Ingrown Toenail

Ingrown Toenails: A Painful Podiatric Issue

Ingrown toenails are not a pleasant experience to go through. In fact, they are one of those injuries that quickly gets associated with pain and for good reason. These injuries tend to be extremely painful and can cause other serious issues to boot. While this injury is pretty common, you will not find many people who want to talk about it unless they are suffering and looking to find a solution to that issue.

So Just What Is An Ingrown Toenail?

ingrown-toenail-festering-woundIngrown toenails can go by several names. While scientific names like unguis incarnates or onychocryptosis might refer to a very specific type of injury, but there’s a reason that even doctors and researchers still go by its common name: because regardless of what part of the toe is being afflicted, everyone knows what an ingrown toenail is and can understand at least the concept of pain that comes with it.

An ingrown toenail basically doesn’t grow in correctly. Instead of growing straight out it grows in some way so at least part of the nail either cuts into the nail bed itself or goes slightly to the side and cuts one (or in severe cases both) of the paronychium that flank the nail on both sides. This tends to cause extreme pain and can also result in open wounds which result in infection and other serious problems.

What Are The Symptoms Of Ingrown Toenails?

The symptoms for ingrown toenails can vary from person to person, and the overall severity of the ingrown nail will have a lot to do with what symptoms show and which common ones don’t. Obviously the more severe the situation, the more serious and obvious the symptoms.

The one symptom almost every single case of an ingrown toenail shares from person to person: pain. These injuries are extremely painful and even beyond that can increase sensitivity and discomfort in the afflicted area. Combining all of these together is part of the reason that this particular affliction gets cringes from people who have experienced it before.

Ingrown toenail symptoms include:

  • Extreme pain and tenderness on one toe (especially on the sides
  • Major redness and discoloration
  • Swelling
  • Infected tissue
  • “Puffing” of tissue around the nail
  • Cuts and open woulds along one or both sides of the toe nail

The more serious the problem, the more obvious that these symptoms will be and the bigger the chance that you will be suffering from more than one of them. If any of these symptoms show up, it’s time to talk to a doctor because infections can set in quite easily when an ingrown toenail is involved.

What Causes Ingrown Toenails?

There are several different potential causes that can result in an ingrown toenail, usually the culprit can be easily determined after winnowing the suspects down. Trimming a toenail too closely to where it grows is one of the most common issues. If you feel a sharp pain and a cut, you probably trimmed too far in and that can result in some strange growth as the nail repairs itself and comes back in. Improper trimming is a very common cause.

The next most common cause comes from shoes that don’t fit right. Shoes that are too tight, especially ones that pinch the toes, are going to be a major problem for healthy toenails and will no doubt cause more instances of these painful afflictions. This is why taking the time to make sure a shoe fits every single part of the foot is so important.

While having shoes that are too tight and over exuberant trimming are the two most common causes of having to deal with ingrown toenails, there are others worth noting. Picking at your nails, getting pedicures that go too far with treatment, and even genetics can all contribute to more ingrown toenails and all the problems that come with them.

Most common causes:

  • Poor fitting shoes (too tight)
  • Improper trimming & maintenance of nails
  • Nail picking
  • Pedicures that go too far (another example of improper trimming)
  • Hereditary condition (some people are simply more prone)
  • Trauma from injury

These are by far and away the main causes of ingrown toenails. Being able to recognize these also allows the majority of people to actively work towards preventing more of these injuries in the future.

When Should You See A Doctor For An Ingrown Toenail?

Ingrown toenails might not seem like a big deal, but whenever you show any early signs of these symptoms you need to see a doctor and refrain from the temptation of self surgery. Trying to “dig out” the toenail when it’s growing into the side of the paronychium (the little bit of skin on both side of the nail that set it apart from the rest of your toe. Even if you manage to get temporary relief you will open yourself up from infection in addition to almost certainly making your next toenail even worse as far as the ingrown portion of it goes.

Since an ingrown toenail will get more painful, can prevent you from walking properly, and opens up a lot of problems with infection, it’s critical to get these nipped in the bud as soon as possible. Once you see one of multiple of these symptoms it’s time to see a doctor to see what the issue could be and how to rapidly fix it.

How Are Ingrown Toenails Diagnosed?

Most doctors will find that diagnosing a toenail that has become ingrown is actually fairly easy and straight forward. While the symptoms and the severity of them can vary immensely, looking for tenderness, seeing some unnatural pressure off to the side, and being able to study the curve of the nail will be a dead give away for a trained medical professional who knows what exactly to look for.

This even includes early ingrown toenails that are less severe, much less the ones that bring red color to the entire foot or have issues with tightness, puss, and other issues. While your medical history will be taken into account, a doctor will usually be able to tell almost right away whether you are dealing with an ingrown toenail or if there is something else going on like trauma, fungal infections, or event small tumors. All of those potential “other causes” are in and of themselves still reasons to go see a doctor.

This is why getting a proper diagnosis of the situation is so important. That’s even before taking into account the fact that since your feet are likely to be sweaty or surrounded by damp socks a good part of the day, which means infection is right around the corner if left untreated.

What Are The Health Ramifications Of An Ingrown Toenail?

ingrown-toenail-pussMany people are surprised at the ramifications that can result from a simple ingrown toenail, but these potential health problems are nothing to sneeze at! An ingrown toenail by itself can cause swelling, an uneven gait that puts pressure on different leg muscles and causes hip and back issues, and even become infected leading to much more serious issues for the entire body and even your heart health.

If you leave your ingrown toenail untreated, or just ignore the pain, you’re just asking for infection to come in and wreak havoc. Soft tissue infections are common with ingrown toenails that don’t get treated quickly, and there’s no question that complications can abound. The soft tissue infection can spread throughout the foot causing more pain and actual nerve and blood vessel damage throughout the foot.

These soft tissue infections can grow into infections in the bone as well, which is even worse. A serious bone infection can lead to severe issues that affect every part of your body and even cause permanent damage to the foot and leg if you don’t treat it in time. All this from an ingrown toenail that is ignored!

Individuals who suffer from diabetes need to especially take care. Because of the particular issues with blood flow that come with being diabetic, an ingrown toenail’s potential issue can become even more serious. When completely ignored and left untreated in extreme circumstances this can even lead to open sores, bacterial, flesh, and bone infections, and more. Those often lead to gangrene and in the worst situation that means amputation.

That’s a huge jump from the pain (however severe) that comes from a rough growing toenail. Even if it doesn’t go this far permanent scarring and nerve damage is not unheard of in extreme circumstances. This is especially worrisome considering how easy it would be treat the original problem.

How To Cure An Ingrown Toenail

There are multiple treatments available for an ingrown toenail. The specific one that will be chosen depends on a variety issues including the severity of the damage.

In the case of minor cases the first round of treatment may be conservative and full of common home remedies that can be helpful in the right situations. These often involve soaking your feet in saltwater to see if taking down the swelling can help in and of itself, and in addition to this using dental floss and special conservative splints can help to right the ingrown nail and get it back on track and growing the way it should be instead of causing more damage.

Lifting the nail is another treatment that often comes from a doctor deciding to go that extra step to try and correct the issue without surgery or serious antibiotics (assuming no sign of infection is there yet). In these situations a doctor will lift the edge and place a cushioned splint generally out of cotton and dental floss to separate the nail from the skin and help encourage the nail to grow above the skin instead of into it. This still requires you to replace the splint material daily and soak your foot in warm salt water.

Partial nail removal is another option that your doctor might decide to go with. This is for more severe cases, often you’re talking about severe pain, redness, and pus in the afflicted area. A local anesthetic will numb the toe before the worst part of the nail is removed. Make sure to follow any instructions he or she gives for follow up care at that point.

Nail bracing isn’t nearly as common, but it is a treatment that might be appropriate depending on the circumstances. This is a process where the sides of your afflicted toenail are lifted gently and braced or “split” for a longer term setup that “trains” the nail to grow correctly and reshapes it. Normal maintenance needs to take place during this time around the bracing but when done correctly this can allow the toenail to be retrained. This is an option that is much more common if ingrown toenails are a recurring issue that you can’t seem to shake, but even then only certain specialists will recommend this treatment over the other more common ones.

Finally, full nail removal is an option that occasionally must be considered. In this situation localized anesthesia will almost certainly be used as the nail and possibly the nailbed will be removed depending on the severity of the issue and the damage.


How To Prevent Ingrown Toenails

The old saying goes that an ounce of prevention is worth a pound of cure, and the same goes with ingrown toenails. While some people are more genetically predisposed to these than others, there are steps that you can take to make it more likely you won’t have these issues.

First, pay attention to your feet. If they tend to swell a lot, then make it a habit to soak them in warm salt water each night. This is a small step that can save you some major long term pain and issues. Next, whenever you need to get new shoes make sure they are properly measured not just for the side of your foot, but you don’t want them pinching your toes at any point, either. Finally, trim your toenails, but do so carefully and never overdue it!

Following these simple steps can help prevent future problems with ingrown toenails.

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