Ingrown nails – causes and treatment
By Dr. Sergio Mazzei, General Surgeon
Ingrown toenails occur when the edges of your nails grow into the skin next to the toenail. Your big toe is most likely to get an ingrown toenail, but any toe can be affected.
Sometimes, you can treat ingrown toenails at home. However, they can cause complications that might require medical treatment. The risk of complications is higher if you have diabetes or other conditions that cause poor circulation.
This problem occurs in both men and women, babies, and adults. It is more common among teenagers and people with sweaty feet, and older people may be at risk because nails thicken with age.
Many things can cause an ingrown toenail: using uncomfortable shoes, either too small or too large, repetitive trauma to the feet, poor nail care, feet or toes deformities, diabetes, obesity, fungal or bacterial infection, hyperhidrosis, congenital deformities of the nail, cutting the nail too short.
Athletic activities can make you especially prone to getting ingrown toenails. Activities in which you repeatedly kick an object or put pressure on your feet for long periods can cause toenail damage and increase your risk of ingrown toenails: ballet, football, kickboxing, soccer, etc.
- Cut the nails straight across, avoiding to cut too short at the sides; keep the feet clean and dry
- Avoid tight shoes
- It is better to use cotton socks
- If there is a numbness in the feet, consult a specialist
Ingrown toenails can be painful, and they usually worsen in stages.
Early-stage symptoms include:
- The skin next to the nail becoming tender, swollen, or hard
- Pain when pressure is placed on the toe
- Fluid building up around the toe
- Red, swollen skin
- Oozing pus
- Overgrowth of skin around the toe
If you don’t treat your ingrown toenail, the symptoms will become worse.
Your doctor will diagnose your toe with a physical exam. If it seems infected, you might need an X-ray. An X-ray can also reveal if your ingrown nail was caused by an injury.
An ingrown toenail can cause an infection in the bone in your toe. The infection can also lead to foot ulcers, or open sores, and a loss of blood flow to the infected area.
A foot infection can be more serious if you have diabetes. Even a small cut, scrape, or ingrown toenail may quickly become infected due to the lack of blood flow and nerve sensitivity. See your doctor right away if you have diabetes and are concerned about an ingrown toenail infection.
If you have a genetic predisposition to ingrown toenails, they may keep coming back or appear on multiple toes at once. In this case, your doctor may recommend partial or full removal of the toenails causing chronic pain.
Conservative treatment: Mild clinical cases are treated conservatively with warm water, salt soaks, local cream (antibiotic), and the use of advanced dressing. If there is no improvement after this treatment, or if the ingrown toenail is severe, surgical treatment should be performed.
Surgical treatment: It usually requires local anesthesia. The surgical approach is the removal of the lateral part of the nail plate (it is called wedge resection). If there is recurrence after this treatment, the excision of the whole nail should be performed (it is called matrixectomy). It is a daycare surgery.
If you have a problem with an ingrown toenail, book a consultation now and solve it at the very beginning.