The Painful (and Gross) Truth About Ingrown Toenails

If you or a loved one has ever had an ingrown toenail, you know how painful and miserable it can be.

We’re in the business of treating ingrown toenails — which is pretty cool because that means we relieve pain and misery.

But as we write this email, we have a challenge… How do we discuss — or, worse yet, show — ingrown toenails (all in the spirit of relieving pain and misery) without…well…grossing you out?

Here’s what we’re going to do… We’re going to hide a picture of an ingrown toenail (kind of gross) behind the curtain. Look at it if you dare.

As for the discussion, you can find some in-depth information on treatment and prevention tips for ingrown toenails below… Enjoy.

Treatment

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 immediate relief and very little pain after surgery. They usually 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.

Causes

Ingrown nails, the most common nail impairment, are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is the most common location for this condition, but other toes can also become affected.

Ingrown toenails may be caused by the following:

• Improperly trimmed nails
• Heredity
• Shoe pressure; crowding of toes
• Repeated trauma to the feet from normal activities

Home Care

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is 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.

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.

If your symptoms fail to improve, it is time to see a foot and ankle surgeon.

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 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.

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.