What is an ingrown toenail?

An ingrown toenail is exactly what it sounds like. It’s when your nail grows into the skin (or vice versa) which causes the skin on the inside or outside of the nail to become inflamed and painful. You may also develop a localized infection in the area, which can drain or expel pus. This can have a more gradual onset over a period of time or come on suddenly.

 

What causes an ingrown toenail?

There are several causes, and sometimes it is difficult to determine the culprit with any certainty. However, in most cases, it is just that you are predisposed due to the shape of your nail. Some nails are relatively flat and less likely to ingrow, and some are more curved which can cause frequent issues.  An ingrown nail can also be caused by trauma or poor nail-trimming techniques. In general, it is recommended to cut a toenail straight across as trying to round off the edge can leave a spicule that as it grows out, can dig into the skin.

 

How do you treat an ingrown toenail?

1. Once the nail grows into the skin, the skin around the nail will reject the nail as if it were a foreign body, no different than stepping on a piece or glass or getting a splinter. Once this happens, the only way to treat it is to have a procedure to remove the offending piece of nail. If there is pus or an abscess present, this must be drained, and your physician may choose to put you on a short course of antibiotic if there is concern for infection.
2. If this is a chronic issue, it is sometimes recommended that a more permanent procedure be performed which uses an acid to kill the “matrix” or nail producing cells in the corner so that your nail will grow out more narrow and be less likely to dig into the skin in the future.
3. Home remedies such as Epsom salt soaks or trimming may temporarily alleviate the soreness but are not likely to cure the condition.

 

How do you prevent them from happening?

Make sure that your shoes fit properly. If your shoes are too tight, this may push the skin over the nail and cause the skin to become inflamed. If your shoe is too big, your foot may slide and continually bump the side of your toenail against the shoe. This microtrauma can also cause inflammation.
If you are getting a pedicure, make sure that you were going to a reputable salon that uses sterilized tools and do not let the technician try to dig out the nail in the corner, but rather ask that they just cut the nail straight across and then buff or file it as needed.
If you have a bunion, which means that your big toe is starting to drift to the side, your toe may start to rub against the second toe, and can contribute to forming an ingrown nail. In that case, you may consider treating the bunion deformity itself to prevent the ingrown nail from recurring.

An ingrown toenail may be the start of a more serious issue, and it is recommend to have this looked by a medical professional at at the first sign of discomfort, redness, or pus since an underlying infection can ultimately spread. If left untreated, it may ultimately infect the underlying bone which would require long term IV antibiotics and can lead to amputation in extreme cases.

If you are experiencing any of these symptoms, please call our office to schedule a consultation. Same day or next day appointments are typically available for this condition.