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An ingrown toenail occurs when the nail border penetrates the skin causing pain. If left untreated, infection may result. An ingrown toe nail has many causes: Improper nail cutting, aggressive cuticle care, tight fitting shoes, or direct nail trauma are the most common. A fungal infection of the nails can cause the nail to change shape and grow inward. Initial treatment consists of removal of the offending portion of nail and drainage of infection if present. If the ingrown nail is recurrent, then permanent removal of the ingrown portion of nail is performed.