INGROWN TOENAIL

Does your toe hurt when you wear your most comfortable shoes? Does it hurt when you are walking or running? Is the toe red around the nail? Is there blood or drainage coming from the edge of the nail? Does it feel like the nail is digging into your toe? If so, you probably have an ingrown toe nail, which is called Onychocryptosis.

The big toe is more likely to have an ingrown nail compared to the smaller toes. The causes for ingrown toenails include:

  • Not cutting the toenails straight across
  • Shoes that are too tight, which puts additional pressure on the toe
  • Fungal infections
  • Trauma
  • Soccer or other kicking sports

The diagnosis of ingrown toenails is an easy one; no x-rays are needed. The podiatrist will be able to look at the toe and make the diagnosis of an ingrown toenail by finding that the skin has grown over the edge of the nail. Also, the skin surrounding the toenail will be red, hard, sore, and sometimes there may be drainage.

There can be relief from ingrown toenails by soaking the feet in luke warm water with Epsom salts. However, NEVER try to remove your ingrown toenail. There are some over-the-counter medications that can help to decrease the pain. Try to wear open toe shoes while the ingrown toenail is healing.

If these suggestions do not help the nail, visit a podiatrist. The podiatrist will be able to remove the ingrown toenail either temporarily by performing a partial nail avulsion or permanently by a chemical matrixectomy. A partial nail avulsion includes removing the nail border that is digging into the skin; the nail border will grow back in two to four months. A chemical matrixectomy may be performed if the patient has continuous problems with ingrown nails since ingrown nails can reoccur. The chemical matrixectomy includes removing the nail border as in the partial nail avulsion, but then putting a chemical on the nail matrix to prevent the nail border from growing back and continuing to cause problems; the skin will eventually grow to meet the nail border. Both of these procedures are performed with the toe numbed, so no pain will be felt during the procedure, but there may be minor pain after the procedure. However the minor pain afterward will be far less than the pain from the ingrown toenail.

Patients with diabetes, poor circulation, and peripheral neuropathy are at a higher risk of the ingrown toenail infection spreading and causing infection of the bone, so it is important to seek treatment immediately.

Since some ingrown toenails are caused by not properly trimming the toenails, here are some tips to prevent ingrown toenails:

  • Soften the nails by either bathing or soaking the foot before trimming
  • Use a clean and sharp nail trimmer
  • Most importantly, trim the nails straight across; do not try to shape or round the nail

Patients with diabetes, elderly or those with disabilities can visit a podiatrist for their nails to be trimmed and routine foot care.

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