrown toenail - imageId=2285888. Click to open in gallery.  caption: 'Lateral ingrowing toenail, with adjacent pink erythema and edema of the nail fold (paronychia).'
Lateral ingrowing toenail, with adjacent pink erythema and edema of the nail fold (paronychia).
Copyright © 2024 VisualDx®. All rights reserved.