What Are Ingrown Toenails?
An ingrown toenail occurs when the sides of your toenail grow into the skin around your nail, causing pain and inflammation of the affected area.
Causes of Ingrown Toenails
Ingrown toenails can be caused by wearing improperly fitting shoes or cutting your toenails incorrectly. You should always cut your toenails straight across, rather than rounding them down around the edges, and never cut them too short; both allow toenails to grow up into the skin surrounding the nail. Physical activity or injuries to your toes can also cause ingrown toenails. Genetic deformities can also result in frequent ingrown toenails.
Symptoms of Ingrown Toenails
Symptoms of an ingrown toenail include pain, redness, and/or swelling at the affected site of the ingrown nail. The area can become infected, which is evident by discharge or pus, foul odor or redness, and warm to the touch.
In rare cases, an ingrown toenail can become so infected that the infection spreads to the toe and into the bone. This is called osteomyelitis. An infection left untreated can cause gangrene, which results in the surrounding tissue dying and requiring amputation.
Diagnosing Ingrown Toenails
Diagnosis of an ingrown toenail is uncomplicated, however there can be different degrees of severity to an ingrown toenail. Initially, just redness, tenderness, and swelling are present. After the infection develops, there may be pus or discharge and increasing pain and inflammation.
Treatment for Ingrown Toenails
There are both surgical and nonsurgical treatments for an ingrown toenail.
At-home treatments
There are many at-home treatment options for an ingrown toenail that are often successful. These include:
- Epsom salt soak: Soak the affected foot in a warm bath for 20-30 minutes using a couple of teaspoons of Epsom salt. You can do this multiple times per day to help relieve pain and inflammation.
- Nail edge separation: After soaking your foot in an Epsom salt bath use a small piece of cotton ball or dental floss and carefully insert it under the nail to separate the nail from the skin. Using an antibiotic ointment can help prevent infection.
- Keep the area dry and bandaged.
- Avoid wearing small or closed-toe shoes that could aggravate the affected toenail any further.
If your toenail doesn’t improve within a few days of at-home treatment, you should consider seeing a healthcare provider.
In-office treatments
If at-home treatments are unsuccessful after several days, it may be best to contact your primary care provider or foot and ankle surgeon regarding your ingrown toenail. They may prescribe topical creams and/or oral antibiotics if the toe is infected. Common medical procedures can usually be done in the clinic and could include:
- Nail edge separation: Similar to the at-home treatment, just done by a trained physician. They could use materials such as cotton or a splint (or a gutter splint), or a cotton soaked with a solution that fixes it in place (collodion).
- Wedge excision: In a wedge excision, a physician removes the portion of your toenail that is growing into the skin along with the area of tissue your nail grows from.
- Nail avulsion: A partial nail avulsion is a procedure in which a small, vertical strip of nail is cut from the base of the nail to the top and removed. A full nail avulsion is where the physician removes the entire nail. A chemical (such as phenol) may be applied to the area beneath the cuticle to prevent nail regrowth. A numbing agent is injected into the toe before this procedure.
After any in-office procedure, it’s best to wear open-toed shoes for a few days to avoid further hurting your toe.