Ingrown Toenail

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What Is an Ingrown Toenail?

Toenails usually grow straight out. When a toenail is ingrown, the sides of the nail may curve or grow into the flesh. This “digging in” of the nail irritates the skin, and can create pain, redness, swelling, and warmth in the toe. It’s most common with the big toe but any toe can become affected.

Ingrown toenails can become infected. Signs of infection may include drainage and a foul odor. People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self-treatment and seek podiatric medical care as soon as possible.

Causes

  • Trauma. trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.

  • Improper trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.

  • Improperly sized footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.

  • Heredity. In many people, the tendency for ingrown toenails is inherited.

  • Nail Conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.

Treatment

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected, or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot, or poor circulation.

Home care (for those not at high risk)

If you don’t have an infection or any of the above medical conditions, you can soak your foot in room-temperature water (adding Epsom’s salt may be recommended by your doctor), and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon.

Physician Care

After examining the toe, the foot and ankle surgeon will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, the doctor removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

Prevention

  • Trim toenails properly: cut them straight across, not longer than the tip of the toes. Do not dig into corners and only gently round off corners with a nail file. Use toenail clippers.

  • Avoid shoes with pointy or narrow toe boxes.

  • Never rip or tear edges of nails.