An involuted toenail is not the same thing as an ingrown toenail. An ingrown toenail grows into the toe and parts of it may disappear. An involuted toenail is a nail that is in clear view on the toe, but the sides start “pinching” into the toe, and an upward arch is formed with the nail. The sides of the nail are like the sides of the arch. The top of the arch sticks up above the level of the toe where the nail should be. Pain can result from the toenail rubbing against the shoe. It’s possible that the arched toenail can get snagged on socks and other items if someone is walking barefoot as well. Cause Why people develop involuted toenails is unknown. Some experts say the cause is tight shoes while others say it’s inherited. It’s possible that cutting the sides of the nail too far down can contribute to this condition. Treatment and Prevention If poor-fitting shoes caused the involuted toenails or contributes to the irritation of them, then it’s important to replace the shoes. Shoes with a tall toe box are especially important. In severe cases where the nail appears to be progressively buckling, the nail may need to be removed. This may prevent nail infections from occurring in the future.