When a toenail is in-grown, the nail is curved downward and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe.
If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn’t painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection
• Improper trimming of toenails can cause the corners of the nail to dig into the skin. Nails should be trimmed straight across, not rounded.
• Disorders such as fungal infections of the nail can cause a thickened or widened toenail to develop.
• Either an acute injury near the nail or anything that causes the nail to be damaged repetitively (such as playing soccer) can also cause an ingrown nail.
• If a member of your family has an ingrown toenail, then you are more likely to develop one, too
• Tight-fitting shoes or high heels cause the toes to be compressed together and pressures the nail to grow abnormally
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk for example, diabetes, nerve damage in the foot or poor circulation.
If you don’t have an infection or any of the above conditions, you can soak your foot in room-temperature water.
Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon
The foot and ankle surgeon will examine your toe and select the treatment best suited for you. Treatment may include:
• Oral antibiotics: If an infection is present, an oral antibiotic may be prescribed.
• Surgery: A simple procedure, often performed in the office, is commonly needed to ease the pain and remove the offending nail. Surgery may involve numbing the toe and removing a corner of the nail, a larger portion of the nail or the entire nail.
• Permanent removal. Various techniques may be used to destroy or remove the nail root. This treatment prevents the recurrence of an ingrown toenail.
Preventing Ingrown Toenails
Many cases of ingrown toenails may be prevented by following these two important tips:
• Trim your nails properly: Cut your toenails in a fairly straight line and do not cut them too short
• Avoid poorly-fitting shoes: Don’t wear shoes that are short or tight in the toe box. Also avoid shoes that are loose, because they too cause pressure on the toes, especially when you run or walk briskly.