Fast Facts
- When the corners or edges of the nail grow into the skin, ingrown toenail occurs.
- If not infected, an ingrown toenail will often respond to home treatments. However, medical treatment is recommended if the nail has pierced deep into the nail fold.
- People with diabetes or other conditions that may cause poor blood circulation are at a higher risk of developing complications from ingrown toenails.
Causes
Ingrown toenails can be attributed to a lot of causes, including:
- Improper cutting of the toenails (cutting the edges or cutting the nails too short might cause the skin to fold over the nail, resulting in the nail growing under the skin).
- Wearing of improper footwear (i.e. too narrow or too tight)
- Injury (blood clot under the nail)
- Genetic predisposition
- Improper foot hygiene or fungal infection
Using the feet extensively especially during athletic activities can also make some individuals more susceptible to developing the condition.
Activities that entail repetitive kicking or putting pressure on the feet for long periods (i.e. kickboxing, soccer, football, ballet, etc.) may also result to toenail damage and increases one’s risk of getting ingrown toenails.
Symptoms
Ingrown toenails can be very painful and the pain can get more severe if the condition worsens, to the point that wearing closed shoes is not possible. In its early stage, common symptoms of ingrown toenails include:
- Skin next to the affected nail can become hard, tender, or swollen
- Pain (especially noticeable when there is pressure on the affected toe)
- Fluid building up around the affected toe
If the toenail becomes infected, other symptoms may manifest, including:
- Swelling
- Redness
- Bleeding
- Pus discharge
- Skin overgrowth around the toe
Diagnosis
When diagnosing ingrown toenails, physical examination alone would often suffice. However, if the toe has been infected, an X-ray might be recommended to assess how deep the infection is.
Treatment Interventions
Home Care Remedies
An ingrown toenail that is not infected will often respond well to home care treatments. To treat ingrown toenails at home, the following will prove beneficial:
- Soak the feet in warm water for at least 15 to 20 minutes, 3 to 4 times daily.
- Using a cotton ball soaked in olive oil, push the side skin away from the toenail edge.
- Use a topical antibiotic or a steroid cream to prevent infection.
- Take over-the-counter medications to minimize pain.
If the condition does not respond to home treatments or when infection occurs, ingrown toenail surgery might be recommended.
Surgical Treatment
Partial nail avulsion – this procedure is considered very effective and is often used to treat ingrown toenails. The toe is numbed using a local anaesthetic before the procedure is carried out. A chemical known as phenol is applied to the area affected to keep the nail from growing back. Pus will be drained and a course of antibiotics may be prescribed if there is an infection.
Total nail avulsion – if the nail is thick and presses into the surrounding skin, this procedure might be carried out. Once the toenail has been removed, there will be an indentation where the nail used to be but it is perfectly safe. Concomitant chronic fungal infection is also treated this way.
Post-Surgery
The toe will be wrapped in a sterile bandage after the surgery. This is done to help prevent any bleeding and infection. The affected foot should also be elevated at least a day or two after the operation. To help minimize the pain, painkillers (ibuprofen or paracetamol) might be prescribed.
Prevention
Taking proper care of the feet can help prevent toenails (and other foot problems). Since the feet take the weight of the entire body, ingrown toenails and other foot problems can result in discomfort and can affect the way one walks. Below are some effective ways to take proper care of the feet to ensure ingrown toenails and other foot issues are kept at bay:
- Ensure the toenails are cut straight across and make sure the edges are square.
- Refrain from cutting the toenails too short by leaving a white edge.
- Avoid wearing ill-fitting socks, tights, and shoes.
- When needed, wear steel-toed boots at work.
- When wearing heels at work is required, wear comfortable shoes to and from the office and only wear the heels at work.
- Also, as much as possible, wear pointed shoes and high heels for special occasions only.
- While unknown to many, wearing flip-flops all the time is not advisable as they don’t provide proper feet support and may result in heel pain.
For people who are over 60, foot care can become even more vital. Age can take its toll—the joint can stiffen, the skin and sole thins, and the feet can become even more vulnerable to the cold. As a general rule of thumb, do not put up with foot pain and see a professional right away so any conditions are remedied before they complicate.
