Ingrown Toenails
What Are Ingrown Toenails?
Ingrown toenails, also known as onychocryptosis, are a common foot condition which can cause significant pain and discomfort and often lead to infections requiring antibiotics.
What are Ingrown Toenails?
Ingrown toenails occur when the edges or corners of the toenail grow into the surrounding skin, leading to irritation, inflammation, and sometimes infection. While ingrown toenails can affect any toe, they most commonly occur in the big toe.
Causes of Ingrown Toenails
Several factors can contribute to the development of ingrown toenails, including:
Improper Nail Trimming: Cutting toenails too short or rounding the edges can cause them to grow into the surrounding skin.
Ill-Fitting Footwear: Wearing shoes that are too tight or narrow can compress the toes and increase pressure on the toenails, leading to ingrown toenails.
Trauma: Stubbing the toe or sustaining an injury to the toenail can cause it to grow irregularly or become ingrown.
Genetics: Some individuals may inherit a predisposition to ingrown toenails, such as a curved nail shape or excessive nail width
Poor Foot Hygiene: Neglecting proper foot hygiene, such as failing to clean and dry the feet thoroughly, can increase the risk of ingrown toenails.
Age: Ingrown toenails are more common in adolescents and teenagers due to their rate of growth. Often this is due to their feet growing before they change their shoe size leading to increased pressure on the nail.
Symptoms of Ingrown Toenails
Ingrown toenails typically present with the following symptoms:
Pain and Tenderness: Discomfort and tenderness along the edge of the toenail, especially when pressure is applied.
Redness and Swelling: Inflammation and swelling around the affected area, accompanied by redness or warmth to the touch.
Pus or Drainage: If the ingrown toenail becomes infected, it may produce pus or fluid, indicating an underlying infection.
Difficulty Walking: Severe ingrown toenails can make it painful and difficult to walk or wear shoes comfortably.
Hypergranulation tissue: If present for a long time, hypergranulation tissue may develop. This is characterized by excessive granulation or overgrowth of tissue around the ingrown toenail and may appear as red, swollen, and tender tissue protruding from the nail fold.
Treatment Options for Ingrown Toenails
Treatment for ingrown toenails depends on the severity of the condition and may include:
Soaking: Soaking the affected foot in warm water several times a day can help soften the skin and reduce inflammation.
Proper Nail Trimming: Trimming toenails straight across and avoiding rounding the edges can prevent them from growing into the skin.
Wearing Proper Footwear: Choosing shoes that provide adequate room for the toes and avoiding tight or narrow footwear can alleviate pressure on the toenails.
Packing: Placing a small piece of cotton under the edge of the ingrown toenail can help lift it away from the skin and promote proper growth, this is also known as cotton wool packing.
Topical Medications: Applying antibiotic ointment or antiseptic solutions to the affected area can help manage infection and promote healing.
Oral Antibiotics: If the ingrown toenail becomes infected, oral antibiotics may be prescribed to treat the underlying infection. Note if the nail has grown into the skin, the ingrown portion would still need to be removed as the portal of entry would still be open, creating further routes for infection and pain.
In severe or recurrent cases of ingrown toenails, a podiatrist may recommend more advanced treatments, such as:
Partial Nail Avulsion: Surgical removal of a portion of the toenail to prevent it from growing into the skin, this can be combined with cauterisation to prevent regrowth of the ingrowing portion.
Total Nail Avulsion: Complete removal of the toenail, this can also be combined with cauterisation to prevent regrowth of the nail.
Nail Matrixectomy: Surgical procedure to remove a portion of the nail matrix, preventing regrowth of the ingrown toenail.
Prevention Tips for Ingrown Toenails
To prevent ingrown toenails, consider the following tips:
Trim Toenails Properly: Cut toenails straight across and avoid rounding the edges to prevent them from growing into the skin.
Wear Proper Footwear: Choose shoes that provide adequate room for the toes and avoid tight or narrow footwear.
Practice Good Foot Hygiene: Keep the feet clean and dry, and avoid picking or tearing at the toenails.
Avoid Trauma: Take care to protect the toes from injury and trauma that could lead to ingrown toenails.
Seek Prompt Treatment: If you notice signs of an ingrown toenail, such as pain or redness, seek prompt treatment to prevent complications.
To summarise, ingrown toenails are a common foot condition characterised by the growth of the toenail into the surrounding skin. By understanding the causes, symptoms, and treatment options for ingrown toenails, individuals can take proactive steps towards managing this condition effectively and maintaining optimal foot health. If you're experiencing persistent or severe ingrown toenails, consult with a healthcare professional or podiatrist for a comprehensive evaluation and personalised treatment plan tailored to your needs.
Conservative Management of Ingrown Toenails
Dealing with an ingrown toenail can be a painful and frustrating experience, but there are steps you can take to manage it conservatively at home. An ingrown toenail occurs when the edge of the toenail grows into the surrounding skin, leading to pain, swelling, and potential infection. While severe cases may require professional intervention, many mild to moderate ingrown toenails can be effectively managed with gentle care and proper technique.
1. Soak Your Feet
Start by soaking your feet in warm, soapy water for 15-20 minutes, two to three times a day. This helps to soften the skin around the ingrown toenail and reduces inflammation. Using additives such as Epsom salts can also provide additional relief and help prevent infection.
2. Apply Topical Treatments
Apply over-the-counter antiseptic or antibiotic ointment to the ingrown toenail and surrounding skin to prevent infection. Covering the area with a clean bandage can help protect it and keep the ointment in place.
3. Trim the Nail Carefully
If the edge of the toenail is causing discomfort, carefully trim it straight across, avoiding rounding the corners or cutting too short. Use clean, sterilised nail clippers or scissors, and be mindful not to cut into the skin. If you're unsure or uncomfortable trimming the nail yourself, it's best to leave it to a professional podiatrist.
4. Wear Proper Footwear
Choose shoes that provide ample room for your toes to move freely and avoid putting pressure on the ingrown toenail. Opt for breathable materials and avoid tight-fitting or narrow shoes that can exacerbate the condition. Wearing open-toed sandals or shoes with a wide toe box can provide relief and allow the ingrown toenail to heal.
5. Practice Good Foot Hygiene
Keep your feet clean and dry to prevent bacterial or fungal infections. Wash your feet daily with mild soap and water, and be sure to dry them thoroughly, especially between the toes. Avoid using harsh soaps or scrubbing the affected area vigorously, as this can irritate the skin further.
6. Monitor for Signs of Infection
Keep an eye on the ingrown toenail for any signs of infection, such as increased pain, redness, swelling, or discharge. If you notice any of these symptoms, or if the ingrown toenail doesn't improve with home treatment, it's important to seek professional medical attention promptly.
By following these conservative management techniques, you can effectively relieve pain and discomfort associated with an ingrown toenail and promote healing. However, if the ingrown toenail persists or worsens despite home treatment, or if you have diabetes or circulation problems, it's essential to consult a podiatrist for further evaluation and appropriate care. Remember, gentle care and patience are key to managing ingrown toenails conservatively and preventing future recurrences.
