Pincer nails (also known as trumpet or convoluted nails) are a type of nail deformity that causes the sides of the nail to curve inward. The condition can lead to pain and discomfort in the toes.
Usually the result of years of wearing shoes that squeeze the toes, pincer nails are hereditary or acquired. The condition is often painful and requires treatment to relieve symptoms.
Genetics
Pincer toenails are the most severe form of ingrown toenails, which develop when the edges of a nail curl into and dig into the surrounding skin. The condition can cause pain, redness, swelling, and infection if left untreated. Pincer toenails are most common in the big toe but can occur in any toenail. They are also known as in-curved nails, trumpet nails, convoluted nails, and omega nails.
A doctor can diagnose pincer toenails by examining the affected toenails and asking questions about symptoms, health history, and habits that could affect nail shape and growth. They may also order diagnostic tests like X-rays or nail cultures to rule out underlying causes of the problem.
Genetics is the most common cause of pincer toenails, but this type of ingrown toenail can also be caused by ill-fitting shoes and improper toenail trimming. Certain medical conditions, including psoriasis and fungal infections, can also impact the shape of a nail. Over time, a toenail can also become thicker, which makes it more likely to curve inward and develop a pincer shape.
Over the counter treatments, such as medicated ointments and pads, can help ease the pain of a pincer toenail. These products often contain antiseptic ingredients to prevent infections and soften the toenail, making it easier to trim or lift ingrown areas. However, over-the-counter treatments are not a cure for the condition, and they should be used in conjunction with regular visits to a foot care specialist.
Pincer toenails can also be treated by performing a surgical procedure called a K-D deformity. This involves attaching a small device, similar to a mosquito clamp, to the edge of the nail and pushing it against the lateral side of the nail bed. The nail will eventually straighten out, preventing it from curving into the lateral side of the toe and eliminating pain.
Pincer toenails are a painful condition that can be prevented with proper foot care and regular visits to a podiatrist. Avoid wearing shoes that are too tight and choose footwear with wide toe boxes. Keep toenails trimmed correctly to avoid encouraging excessive curvature, and make sure to wear nail strengtheners to promote healthy growth.
Ill-fitting Footwear
Pincer nails, also called trumpet nails, develop when the sides of a toenail curve inward and pinch or press against the skin on either side. It’s a common and painful form of ingrown toenail and can feel like a splinter when left untreated. They can affect any toenail, but most commonly occur in the big toe and may lead to redness, tenderness, pain, or infection. They can also cause a buildup of calluses or corns on the tops of the toes.
This condition can be hereditary, but it is more often the result of years of wearing shoes that squeeze the toes too tightly. This can progressively reshape the toenail so it gradually becomes more and more curved inward. It’s more common in women due to their tendency to wear pointy-toed and tight shoes that cram the toes together, as well as high heels that add pressure on the toes. People with diabetes should be especially attentive to footwear fit as they may suffer from nerve damage (peripheral neuropathy) in their feet, which can affect their ability to feel any pain or pressure on their feet.
Improper nail trimming or foot care can also contribute to the development of a pincer toenail. Cutting the toenails too short or rounding the edges excessively can encourage the nails to grow in an abnormal shape. Repeated trauma to the nails or minor injuries may also increase your risk for developing this problem.
Fortunately, there are many ways to prevent or treat pincer toenails. Proper nail trimming can help to prevent abnormal curvature, and making sure you wear well-fitting shoes that don’t squeeze the toes can also prevent this issue. Using moisturizers and nail-strengthening treatments can also promote healthy, straight nail growth.
It’s important to see a foot and ankle specialist at the first signs of abnormal nail growth or changes in your toenails. These specialists can assess your symptoms and provide the best treatment options to manage this painful problem. With the right management, your pincer toenails can improve over time and you can enjoy a comfortable and pain-free life!
Medical Conditions
A pincer toenail, also called a trumpet nail, is a deformity that causes the sides of the toenails to curve inward, pinching the skin around the nails. The condition may be painful and can cause an infection if not treated properly. Pincer toenails can affect both fingernails and toenails, but they are most commonly found in the big toes. The condition can be caused by genetic predisposition, tight shoes, improper toenail trimming, and medical conditions. People who have a chronic illness or are taking certain medications may be more likely to develop the condition.
There are two types of nail deformities: dystrophies and atrophies. Dystrophies are changes in the shape and texture of the nail, while atrophies involve a loss of the structure of the nail. Atrophies can be caused by injuries, fungal infections, psoriasis, lichen planus, benign tumors, and occasionally inflammatory diseases of the nail matrix. Often, these changes can be corrected with proper nail care and treatment.
Ingrown toenails and pincer nails are similar, but they differ from one another based on morphology and symptoms. Ingrown toenails can be difficult to differentiate from a pincer nail because they can develop on both sides of the nail and are usually only painful when pressure is applied. Pincer nails are typically only painful when they pierce the side of the toe and can be caused by genetic predisposition, ill-fitting shoes, or other health conditions.
A 29-year-old male presented with a painful left toenail. The patient reported no history of trauma or drug intake. On examination, the patient’s toenail was excessively curved with a crease in the lateral fold and fissuring at the distal end. The authors used a prefabricated transparent splint to suture the lateral toe and proximal cunychial fold. After a 10-day period, the authors noted that the nail had returned to its normal morphology and there was no further pain or recurrence.
It is important to seek professional care at the first signs of a problem with your nails, especially if you have diabetes or poor circulation. Ingrown toenails can lead to a severe soft-tissue infection and, in extreme cases, can even spread to the bone. Consult a podiatrist to learn more about how to take care of your nails and prevent problems like a pincer toenail from developing.
Age
Pincer nails are a common condition in which the sides of the nail curve inward, resembling a pincer or clamp. The abnormal growth can lead to discomfort or even pain when pressure is applied, often from footwear. The condition can also contribute to infections. Understanding the causes of this condition can help you avoid it and seek treatment early if symptoms occur.
Genetics can make some individuals more susceptible to developing curved nails, but it’s often a combination of factors that cause the condition. Improper nail trimming can encourage a curved shape, and certain health conditions like fungal infections and psoriasis can alter how the nails grow as well. Ill-fitting shoes that create pressure on the toes can also encourage a curved nail, and repeated trauma to the nail bed may result in permanent curvature.
A 29-year-old male presented with a painful left big toenail. He had no history of preceding injury or drug intake and was a non-smoker. On examination, the toenail was severely curved with the lateral edges impinging on the lateral nail folds. There was a fissuring at the distal end of the nail, which was also pressed into the surrounding skin (Figure 4(a)).
Over time, the excessive curvature can irritate and entrap the toe. In severe cases, the nail can become so curved that it is almost touching the skin on either side of the toe. This can progressively entrap the toe and cause pain or even infection.
In addition to reducing the severity of the curvature by trimming nails correctly and wearing shoes that fit properly, there are a number of other methods for treating this condition. Moisturization can help improve flexibility, and specialized nail braces or corrective splints can help to straighten the nails.
A podiatrist can assess the severity of a pincer toenail and recommend the best treatment option. In most cases, the goal is to keep the nails as healthy and normal as possible, avoiding any further damage and keeping them free of infections. This can include taking preventive measures, such as wearing comfortable shoes that don’t squish the toes and moisturizing regularly. In more serious cases, however, surgery may be necessary to remove the impacted toenails.
