Can Toenail Fungus Lead to Ingrown Toenails? Causes, Prevention and Treatment

What is Toenail Fungus?

Toenail fungus, also known as onychomycosis, is a common fungal infection of the toenails. It is caused by dermatophytes, fungi that feed on keratin, the protein that makes up the surface of the skin, nails and hair.

The most common symptoms of toenail fungus include:

• Thickened, brittle, distorted nails
• Debris build-up under the nail
• Nails separating from the nail bed
• White, yellow, black or green discoloration
• Crumbling edges

If left untreated, the infection can spread to other toenails and even fingernails. It can also become painful as the nail thickens and presses against the inside of shoes.

Causes of Toenail Fungus

There are several factors that can increase the risk of developing toenail fungus:

• Wearing tight-fitting shoes and socks that don't allow ventilation
• Walking barefoot in warm, moist areas like pools, showers and locker rooms
• Having a minor skin or nail injury
• Having a suppressed immune system
• Having diabetes, peripheral vascular disease or other conditions that affect blood circulation
• Smoking
• Advanced age

The fungi that cause nail infections thrive in warm, moist environments. Anything that causes the toenails to be excessively moist can provide the perfect breeding ground for infection.

Risk Factors

Certain groups have an increased risk of developing toenail fungus:

• Older adults - Prevalence increases with age. By age 70, around 20% of adults have fungal nail infections.
• Men - Men are more prone to infections than women.
• Athletes - Runners, swimmers, dancers, gymnasts, etc. are at higher risk due to wet feet.
• Diabetics - Elevated blood sugar impairs immune function and circulation.
• Smokers - Smoking constricts blood vessels, decreasing circulation.
• Individuals with reduced immunity - HIV, cancer treatment, steroids, organ transplant recipients are more susceptible.
• Genetics - Some people are simply more prone to fungal infections.

Good hygiene and foot care habits can help reduce the risk of infections in those more prone to toenail fungus.

Ingrown Toenails Explained

An ingrown toenail develops when the edges of the nail grow into the surrounding skin. It usually affects the big toe, but other toes can also be affected.

As the nail pierces the skin, it causes irritation, redness, swelling, and pain. If left untreated, the condition may worsen leading to infection of the toe.

Symptoms of Ingrown Toenails

• Pain and tenderness around the toe
• Redness, swelling and inflammation of the toe
• Discharge of pus from the area
• Difficulty wearing shoes due to discomfort

The pain is usually aggravated when wearing closed tight shoes like sneakers that press on the affected area.

Causes of Ingrown Toenails

Ingrown toenails often occur when:

• Toenails are cut too short allowing the edges to dig into the skin
• Toenails are rounded off at the edges during trimming
• Toenail injury damages the nail bed allowing the nail to curve into the skin
• Pressure from footwear pushes the nail into the toe
• Abnormally shaped nails are inherited
• Unusually curved or misaligned toes alter the way the nail grows

Wearing improperly sized footwear that rubs against the toe or applying too much pressure is one of the most preventable causes of ingrown toenails.

Risk Factors

The following factors increase the chances of developing ingrown toenails:

• Improper nail trimming techniques
• Hereditary nail and toe deformities
• Wearing tight, narrow shoes and socks
• Excessive sweating of the feet
• Injury to the nail or toe
• Repeated pressure on the toes
• Age - More common in adolescents and young adults
• Gender - Males are affected more often than females

Taking care to trim nails properly, wearing well-fitted shoes and treating nail or toe injuries early can help prevent ingrown toenails.

The Relationship Between Toenail Fungus and Ingrown Toenails

At first glance, toenail fungus and ingrown toenails seem to be two separate conditions. But if you look closer, they do have some connections.

Toenail Fungus Can Lead to Ingrown Toenails

One of the ways toenail fungus contributes to ingrown toenails is by causing thickening and distortion of the nails. As the fungus infection progresses, the nail becomes brittle, starts separating from the nail bed and can curve downward at the edges.

These curved, irregular edges are more likely to cut into the flesh, resulting in an ingrown toenail. The problem becomes worse when shoes press the jagged nail into the toe.

Repeated Infections Can Worsen Both Conditions

Once an ingrown toenail forms, the area becomes more susceptible to infection. Bacteria and fungi can enter through the open wound created by the nail edge digging into the skin.

If the ingrown nail gets infected with fungus, it creates an entry point for the fungus to spread to the nail bed and infect the entire toenail. This recurrent fungal infection makes the nail more misshapen and prone to becoming ingrown.

Conversely, a toenail already infected with fungus is more likely to become ingrown when the brittle, detached edges pierce the surrounding skin. The ingress of bacteria through this route then sets up the ideal conditions for additional infections.

Both Conditions Cause Damage to the Nail and Surrounding Tissue

Ingrown toenails cause injury to the nail bed as the corner of the nail grows into the flesh. This can damage or distort the area where the nail originates.

Toenail fungus also causes structural changes and slowly destroys the nail as the infection advances. The debris that accumulates beneath the nail also pushes it away from the nail bed.

This damage makes the nail more likely to become misshapen or curved, increasing the chances of it becoming an ingrown nail. The abnormal growth then sustains further damage trying to cut through the skin. This sets up a vicious cycle between the two conditions.

Treatment is More Complex When Both Conditions Are Present

Seeking prompt treatment for ingrown toenails and fungal nail infections is important to avoid complications. But when both conditions affect the same nail, it can require more extensive treatment.

The first step is usually to remove the ingrown portion of the nail along with any infected debris accumulation beneath it. Antifungal creams or oral medications may be prescribed to clear the fungal infection.

However, the infection may be resistant if it has spread to the nail bed. In severe cases, the entire nail may need to be removed surgically so that the antifungal medication can penetrate beneath the nail.

Recurrence rates for ingrown nails are also higher when a coexisting fungus infection is present. Periodic debridement and medication may be required to manage both conditions.

Can Toenail Fungus Lead to Ingrown Toenails?

Based on the above associations, its clear that toenail fungus can definitely raise the risk for ingrown toenails. Heres a summary of the key points:

• Toenail fungus causes thickening, distortion, detachment and crumbling of nails.
• The brittle, jagged edges of the fungus-infected nail can dig into the flesh.
• As the nail separates from the bed, it leaves space for overgrowth at the corners.
• Curled fungal nails provide an entry point for bacteria to infect the wound.
• The fungal infection spreads from the nail edge to the nail bed and matrix.
• Repeated infections worsen the damage to the nail and surrounding skin.
• Ingrown nails with fungal infections are harder to treat.

For all these reasons, toenail fungus often precedes and contributes to ingrown toenail formation, especially in the case of severe infections affecting multiple nails.

However, while having toenail fungus makes you more prone to getting ingrown nails, it doesnt mean everyone with nail fungus will develop ingrown toenails. Proper foot care and hygiene can help prevent complications.

Preventing Ingrown Toenails Related to Toenail Fungus

You can reduce the risk of getting ingrown toenails associated with toenail fungus by following these preventive measures:

Get early treatment for toenail fungus

The sooner you get treated, the less damage the infection can cause to the nails. Oral and topical medications can eradicate fungus in the early stages before it spreads through the entire nail.

Trim nails properly

Cut nails straight across without rounding off the edges. Dont cut them too short to avoid injury that allows ingrowth. File away sharp corners.

Wear clean cotton socks and well-fitted shoes

Choose shoes with adequate toe room to avoid constant pressure on nails. Change socks regularly to avoid trapping moisture.

Alternate shoes daily

This allows them to air out and dry completely between uses to prevent fungal and bacterial growth.

Disinfect nail tools

Sterilize nail clippers, files and other manicure instruments so you dont transfer infections through them.

Avoid injury to toes and nails

Use care to prevent stubbing your toes, dropping things on them, or damaging nails to lower infection risk.

Treat ingrown nails early

See your doctor at the first sign of an ingrown nail to prevent worsening. Follow suggested treatments to allow proper healing.

Practice good foot hygiene

Wash and dry feet well, especially between the toes. Apply antifungal powder to help keep them dry.

Treating Ingrown Toenails Caused by Fungus

Several treatment options are available for ingrown toenails with or without an associated fungal infection. Your doctor will determine the best approach based on the severity.

Nail trimming

For mild cases, trimming away the ingrown section followed by proper nail care may be sufficient. Regular trimming helps prevent recurrences.

Partial nail removal

Removing part of the affected nail edge and underlying debris provides relief from pain. Chemical or surgical methods can be used for partial removal.

Temporary nail braces

Plastic braces inserted under the nail edge lift it away from the skin allowing healing. But fungal infections may persist.

Permanent nail removal

For severe or recurrent cases, permanent surgical removal of part or all of the nail may be done. This fully exposes the nail bed to receive treatment.

Medications

Oral antifungal medications are usually prescribed for 2-3 months for fungal nail infections. Creams and nail polish may also be used.

Preventive surgeries

If there is abnormal nail shape or toe alignment, minor procedures can be done to prevent repeat ingrowth.

Following the treatment plan consistently is key to preventing recurrence of complications. Notify your doctor promptly if any new problems arise.

When to See a Doctor

Consult a podiatrist or dermatologist if you notice any of the following symptoms:

• Thick, brittle, discolored nails
• Detached nails with debris accumulation
• Foul nail odor
• Nail fungus spreading to other toenails
• Redness, swelling or pain around the toe
• Drainage of pus or fluid from the toenail
• Difficulty walking due to toe pain
• Worsening of ingrown toenail condition

Early diagnosis and prompt treatment can help resolve fungal nail infections before they progress to ingrown nails. Even if you already have ingrown nails, treating the underlying fungal infection is key to preventing recurrences.

Let your doctor know if you have a history of either toenail fungus or ingrown nails so that preventive care can be emphasized. With proper foot care habits and hygiene, complications can be avoided.

In Conclusion

Toenail fungus is a common cause of ingrown toenails. The structural changes and distortion caused by the fungal infection alter the way the nail grows. This increases the risk of the edges curling into the skin leading to infected ingrown nails.

Left untreated, the two conditions can aggravate each other resulting in greater damage. Catching and treating toenail fungus early can help prevent progression to ingrown nails. Proper nail care and hygiene is key to avoiding complications.

If you already have ingrown toenails with fungus, seeking medical care is highly recommended. Following the treatment plan prescribed by your doctor offers the best chance for resolving both issues and preventing recurrences.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.