Ingrown Toenails

What is an Ingrown Toenail?

Ingrown toenails are one of the most common conditions treated by podiatrist. When a toenail is ingrown, it becomes curved and pointed like a spear, and grows into the skin, along the side of the toenail. Ingrown toenails are most often caused by incorrect cutting of the corner of the toenail. As the toenail continues to grow forward, it digs into the skin. The ingrown toenail then continues to grow into the soft tissue and irritates the soft tissue around the ingrowing toenail. As the ingrown toenail continues to grow, it causes significant pain, redness, swelling and warmth in the toe. Pain can be significant enough, that one may not be able to put their shoes on; this indicates that you probably have an infection in your toe as well.

Although an ingrown toenail may seem harmless, it is actually a serious condition that should be treated. Delaying treatment can be very serious because ingrown toenails are often infected. If your toe is red, draining and very painful you will need to have a surgical procedure to alleviate the pain and stop the infection from spreading further. Antibiotics will probably also be required to resolve any active infection. In serious cases infection can spread to your bones or get into your blood and will require hospitalization. Serious infections from ingrown toenails can interrupt your life for days or month and regular activities such as work, exercise, or family time.

At the first sign of an ingrown toenail, you should reach out to a podiatrist for medical help. Dr. Joseph E. Mechanik is an ingrown toenail specialist and will help you get the treatment you need.

Causes of Ingrown Toenails

Causes of ingrown toenails include:

  • Hereditary. In many people, the tendency for ingrown toenails is inherited.
  • Trauma. Sometimes an ingrown toenail is the result of 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 toenail in the corners or 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.
  • 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 treatments are 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

If you do not have an infection or any of the above medical conditions, you can soak your foot in room-temperature water and Epsom salts and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” and repeated cutting of the toenail. This can cause the condition to worsen. If your symptoms fail to improve, it is time to seek medical attention.

Physician Care

After examining the toe, Dr. Mechanik will select the treatment best suited for you. If an infection is present, an oral antibiotic will probably be prescribed.

A Minor surgical procedure, often performed in the office, will ease the pain by removing the offending nail border.  After injecting a local anesthetic, to put the toe to sleep, Dr. Mechanik will remove the problematic portion of the toenail.  Following the procedure, a light dressing will be applied. Most people experience little pain after the surgery and may resume normal activity in a few days. Antibiotics may be prescribed as well.  If you are prescribed an oral antibiotic, make sure to take all the medication, even if your symptoms have improved.

For chronic/recurrent ingrown toenails, the offending portions of the ingrown toenail(s) roots can be eliminated to stop the ingrown toenail from reoccurring.  Most of the time a special chemical is applied to the nail root (nail matrix) to stop the offending nail edge(s) from re-growing. Sometimes, surgical excision of the nail root is required. Your toe will heal in a few weeks and the ingrown toenails should not reoccur.  These are also minor surgical procedures and can performed in the office as well.  

 

 

Preventing Ingrown Toenails

Many cases of ingrown toenails may be prevented by:

  • Proper trimming. Cut toenails in a fairly straight line across the toenails. Try not cut them too short. You should be able to get your fingernail under the sides and end of the nail.
  • Well-fitting shoes and socks. Do not wear shoes that are short or tight in the toe area. Avoid shoes that are loose because they too cause pressure on the toes, especially when running or walking briskly.
  • Cutting in Corners of Toenails: This is the most common cause of ingrown toenails.  You should not cut into the corners of your toenails.  If you get pedicures you should tell your nail technician to stay out of the corners of your toenails.  Make sure any instruments that are used, come from a sterilized bag.  

 

What You Should Know About Home Treatment

  • Do not cut a notch in the nail. Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.
  • Do not repeatedly trim nail borders. Repeated trimming does not change the way the nail grows and can make the condition worse.
  • Do not place cotton or dental floss under the nail. Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.
  • Over-the-counter medications are ineffective. Topical medications may mask the pain, but they do not correct the underlying problem.
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