Ingrown toenails occur when the lateral side of the nail pierces the groove on the toe where the nail usually rests. This irritation causes inflammation and infection.

There are a number of predisposing factors that cause ingrown nails, but the most common causes of ingrown toenails are:

• Incorrect nail cutting
• Ill-fitting footwear causing pressure on the wall of the nail groove
• A deformity of the great toe (for example, bunions) which causes the wall of the nail groove to become irritated.

Typically the patient feels a painful pricking sensation in the toe when walking.

Treatment consists of removing the pressure with a Black's file or removing the nail spike under local anaesthetic.

95 percent of the patients seen in my clinic have the nail removed without anaesthetic and with minimum discomfort.