Dancers exhibit strength and grace and impressive control over their bodies. Professional, pre-professional, and competitive dancers spend many hours each week in the studio honing their skills. All that hard work can wreak havoc on their feet. At some point in their careers, most dancers have to deal with ingrown toenails.

Development of Ingrown Toenails

The nail of the big toe, or hallux, can become ingrown when the sides of the nail start growing down into the skin. The edges or corners of the nail start to embed in the tissue, which causes irritation. Over time, the inflammation triggers redness, swelling, and pain in the tissue surrounding the ingrown edge of the nail. An infection can develop if the source of inflammation is left untreated, causing additional pain and swelling as well as pus drainage. 

Shoe Fitting

One cause of ingrown toenails is wearing shoes that fit too tightly or restrict movement of the toes. Tight-fitting shoes put pressure on the nail, causing the corner or the nail to start growing down into the surrounding flesh. Dancing in constrictive shoes such as tap shoes or pointe shoes can lead to ingrown nails. 

If the tap shoes are too small, they will cause ingrown toenails by compressing the toes together while dancing. Toe stands are a common tap step where the dancer balances his or her weight on the tips of the toes. This dance move contributes to ingrown toenail development due to added pressure on the toes. Frequent or extended periods of pressure exerted on the nail from repetitive dance steps can cause a toenail to grow down into the skin.

Dancing en pointe involves spending long periods of time with the dancer's weight balanced on the pads of their toes. Pointe shoes contain hardened layers of cardboard and glue that the dancer balances on when they raise themselves up on their toes. Pointe shoes must be exactly fitted to the dancer's feet with no wiggle room. The pressure exerted on the toes by the dancer's body weight, combined with the compression from the snug fit of the shoes can lead to ingrown toenails.

Nail Trimming

Cutting the nails too short or cutting the corners at an angle instead of straight across can also lead to ingrown toenails. Dancers must trim their toenails frequently to avoid discomfort caused by too-long nails inside their shoes and to make sure their pointe shoes fit correctly. Overzealous nail trimming can result in nails cut below the distal edge of the toe or nails that are angled at the corners.

Managing and Treating Ingrown Toenails

Dancers can manage their ingrown toenails by keeping them covered with adhesive pads designed to relieve some of the pressure on the inflamed area. Applying antibiotic ointment and keeping the toes bandaged can reduce the risk of infection. However, once the nails start growing inward, it is difficult to make them grow normally. Seeking ingrown toenails treatment from a podiatrist at the first sign of an in-growing nail increases the chance for success. If conservative treatment isn't successful,  eventually the ingrown portion of the nail must be surgically removed and the root of the nail killed to avoid a recurring ingrown toenail.