Ingrown Toenails

Ingrown toenails are diagnosed and treated by the Podiatry Division of Premier Medical Group.

What is an ingrown toenail?

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An ingrown toenail is a nail that has grown downward into the flesh. On a normal toe, the nail grows straight over the flesh, resulting in a flat, slightly rounded surface. When the nail becomes warped, especially at the edges or corners, it grows into the skin.

The big toe is the most likely to become an ingrown toenail, but it can happen on any toe or finger. When not treated, ingrown toenails can become extremely painful, eventually leading to serious health complications. In some cases, this may include the risk of losing a limb. If you have identified an ingrown toenail, seek treatment as soon as possible, either through at-home treatment or medical support.

Individuals with diabetes, numbness in the toes, and other problems that result in poor circulation need to be especially aggressive in treating and preventing ingrown toenails. Pain is often a useful indicator for the severity of an ingrown toenail, and these conditions prevent an individual from fully understanding that discomfort.

What causes an ingrown toenail?

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Ingrown toenails can affect any person, but they are especially common in people with naturally sweaty feet and those with thicker toenails. There are many known causes of ingrown toenails, but some of the most common are listed below.

  • Genetic predisposition, including irregular toenails that curve inward
  • Poor posture
  • Toenail injury, which can include a stubbed toe, kicking a ball, and dropping a heavy object on the foot
  • Incorrectly cutting toenails
  • Poor foot hygiene, including not keeping the feet dry or clean
  • Ill-fitting footwear, especially that which places pressure on the big toes (tight, narrow, and flat shoes)

While some people are genetically predisposed to developing ingrown toenails, most will develop the abnormality as a result of lifestyle. Some activities can make a person more prone to ingrown toenails, especially sports that put pressure on the toes and feet for long periods of time (football, kickboxing, soccer, ballet). If you frequently engage in these activities, it is imperative to find well-fitting footwear and to check your toes frequently for any abnormalities.

What does an ingrown toenail look like?

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An ingrown toenail is fairly recognizable. The condition will typically worsen in stages, but the first symptoms will include tenderness and swelling around the nail, the sensation of pain when pressure is placed on the toe, and the build-up of fluid around the toe. As the condition worsens, it will likely become infected. Signs of infection include severe pain, bleeding, oozing pus, an overgrowth of skin around the toe, and red, swollen skin.

Ingrown toenails may be mistaken for other conditions. For example, the swelling of your big toe could indicate a fracture or bunion. A swollen big toe can also indicate gout, which is a painful form of localized arthritis. If you are unsure what is causing your pain and swelling, use a mirror or a friend to get a better look at your toe. If the nail is visibly growing into the skin, you have an ingrown toenail. If you cannot determine the cause of the pain, you’ll want to visit a doctor.

Ingrown toenails are easily treated at home while in their early stages. That said, if you notice signs of an infection, or if home remedies do not improve the condition, you’ll need to see a doctor. The doctor can better assess and diagnose the ingrown toenail and provide the antibiotics you may need to reduce pain and swelling.

How do I care for and cut an ingrown toenail?

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When in its early stage, an ingrown toenail is relatively easy to care for. Using a pair of nail clippers or scissors, trim the nail straight across, avoiding making it rounded or pointed in any way. Do your best to avoid cutting the nail too short, as this could encourage further ingrowth. Healthcare professionals don’t recommend cutting an ingrown nail at home, but the process is safe if the nail has not grown completely into the flesh (i.e. it is just touching the skin). That said, if the nail has grown significantly into the skin, visiting a doctor is the safest way to remove the toenail.

There are also several home remedies that can make a significant impact on mild ingrown toenails. For example, using a toe protector can provide a helpful cushion to prevent pain and pressure on the nail. A toe brace can shield the skin from the ingrown nail, and wearing comfortable socks and shoes can both alleviate pain and prevent the ingrown nail from returning. Soaking the toe in warm water or apple cider vinegar can also clean the wound and reduce swelling. When combined with properly cutting the ingrown nail, these home remedies should be enough to prevent you from needing to visit the doctor. If you determine you need to see a doctor for your ingrown toenail, these remedies can help alleviate any discomfort you experience while waiting for the appointment.

How does a podiatrist treat an ingrown toenail?

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Visiting a podiatrist for an ingrown toenail will result in one or more treatment options. The doctor will diagnose the nail based on your symptoms and a physical exam of both the nail and the surrounding skin. Once the diagnosis is made, they will determine the treatment best suited to your condition. The following are the most common podiatrist treatments for ingrown toenails.

  • Lift – Lifting the nail is a great option for slightly ingrown toenails. In this procedure, the doctor will carefully lift the ingrown edge and place a splint underneath. This will separate the nail from the skin, helping the nail grow above the skin and reducing pain or swelling.
  • Partial Removal – More severe ingrown toenails will require a trim, or partial removal. The doctor may use a local anesthetic before the procedure, and this will typically utilize a surgical blade or nail clipper.
  • Full/Permanent Removal – This is a popular treatment option for repeated or chronic ingrown toenails. In this case, the doctor may suggest removing a portion of the nail and underlying tissue. By removing the tissue, the podiatrist will ensure that part of the nail does not grow back. This procedure often uses a chemical or laser to remove the nail and tissue.

How to prevent ingrown toenails?

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If you’ve had an ingrown toenail, you’re at risk for recurrence. Even if you’ve never had one, you may be curious about how to prevent an ingrown nail from developing. Most prevention techniques involve small lifestyle changes including:

  • Wearing comfortably fitting shoes and socks.
  • Wearing protective footwear, like steel-toe boots, if working in hazardous condition.
  • Maintaining good foot hygiene, including washing and drying the feet.

Additionally, it is important to trim nails straight across, ensuring that the edges do not curve in, and avoid cutting the nails too short.

That said, those with limited mobility may not be able to adequately trim and care for their toenails. If this describes your situation and you have had ingrown toenails in the past, opting for a permanent removal may be a good option. This will ensure the ingrown nail does not return regardless of your ability to continue upkeep. For those looking for a less invasive option, using a toe protector or toe brace can also prevent an ingrown nail from returning. In all cases, regularly visiting a podiatrist for professional trimming can significantly reduce ingrown toenail development.