Ingrown Toenail

Ingrown toenails are one of the most common causes of foot pain and is most likely to occur on the big toe. The medical term for an ingrown toenail is onychocryptosis or unguis incarnates. Ingrown toenails are most common in people that are in their twenties or thirties, but can occur in anyone. An ingrown toenail refers to a toenail that has the sides or corners curled down and digging into the skin. Clinically, the  condition presents as a painful, red, swollen toe. Bumping of an affected toe can produce sharp, even excruciating pain and patients may complain that even having the bed sheets touch the toe is extremely painful. Often, the side that is ingrown will also have clear, yellow, bloody drainage. This drainage typically develops into crusty debris that will develop where the side of the nail meets the skin.

As the nail grows, the nail will continue to move into the toe which causes the body to treat the toenail as a foreign body (similar to a splinter or a piece of glass). As a result,  pain, redness, and swelling continues and an infection may occur. If left untreated, the underlying bone can become infected. This condition is called Osteomyelitis. Osteomyelitis is a serious condition and often results in the patient being admitted to the hospital or in some situations amputation of the toe.

Causes

Improper nail trimming:
Nails that are trimmed down into the corner or peeled off at the edge are likely to become ingrown.

Ill-fitting Shoes:
Tight fitting shoes, which encourage nails to curl in.

Hyperhydrosis:
Excessive sweating of the feet can also cause ingrown toenails.

Trauma:
Trauma such as stubbing the toe or dropping something heavy on the toe, can also result in the formation of an ingrown. In these incidences it is often not the nail that is causing the ingrown toenail, but the inflamed tissues around the nail from the trauma. The swollen tissues envelop the nail border. While the mechanics of how the ingrown developed are different, it is still classified as an ingrown and must be addressed as such.

Other Causes:
Some other conditions that may predispose feet to ingrown toenails include prominent nail folds (bulbous toes) and a fungal toenail infection.

Treatment

Sometimes if an ingrown toenail is caught early enough, simply soaking it in warm water and Epsom Salt for 20 minutes a day will alleviate the symptoms. In addition to soaking, home treatment can include placing a very small wisp of dry cotton under the offending nail border. The cotton elevates the nail from the skin and will redirect the nail to grow out properly. A common old-wives tale is to cut a “V” in the center of the toenail. As the theory goes the sides of the toenail will then grow inward alleviating the painful nail border. Don’t try this technique, it does not work. Nails grow from the back to the front only.

Unfortunately most home remedies for ingrown toenails do not work. If the toenail doesn’t respond, it’s time to visit the Doctor’s of Gulf South Foot & Ankle. Most likely there is a splinter of nail embedded in the flesh of the toe and it needs to be removed. With a skilled hand and the right instruments,many ingrown nails can be removed in minutes with little or no pain.

In more severe cases or with recurring ingrown toenails, there is an option for permanent correction. This involves removing the portion of the nail that is ingrown and applying a chemical to the root or matrix of the nail to prevent it from regrowing. The condition is called a chemical matrixectomy. The whole nail does not need to be removed only a small section of nail is removed where the ingrown nail is pressing on the tissues. The procedure is relatively painless with the use of local anesthesia and takes only minutes in a Podiatrist’s office. Patients are able to walk immediately and return to work the same day. If you think that you might be suffering from an Ingrown nail call our office or schedule an appointment online!

Tips for Preventing Ingrown Toenails:

  • Cut toenails straight across
  • Don’t cut nails too short
  • Don’t pick your nails or tear at the corner
  • Wear shoes with plenty of toe room
  • Avoid wearing tight socks or pantyhose

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