An ingrown toenail is a common condition characterized by the corner (or side) of the toenail growing into the soft flesh.
The condition often affects the big toe and can result in redness, swelling, pain, and in some cases, an infection.
While minor cases will respond to homecare treatments, others might result in complications that will require medical intervention.
Complication risk is higher for those individuals who have diabetes or other conditions that cause poor blood circulation to the legs and feet.
An ingrown toenail can be attributed to some of the following causes:
- Incorrect cutting of the toenails (should be straight across so the sides of the nail will not grow into the skin)
- Curved and irregular nails
- Shoes that are too narrow, flat, or tight
- Toenail injuries
- Genetic predisposition
- Improper foot hygiene
Excessive use of the feet during athletic activities can also make one susceptible to an ingrown toenail.
Athletic activities that increase one’s risk for ingrown toenail include:
Ingrown toenails can be very painful and can worsen over time.
In its early stage, some of the prevalent symptoms of the condition can include:
- Pain (especially when pressure is placed on the affected toe)
- Fluid build-up
When an infection has set in, other symptoms can manifest including:
- Redness and swelling
- Skin overgrowth (around the affected toe)
When left undetected or untreated, the condition can infect the underlying bone and may result in serious bone infection.
Complications can be especially severe in patients that are diabetic or any other conditions that cause poor blood flow.
A doctor or a podiatrist (foot doctor) can easily diagnose an ingrown toenail.
To accurately diagnose the condition, the doctor will likely ask relevant questions aside from physically examining the affected toe.
Some of the possible questions can include:
- When did the symptoms begin?
- Are the symptoms experienced all the time?
- What are some of the homecare treatments that have been tried?
- Do you have diabetes or other conditions that may cause poor blood flow to the legs and feet?
To make the most out of your scheduled appointment, it is ideal that you also prepare a list of questions you may have about the condition.
Some of the questions that should make it to your list should include:
- Is the condition long-term or just temporary?
- What are the possible treatment options for my case?
- What are the pros and cons of each?
- What results can I look forward to?
- Is it advisable to just wait until the condition heals on its own?
- What nail care regimen would be recommended while the affected toe is healing?
In mild cases (with no infection), the condition will often respond very well to home care remedies.
Treat ingrown toenail at home by:
- Soaking feet in warm water three to four times a day (at least 15 to 20 minutes each time)
- Pushing skin away from the toenail’s edge (use a cotton ball soaked in olive oil)
- Using over-the-counter medications such as acetaminophen (Tylenol) to relieve the pain
- Applying topical antibiotic like neomycin and polymyxin (or a steroid cream) to prevent the affected toenail from getting infected
If the condition does not respond to homecare treatments or when an infection develops, ingrown toenail surgery might be required.
Partial Nail Removal – this involves removal of only the portion of the nail that digs into the skin. A piece of cotton is placed under the remaining portion to keep the condition from recurring. A compound called phenol may also be used to keep the nails from growing back. This procedure is considered 98 per cent effective in preventing future ingrown toenails.
Total Nail Removal – may be recommended when the condition is caused by thickening. A local pain injection will be given and the entire nail is removed. The procedure is also called matricectomy.
After the procedure, patients will be sent home with a bandaged toe.
Keeping the affected foot raised for a day or two may also be recommended.
Wearing special footwear to help the toe heal properly may also be suggested.
Usually, the bandage is removed two days after the procedure.
Wearing open-toed shoes and doing saltwater soaks daily will also be recommended until the toe heals completely.
Pain relief medications and antibiotics will also be prescribed to prevent infection.
To help ensure ingrown toenail is prevented, the following beneficial tips should be kept in mind:
- Toenails should be trimmed straight across – when trimming, do not match the shape of the toe. If you will have your toenails done at a salon, advice the pedicurist to trim straight across.
- For patients who have diabetes or other conditions that can cause poor blood flow, having a podiatrist trim the nails is recommended.
- Ensure toenail length is moderate – trimming too short can prove counterproductive as shoe pressure may cause the nails to directly grow into the tissue.
- Wear proper-fitting footwear – shoes that put too much pressure on the feet may also cause an ingrown toenail to develop.
- Wear protective footwear – if your job puts you at risk of injuring your toes, wearing protective footwear (i.e. steel-toed shoes) is recommended.