Ingrown Toenails: Causes, Symptoms, and Treatment

An ingrown toenail occurs when the corner or edge of your toenail grows into the surrounding skin. This common condition frequently arises from improperly cutting toenails, particularly by tapering around the corners. Although often not serious, ingrown toenails can be painful and may require medical attention, especially if you have diabetes or signs of infection.

What is an Ingrown Toenail?

An ingrown toenail, commonly affecting the big toe, develops when the nail’s corner or side grows into the soft flesh of the toe. This typically results from cutting the toenails too short or rounding the edges, causing the nail to curve and dig into the skin. While ingrown toenails are generally not a health risk for most people, they can be uncomfortable and may lead to infection if untreated.

Who is at Risk?

Anyone can develop an ingrown toenail, but certain groups are more susceptible:

• Adolescents and athletes: Increased physical activity can lead to trauma and improper nail care.
• People with diabetes: Reduced blood flow and nerve damage increase the risk of complications.
• Individuals with poor blood circulation or nerve damage: These conditions can exacerbate the problem.
• Those with nail infections (paronychia): Infections can complicate and worsen ingrown toenails.

Prevalence

Ingrown toenails are a prevalent foot problem, accounting for about 20% of visits to healthcare providers for foot-related issues.

Symptoms and Causes

Causes

Several factors can contribute to ingrown toenails:

• Improper nail trimming: Cutting nails too short or rounding the edges.
• Tight-fitting shoes: Shoes that press on the toes can push the nail into the skin.
• Nail trauma: Injuries from stubbing your toe or repetitive pressure.
• Natural nail shape: Certain shapes, such as larger nails or nails with surrounding tissue growing over them, are more prone to ingrown toenails.

Symptoms

• Redness and swelling: Around the affected nail.
• Pain: Especially when pressure is applied to the toe.
• Infection signs: Pus, liquid discharge, and increased warmth in the area.

Complications

For most healthy individuals, ingrown toenails do not cause severe complications. However, if untreated, they can lead to:

• Infections: Bacteria can enter through the broken skin.
• Scarring: Chronic cases might result in nail fold scarring.
• Bone infections: Rarely, severe infections can spread to the bone.

Diagnosis and Tests

You can often diagnose an ingrown toenail based on symptoms and appearance. A healthcare provider, usually a podiatrist, will examine the toe and look for signs of skin growing over the nail or inflammation. Tests are rarely necessary unless there’s a severe infection, in which case a bacterial or fungal culture might be performed.

Management and Treatment

Self-Care

Managing ingrown toenails at home involves:

1. Soaking your foot: Use warm water mixed with Epsom salt or soapy water twice daily.
2. Keeping the foot dry: Except during soaking.
3. Lifting the nail edge: Place a small piece of cotton or dental floss under the nail to help it grow above the skin edge. Change it daily.
4. Applying antibiotic cream: Follow with a bandage.
5. Wearing roomy shoes: Opt for shoes or sandals that do not press on the affected toe.
6. Taking pain relievers: Over-the-counter options like ibuprofen or acetaminophen.

When to See a Healthcare Provider

If symptoms worsen or do not improve with home treatment, consult a healthcare provider. Immediate medical attention is necessary if you have:

• Diabetes
• Severe nerve damage
• Poor blood circulation
• Signs of infection

Medical Treatment

For persistent or severe cases, medical treatment may include:

• Partial or complete nail avulsion: Surgically removing part or all of the toenail under local anesthesia. This procedure helps prevent the nail from growing into the skin again.
• Chemical treatment: To permanently remove the nail root in recurrent cases.

Prevention

Preventing ingrown toenails involves:

• Proper nail trimming: Cut toenails straight across without rounding the corners.
• Wearing well-fitting shoes: Avoid tight shoes that press on your toes.
• Avoiding trauma: Protect your toes from injuries.
• Foot care for diabetes: Follow medical advice meticulously.

Outlook and Prognosis

Most people recover fully from ingrown toenails with proper care. Adopting good foot care practices can prevent recurrence. Regular foot exams are crucial for individuals with conditions like diabetes or nerve damage.

When to Seek Medical Advice

See a healthcare provider if you have:

• Diabetes with complications
• Infection symptoms: Pus, severe pain, or redness
• Persistent pain despite home treatment

Questions to Ask Your Healthcare Provider

• Is the nail infected?
• How can I best treat it?
• Do I need surgery?
• How can I prevent it from happening again?
• Do I need medication?
• How should I cut my nails to avoid ingrown toenails?

Takeaway

Ingrown toenails, while annoying and painful, are manageable with proper care. Early treatment, good hygiene, and preventive measures can significantly reduce the risk of recurrence. If home remedies do not alleviate the condition, or if you have underlying health issues, seek professional medical advice.

By following these guidelines, you can effectively manage and prevent ingrown toenails, ensuring healthier and more comfortable feet.

A Quick Review

Ingrown toenails develop when the nail’s corner grows into the skin, causing pain, redness, and swelling. Common causes include improper nail trimming and tight shoes. Home remedies like soaking in warm water and applying antibiotic cream can help, but severe cases may require medical intervention. Prevent recurrence by cutting nails straight across and wearing well-fitting shoes.