Is Surgery Required if the Toenail Curves Inward?

What Is A Curved Toenail?

A curved toenail, also known as a pincer nail, is a condition in which the sides of the toenail curve inwards, causing it to penetrate the surrounding skin. 

This is described as an “ingrown toenail” since the toenail curving inwards rather than outwards, effectively becoming embedded within the skin.

This causes severe discomfort, along with swelling and redness. In addition, there is a considerable risk of infection if left untreated. Individuals may initially see a skin hardening, followed by pus or fluid production in the surrounding area. Thus, this is not the best time to put polish when your toenail has fungus or is curved inwards.

Causes of Toenail Curving Inward

a swollen toenail


Damage to the toe is one of the most prevalent causes of toenail curving inward. For instance, if it’s hit with a blunt object head-on which can alter the overall direction of nail growth, leading it to grow in an undesirable direction.

This is one of the reasons why the great toe is the most likely candidate for inner growth, as it is the first to absorb the impact and consequently absorbs most of the shock. It need not necessarily be a one-time occurrence.

People who participate in several sporting activities that place great strain on the toes may also experience toenail curving inward, especially if they don’t wear shoes with memory foam insoles. Another instance is recurrent injuries from kicking a football or balancing one’s full body weight on the tips of one’s toes.

Small toes

In some instances, the toe size is insufficient to accommodate the nail size, causing the nail to curve unnaturally and frequently resulting in ingrown toenails.

Squeaky shoes

feet of people running on a marathon

When wearing shoes that are too tiny, your toes will often become squished together to compensate for the lack of space.

If you wear smaller shoes for an extended time, the persistent pressure on your toenails will lead them to bend inward. This most commonly affects the great toe. This is why we recommend purchasing shoes in the correct size. It can be tough to keep up with your children’s growth spurts while purchasing shoes, so you must be very attentive.

Do not rely on fixed dimensions or hunches. Have them try on every new pair of shoes before you purchase them. Don’t only consider the duration. Even if your toes have ample room in the front, excessively narrow shoes may lead to the formation of downwardly bent toenails.


Some individuals are genetically inclined to have ingrown nails. These individuals must exercise extreme caution with their care. These individuals may get ingrown toenails on nearly all of their toes and may endure persistent pain. Visits to the doctor frequently become the norm, and surgery is not unusual.

Research indicates that a diet lacking in iron and zinc causes nails to curve upward, making them more susceptible to harm. B12 deficiency may also contribute to the curvature of toenails.

Improper cutting

This is by far the most prevalent cause of ingrown toenails. Most individuals trim their nails by following the toe curve, which is acceptable to some degree. However, this frequently causes the nail edge to bend and dig into the flesh.

It is recommended to cut in straight lines to prevent in-growth. Also, do not clip the nails too short.

Poor hygiene

This problem is more likely to occur in sweaty feet that are not cleaned and dried regularly. Every day, you should wash your feet properly and trim your nails every two weeks. In addition, it will prevent infections: This is because such a wet atmosphere promotes bacterial growth. To avoid infections, do not share footwear or wear shoes in public locations.

How do you diagnose an ingrown toenail?

You may often self-diagnose an ingrown toenail based on your symptoms and the appearance of the affected toe. Your doctor (who may be your primary care physician or a foot expert known as a podiatrist) will likely diagnose an ingrown toenail by examining it. They will examine the skin near the nail’s edge.

Ingrown toenails are diagnosed if the skin is: overgrowing the nail, reddish, swollen, sensitive, and heated.

What tests could I undergo to diagnose an ingrown toenail?

Typically, no tests or X-rays are required to diagnose an ingrown toenail. Rarely your healthcare professional may obtain a culture sample to determine the infection when the toenail is seriously infected. In addition, X-rays may be required for more severe infections.

Does a toenail ingrown require surgery?

Most ingrown toenails heal without surgical intervention. Your healthcare professional may need to remove a portion of the nail is difficult situations surgically.

The technique is known as an avulsion of the nail. Surgical intervention prevents the nail’s edge from growing inward and cutting into the skin. Children who repeatedly develop infected ingrown toenails can benefit from permanent nail removal.

An anesthetic (numbing medication) is injected into your toe during a partial or total nail avulsion. The provider then removes a portion or all of the toenails. The nail may require several months to regenerate. These avulsion operations can be performed permanently with the aid of a substance that kills the nail root for recurrent ingrown nails.

What is surgery for ingrown toenails?

Your doctor may consider surgery for an ingrown toenail if:

  • Home cures will not cure your ingrown toenail.
  • You suffer from recurrent ingrown toenails.
  • You have a condition such as diabetes that increases the likelihood of problems.

Depending on the circumstances, a portion or the entirety of your toenail may need to be removed.

To prepare your toe for surgery, your physician will first clean and numb it with an anesthetic injection. This can be pretty uncomfortable. A snug elastic band may be put near the joint between your toe and foot. They may place a wedge under your ingrown nail to hold it in place.

The doctor will then use scissors and specialized tools to separate your toenail from the bed, cutting vertically from the ingrown side to the cuticle. They will then remove the area that was clipped.

The entire nail may be removed if necessary, especially if both sides of the nail are ingrown. Your doctor will use cautery or an acidic solution, such as phenol or trichloroacetic acid, to destroy the nail matrix from which your nail grows. This stops the bleeding from your nail. It also indicates that that portion of your nail is unlikely to regenerate.

If the nail does return, it may seem different than before surgery. Your doctor will then often place a petroleum jelly-coated bandage on your toe.