Causes, Symptoms, Prevention and Treatment for Ingrown Toenails

What are ingrown toenails?

An ingrown toenail is an agonizing medical problem involving the toes. This condition is also preferred as unguis incarnatus or onchocryptosis. Ingrown toenails happen when a toenail’s sharp edge or corner digs deep through the skin, usually seen at the side or end of your toe.

Inflammation, swelling, redness, and pain in the area occur first where a nail curls through the skin. The inflamed part, later on, starts to grow excess tissue or will drain fluid that is yellowish in color. Typically, ingrown toenails affect the big toe.


What causes ingrown toenails?

Ingrown toenails are commonly caused by:

  • Curly toenails that may be unusual. When one of the family members experience ingrown toenail, then most likely, other members may develop the condition as well. Those who have rounded nails are at risk to develop an ingrown toenail.
  • Wearing of shoes that may crowd the toenails. High heels or tight-fitted shoes can cause your toes to compress together, pressuring the nail to abnormally grow.
  • Toenail injury. Acute nail injuries close to the nail as well as other activities that repeatedly cause damage or put pressure for longer periods on the feet causes a problem in the nails like playing competitive soccer, kickboxing, and ballet.
  • Toenails that have been cut very short or is not cut straight across. Trimming the toenails improperly causes its corners to dig deep into your skin. Nails are recommended to be trimmed just straight across, and should not be rounded.
  • Medical disorders. People who have fungal infections that shelter in the nail causes the development of a widened or thickened toenail.

How are ingrown toenails diagnosed?

Doctors diagnose ingrown toenails basing on the symptoms as well as the result of your physical exam of the nail and its surrounding skin.

The ingrown toenail is painful and worsens by stages. Here are some symptoms you need to know:

Symptoms in early stages:

  • There is a pain when you put pressure on your toe.
  • The skin that is next to your nail gets swollen, hard, or tender.
  • There is a build-up of fluid around your toe.

Symptoms that are signs of an infected toe:

  • Pain
  • Oozing pus
  • Swollen skin and appears reddish
  • Bleeding incidence
  • Skin overgrowth around your toe.

Upon inspection of the nail, your doctor will see the following:

  • The skin on the edge of your nail grows over your nail, or your nail starts to grow into the skin underneath it.
  • Skin looks red, swollen, firm and tender when touched.
  • There is also a sign of pus in small amounts.

Other methods of diagnosing like the use of x-ray or blood test are not necessary. But for an advanced form of infection, an x-ray is needed to reveal the depth of your nail. It shows if:

  • The ingrown nail is due to injury.
  • How severe your pain is.
  • History of long-term infections.

Blood tests are only performed when the infection is severe causing a debilitating pain, and if the patient has a diabetes history.

What are the treatment options for ingrown toenails?

For people who have diabetes, circulation of blood in the foot is poor, nerve damage that occurs in the foot or leg, or infection in the nails and its surrounding are, visit your doctor’s clinic straight away. Treating the ingrown nail using home remedies is not a good idea.

But if you have mild ingrown toenails, here is how you should treat it:

  • You should soak your foot using warm water for at least 3 times daily, if possible. Keep them dry after soaking.
  • Massage gently the part of the skin that is inflamed.
  • Place a dental floss or cotton under your nail. The cotton must be wet with antiseptic or just pure water.
  • Wearing of sandals is recommended until the inflammation and pain subsides.
  • Medicines without the need for doctor’s prescription help lessen the pain, so apply the medication on the area. However, this treatment does not solve the problem of infection.

If in any way your ingrown toenail does not heal with some home remedies done for few days or weeks, or if it happens repeatedly, then immediately call for professional help from:

  • Podiatrist (foot specialist)
  • Dermatologist (skin specialist)
  • Family Doctor

If the nail’s inflammation does not subside and the wound not healed, a surgery should be done necessarily to remove part of your nail.

  • Anesthesia or a medicine to numb part of your toe is injected first.
  • Your doctor then cuts the edge of your nail where skin grows over. This part of your nail will be removed.
  • It usually takes about 2-3 months before you see your nail start regrowth.
  • Sometimes, doctors use electric current, do minute surgical cut, or a chemical to remove or destroy part of the nail where your new nail may regrow.
  • Antibiotics are prescribed if your toe gets infected. Although, draining the pus accumulation or abscess can already treat the infection. An ointment may be applied and put with gauze.

Here are the steps recommended that you should do after the surgery:

  • The dressing must be kept intact for two consecutive days.
  • Keep foot and legs raised to control pain and wear some special protective footwear so the toe can heal faster.
  • Avoid unnecessary movement when possible.
  • Remove dressing after two days. Cleanse it with water and soap. Then a triple antibiotic ointment must be applied and covered with clean gauze. This should be done two times a day up until your wound heals.
  • Follow-up with the doctor after 3-5 days to assess the surgical site or if inflammation has lessened.
  • Wound care ordered by the doctor should be strictly followed. Keep wound dry and clean.
  • Take the prescribed medications.
  • Usual activities before the procedure like walking will return to normal. But athletic activities can take longer to normalize.
  • Toenail will regrow a few months after surgery. However, if the surgery was done to remove the whole nail, then it might take a year before it fully goes back.

Complications of ingrown toenails

  • Severe cases of ingrown toenails have seen the rise of infection that spreads through the toes into its bones.
  • There are also toenail infections that can lead to open sores or foot ulcers. Blood loss also occurs at the site of infection.
  • People who are diagnosed with diabetes are prone to complications because of poor flow of blood to the feet. Small scrape or cut just like in the ingrown toenail quickly causes infection.
  • Other conditions that can cause decrease blood flow are also at high risk for ingrown toenail complications.

Preventing ingrown toenails

You can often manage your ingrown toenails by yourself. However, if pain is spreading or severe, there are steps that your doctor can take in order to relieve the discomfort and aid in avoiding ingrown toenail complications.

  • Wear properly fitted shoes all the time. Your everyday shoes must have enough room around the toes. Brisk walking shoes and running shoes that you use should have enough room but is not that loose.
  • Keep the feet dry and clean at all times. People who are diagnosed with diabetes should be checked routinely for proper nail care and foot exams.
  • You can also take some pain relievers such as ibuprofen, naproxen sodium, and acetaminophen to relieve the toe from pain. Antibiotic ointment and cream may also be applied at the tender site, which needs to be bandaged properly.

How to properly trim toenails:

  • Soak foot briefly in water to soften your nails. It is recommended that you use warm water for this.
  • Utilize a sharp and clean nail trimmer.
  • Remember that you must trim your toenails just straight across at the top part. Never round or taper its corners. Also, do not trim your toenails too short.
  • Do not tear or pick at your nails.

Immediately seek medical advice when the ingrown toenail developed an infection anytime. Seeking a professional healthcare attention is a wise decision, even if it is only inflamed minus the infection.

Go see your doctor when these conditions occur:

  • If your last booster shot of tetanus was more than 5 years ago.
  • Wound healing is poor, which can put you high risk for infection. Conditions like AIDS, Diabetes, and people with poor circulation and undergoing chemotherapy are some.
  • When there are no signs of improvement after 3-4 days of care at home.
  • You experience fever, redness, severe pain, or swelling.
  • Incapable to trim the ingrown toenail.

What if your baby develops an ingrown toenail?

If your baby develops ingrown toenail, the best possible treatment is to:

  • Soak your baby’s feet in warm water that is soapy twice or thrice daily.
  • Then the feet is dried and applied thinly with antibiotic ointment or cream.
  • Put a dental floss or sterile gauze piece under their nail in order for the edge of the skin is lifted.
  • Change dressing several times a day.
  • If you see some signs of infection like swelling, pus, or redness, then immediately see your doctor.

Generally speaking, the ingrown toenail prognosis is very good when medical treatment strictly engaged, especially if the condition is not resolved within a week or more and addressed the risk factors properly.

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