What are ingrown toenails?
An ingrown toenail occurs when the top corner or side of your nail begins to grow into the soft tissue of the nail bed next to it instead of outwards. It can occur in any toe, but the big toe is the most commonly affected. The digging of the nail will irritate your skin, causing pain, redness, swelling, and possible infection.
Many ingrown toenails can be treated successfully with at-home care. However, if you have other conditions such as a weakened immune system that makes you more prone to developing infections or if ingrown toenails are a frequent occurrence for you, your doctor may recommend surgical treatment.
If left untreated, ingrown toenails can lead to an infection and worsening of pain. The infection can also spread past the underlying area and into the bone if medical care is not administered.
Common causes of ingrown toenails include:
- Injury or trauma to the nail area
- Improperly trimmed nails
- Shoe pressure or tight-fitting shoes
- Redness around the toe or nail area leading to pain
- Bleeding or discharge around the nail
- Excessive swelling of toes
Though sometimes ingrown toenails can be managed on your own, we always recommend seeking medical attention as an infection may develop. For those who struggle with diabetes, circulatory disorders, or nerve damage, immediate medical care is strongly advised as other complications may occur if left untreated. After examining the nail, your podiatrist will discuss the best treatment options available to you.
Conventional at-home treatments include soaking your foot in warm water several times a day, carefully filing the edge of the nail if possible, wearing open-toed shoes that are comfortable, and taking over-the-counter medication to manage any pain. If at-home treatments have not improved the condition after several days, schedule an appointment with your podiatrist.
A minimal in-office surgery may be recommended to remove a portion of the nail, whole nail, and root, or adjacent soft tissue to relieve discomfort.
To prepare for this surgery, your doctor will clean and numb the targeted area with a local anesthetic injection. Some patients report pain and discomfort during the injection, but once the anesthetic takes effect, they are comfortable during the procedure.
Once you are prepared, the doctor will use scissors and other specialized tools to separate your toenail from the nailbed by making a vertical cut from the ingrown side to the cuticle. They will then remove the cut section, part of the nail, or the entire nail if necessary. If there is swollen tissue that has heaped up onto the side of the toe, it may be drained or removed.
Your doctor may then use a heated electrical device called a cautery or an acidic solution to disrupt the nail matrix, from which your nail grows. By destroying the nail matrix, your nail will be able to regrow correctly.
An antibiotic or other medication may be prescribed to you to eliminate or prevent an infection. Your doctor will provide you with wound care and follow-up instructions. Follow them carefully as these instructions will help to avoid infection and regrowth of an ingrown toenail.
For the first few days, you should rest your feet and limit activity, keeping the foot elevated as much as possible. After 24 hours, keep your toe clean by running warm soapy water over it and patting it dry. Keep it covered with a non-stick dressing until it is fully healed.
Following the procedure, open-toed or loose-fitting shoes should be worn, so your toe has adequate room to heal. You can resume regular activity after a few days, if allowed by your podiatrist, but should avoid strenuous activities for two weeks following treatment.
If you had a partial nail remove, your nail might grow back within a few months. If the complete nail was removed, regrowth could take up to a year. The nail will be thinner than before and may not look the same as it did before it became ingrown.
Trim toenails properly by cutting straight across – the top of your nail should make a straight line. Nails should be no longer than the tip of toes, and your fingernail should be able to slide under the side and top of your toenail. Wear well-fitted footwear that does not press on your toes unnaturally. Another helpful precaution is to avoid picking at your nails or tearing them at the corners. This is a common habit among children that can lead to ingrown toenails.