Ingrown toenails are one of the most common yet unpleasant foot problems. Usually affecting the big toes, ingrown toenails may  cause painful toes, numbness, inflammation, or a warm sensation. There are various causes of an ingrown toenail, which are discussed further below.If you don’t know how to treat an ingrown toenail, read on to find out!

What is an ingrown toenail?

An ingrown toenail is also called onychocryptosis, and  results from the nail's edge pressing into the skin of the toe. In some cases, the nail edge punctures the skin surrounding the toe, which causes irritation and inflammation of the toe skin, whereas for some people there is just too much pressure pushing on the skin. 

If left untreated, ingrown toenails may progress from minor pain to greater pain, and recurring toe infection.

What causes an ingrown toenail?

There are various causes of an ingrown toenail, which include:

• Improper or overly aggressive toenail trimming - cutting the nails near the nail edge will promote skin near the border to fold over it

• Poor foot hygiene

• Trauma - jamming or dropping something on your toe

• Incorrect shoe fitting (too small or too large fitting)

• Injury from aggressive pedicures and nail picking

• Excessive perspiration of the toes (hyperhidrosis), as in adolescents and athletes which makes the nails become soft and eventually split and break into the skin

What are the signs and symptoms of an ingrown toenail?

Common signs and symptoms of an ingrown toenail include:

• Redness, pain, tenderness, and swelling of skin surrounding the toenail

• Yellowish, foul odor, or even pus drainage, in cases of ingrown nail infection

• Presence of nail spike or incurvation on the nail border

• Limping to avoid adding pressure on the ingrown nail, common in children

• A growth of new skin that bleeds easily.

Sometimes, ingrown toenails can resolve without treatment. However, for cases of infected, painful, and recurring ingrown toenails, your podiatrist should intervene and treat the condition. 

How Are Ingrown Toenails Diagnosed?

Diagnosing ingrown toenails does not involve diagnostic and laboratory tests. Instead, it requires an examination of the affected toe. Podiatrists and other personnel with proper training can identify an ingrown toenail based on the affected toe's appearance. Podiatrists provide an appropriate diagnosis and recommend treatment options based on the patient's medical history, medications, risk factors, and overall health.

What are the complications of ingrown toenails?

A recurring, untreated ingrown toenail can have serious complications such as:

• Paronychia - local infection of the nail border, which can lead to osteomyelitis and onychomycosis

• Osteomyelitis - severe bone infection

• Onychomycosis - thick, deformed toenails from fungal infection

• Formation of granulation tissue (areas of increased blood vessel formations) that easily bleed when hit or punctured

Who is  most likely to get an ingrown toenail?

Some people are at greater risk of getting an ingrown toenail, such as:

• Athletes who play sports like basketball, tennis, and soccer that increase pressure on the toes during movement

• People with abnormal gait and foot mechanics

• People with foot or toe deformities such as flat foot, bunions, and hammertoes

• Inherited toenail deformity in which people have the high tendency to have ingrown toenails, like in the case of pincer nails

• Abnormally long toes

• Onychomycosis (fungal infection of the nails)

• Diseases that increase pressure or causes poor circulation on the toes - obesity, diabetes, arthritis, bony or soft tissue toe tumors

• Conditions that cause foot and leg swelling - heart, kidney, and thyroid problems

What causes an infected in-grown toenail? 

Not all ingrown toenails progress into infected ingrown toenails. Paronychia is an infection of the toenail. It occurs when microorganisms such as Staphylococcus, Candida, Trichophyton, dermatophytes, and Pseudomonas thrive in a warm, moist, and closed foot environment. These microbes invade the broken skin caused by the ingrown nail and ultimately cause infection. 

In severe cases, paronychia can lead to chronic foot and toe pain, cellulitis, bone infection, and disfigurement. 

Signs and symptoms of ingrown toenail infection are:

• Yellow, green, or white  pus or discharge

• Swelling of the affected nail area

• Redness

• Pain near the infected area

• Foul odour coming from the nail or discharge

How to Treat Ingrown Toenail at Home?

Fortunately, there are home treatments that can provide relief from an ingrown toenail. Here are some things you can do:

• Soak the infected toe daily in warm salty water for the infection. The water should be quite salty. 

• Use a bandaid or some tape to gently pull the skin away from the nail. Leave the tape/bandaid on during the day.

• Do this treatment every day for a few weeks to allow the nail to grow.

• Avoid pushing things down the side of the nail, as this may make it worse

If pain and other symptoms persist, it is best to seek medical treatment from a podiatrist. 

How to Treat Ingrown Toenail? Treatments Offered by Fitzroy Foot and Ankle Clinic

Podiatrists like those found in Fitzroy Foot and Ankle Clinic have undertaken training to treat ingrown toenails. Your podiatrist will assess the ingrown nail and determine the most appropriate medical treatment based on the cause of irritation. They have state-of-the-art and needed equipment to conduct ingrown toenail procedures. 

Infected toenail management

A podiatrist like Dr. Glen Whittaker can prescribe antibiotics and pain relief for infected ingrown toenails, depending on his assessment. He can also help identify and remove the causes of nail irritation and give necessary education to address ingrown toenails. Not all conditions require surgery, therefore it is important that ingrown toenails undergo a careful assessment before commencing treatment.

Education 

Fitzroy Foot and Ankle Clinic will advise you on proper self-care, how to avoid toenail irritation pressure from footwear. We can also discuss proper shoe fitting and correct nail cutting to prevent recurring ingrown toenails. 

Nail surgery

The podiatrist will carefully assess your ingrown nail and identify the need for surgery before doing a partial nail avulsion. This  involves using a local anesthetic to numb the toe before removing the irritating nail.. After nail cutting, an antiseptic called Phenol (80%) is used to destroy the cells that grow the nail. 

Immediately after the procedure, we will apply dressings on the site And we suggest wearing open or loose-fitting wide shoes. This will prevent pressure on your toe while it heals. Your podiatrist will require you to return to check healing on your treated site. 

Again, the ingrown toenail treatment will depend on the podiatrist’s assessment of the affected nail. It is better to consult a podiatrist first to treat your ingrown toenails. 

Final Thoughts

Ingrown toenails cause significant pain, discomfort, and even limit movement if left untreated. How to treat ingrown toenail starts by identifying the causes and risk factors, which will allow the condition to be treated appropriately.

To treat ingrown toenails and prevent ingrown toenail from developing infection, please schedule an appointment.  get in touch with us for high-quality toenail care at Fitzroy Foot and Ankle Clinic.