Ingrown Toenails

What are ingrown toenails?

Ingrown toenails are painful to the nail border. Most commonly seen in the big toe. The nail becomes embedded in the surrounding skin around the border, and the body triggers a foreign body reaction. This reaction is infection accompanied by the usual signs of redness, swelling, drainage and pus.

As the infection worsens, the pain may subside because the bacteria changes its environment and causes numbness. In more severe cases, a large fleshy growth can develop over the nail plate and nail border (granuloma), and in most advanced cases, the infection can lead to osteomyelistis, which is an infection of the bone located under the nail. In diabetic patients, advancement to a bone infection can occur quickly and can lead to an amputation.

What are the causes of ingrown toenails?
Improper cutting, or tearing of the nail borders most often cause the problem. Trimming the nails too short can create spikes in the corners that can lead to an ingrown nail.  In addition, ingrown nails may result from injury, genetic predisposition, curvature of the nail, nail deformity, sports, improperly fit shoes, improper pedicures, and at times, chemotherapy.

What is the treatment?

If infection, pain, redness, swelling, and/or drainage persists then you should consult with a podiatrist. Trimming back of the ingrown toenail may relieve symptoms but it can lead to it becoming more severe or an infection. Cutting a V-shape in the middle of the nail can alleviate some symptoms temporary.  In more severe cases,  local anesthetic will need to be administered prior to removing part of the ingrown toenail. Severe infections will require oral antibiotics. Repeated problems with ingrown toenails require a surgical nail procedure where a chemical can be applied to the area of where the nail is removed to permanently prevent recurrence.