Ingrown Toenails

WHAT IS AN INGROWN TOENAIL?

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe is not painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection.

CAUSES:

Causes of ingrown toenails include: heredity, trauma, improper trimming of the nail, improper sized footwear, and other nail conditions.

TREATMENT:

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 (adding Epsom 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 is 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.

PREVENTING INGROWN TOENAILS

Many cases of ingrown toenails may be prevented by:

Proper trimming. Cut toenails in a fairly straight line, and do 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.

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 NO REPEATEDLY TRIM NAIL BORDERS. Repeated trimming does not change the way the nail grows and can make the condition worse.
DO NOT PLACE COTTON 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 INEFECTIVE. Topical medications may mask the pain, but they do not correct the underlying problem.