Ingrown Toenail: A Small but Painful Problem!

If you trim your toenail too short, or you taper the corners so that the nail curves with the shape of your toe; you are making a big mistake. This may cause an ingrown toenail. This way the nail begins to grow inside the skin. Ingrown toenail (onychocryptosis) is an unpleasant and painful condition that may also result from wearing shoes that are too tight. At first, it may be hard and red then it gets swollen and infected resulting in severe pain.

What Causes an Ingrown Toenail?

Ingrown toenails can occur at any age though older people are often at higher risk because toenails get harder and thicken with age.

Following are the main causes of ingrown nails:

• Tight footwear: Poorly fitting or narrow shoes places pressure on the toe when it gets pushed into the second toe.
• Incorrect Nail trimming: Toenails need to be cut straight, incorrect trimming or cutting them too short causes bulging tissues which may lead to inflammation.

• Sweating: Sweating is a frequent cause, as the toenails get softer due to moisture and the nail penetrates easily into the skin.
• Toe Injury: Tow injuries like stabbing a toe into something or dropping something on the toe can cause inflammation.
• Kick sports: Sports like football which involves continuous and repeated kicking can cause damage to the toenails.
• Fungal Infection: Fungal infection causes pus and yellow drainage in the wound.
• Improper foot hygiene

Symptoms and Signs

Ingrown toenails are small but very painful. The pain might be mild in some cases but in some, it can get worse in stages.

Some of the symptoms and signs are:

• Redness around the toenail
• Pain along the sides of the toenail
• Swollen and hard big toe
• Pain while putting pressure on the toe
• Bleeding
• Pus or fluid around the toe

At an early stage, the end of the toe turns red with mildly painful. It feels swollen on the touch but there is no pus or drainage.

When an infection develops, the toe becomes extremely swollen and pus starts draining. This is a severe stage.

When to See A Doctor?

It is wise to see the doctor when you start noticing redness or mild pain. See the doctor if the following conditions occur:

• If there is no improvement after 3 days of homecare
• If you have diabetes, heart problem, poor circulation, or other poor wound healing conditions

If an infection takes place

Treatment Options for Ingrown Toenails

Ingrown toenails that are not yet infected can be treated at home. However, if your toe has pierced skin, not getting any better, or is infected you need to seek medical help.

Home Treatment

Homecare can help prevent an ingrown toenail from getting worse.

• Soak your feet in warm water three times a day. This will reduce swelling and tenderness.
• Wash your feet with soap twice a day and keep your foot clean. This will lessen the risk of infection.
• Keep your foot dry. Let them breathe and not get sweaty.
• Apply antibiotic cream on your toe and later cover it up to protect it.
• Do not wear heels, wear comfortable shoes so that your toe does not press on each other
• Try lifting the curling nail corner and take pain relievers.

If these home remedies do not work and the nail doesn’t get better, see a foot specialist.

Surgical Treatment

When nothing works, surgery is an effective way to get the nail fixed. Doctors remove the infected portion of the nail surgically. The surgery is done under local anesthetic and the doctor uses scissors to cut the ingrown toenail without disturbing the nail bed. A piece of cotton in place between the ski and nail so that it doesn’t reoccur.

In extreme cases, the whole toenail is extracted. This is not very painful and most people get back to normal activities the next day.

After Surgery

After the surgery, the patient is sent home with a toe-bandage. It is advisable to keep the foot elevated for 2-3 days. The wound must be kept clean and dry. Antibiotics must be taken on time as prescribed. Toenail usually grows back after a few months.

Complications

If the toe is left untreated, it can cause foot ulcers, infection in the bone, open sores, and loss of blood flow. If you have diabetes then the infection can be more dangerous.

Prevention

• Ingrown toenails can be prevented by the following lifestyle changes:
• Never pick at the toenails or tear them off
• Wear protective footwear, if your work has a higher risk of foot injuries.
• Keep your toenail’s length moderate. Do not cut them too short such that they cause bulging tissues. Neither leaves them too long that they get pushed back into the skin.
• Trim your nails straight, do not trim them in the curve.
• Wear properly fitted shoes and do not wear too-tight shoes.
• Check your feet if you have health issues. Keep a check on your toenails.
• Keep your feet clean and dry

Final Thought

Ingrown nails can be very small but they cause great hassle! When skin grows over the nail or the nail grows into the skin, they both cause pain. This condition gets worse when wearing tight shoes.

Although they can be treated at home, in certain conditions, there is a dire need to see a foot specialist. Doctors surgically remove the ingrown infected nail.

To avoid ingrown nails and their troubles, people should focus on their lifestyle and wear comfortable shoes with lots of space for feet to breathe. They should also use correct trimming techniques.

Despite all the preventive techniques, some people are still prone to getting ingrown nails due to different reasons. They might have a genetic predisposition, sweat problems, or diabetes. Elder people are at higher risk as the nails thicken with aging.

If you want to know more about ingrown toenails and their treatment options, please contact Dr. Gowreeson Thevendran or visit www.orthofootmd.com.