Ingrown Toenail

What are Ingrown Toenails?

There are few minor health complications in this world that are quite as painful and discomforting as ingrown toe nails. It is a foot health complication that affects millions of people all over the world. In fact, the National Institutes of Health estimates that close to 21 percent of all foot complications are ingrown toenails.

In particular, an ingrown toenail comes grows from the nail (usually the big toe), growing backwards rather than on top of the tissue bed. As such, this complication leads to swelling and can sometimes lead to infections. The condition causes the toes to become red and extremely painful. It can even compromise your ability to put on regular everyday footwear. Various studies have shown the different factors that increase the likelihood of suffering from ingrown toenails. These include improper footwear, lack of proper nail care, poor health, and more. The studies have come up with no variations in the shape of toenails in ingrown toenail patients and healthy subjects.

The treatment process of such nails often some form of surgery, to help address the leading cause of the issue.

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 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?

There are several symptoms of an ingrown toenail. They might include pain along the margins of the nail, increased pain when you wear footwear, and sensitivity to any pressure. Even the weight of bedsheets is sufficient to trigger the pain of an ingrown toenail. Bumping of the affected area can also lead to intense pain because the tissue might experience further damage by the nail.

Since the condition causes wounds, ingrown toenails can easily lead to infections unless you apply special care techniques. The common signs of infection include pus, swelling, redness, and more. However, it’s also essential to differentiate the condition from other similar conditions such as callus, small corns, involuted nails, and more.

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?

Ingrown toenails occur as a result of weight-bearing activities such as running, in people who have excessive skin tissue around the nail bed. The increased weight from activities such as running causes the excess skin to bulge, thereby affecting the growth of the nail. Such an issue can lead to infections, swelling, pain, and more. Most treatments are often focused on the nail and might include complete removal of the nail. That said, failing to address other secondary factors can lead to ingrowth and persisting conditions.

An ingrown toenail is a foot-health complication that is associated with many factors. These factors might include:

  • The leading cause of ingrown toenails is wearing ill-fitting footwear, especially shoes that are tight and clammy. In particular, the damp conditions can apply pressure to the toenail, which can soften the nail and compromise the structure of the nail. Other common causes of the complication include disease, trauma, and genetics.
  • Lack of proper nail care is also a common cause of ingrown toenails. Cutting the nail improperly might also cut into the side fold skin, and lead to issues such as infection.
  • Physical damage to the toe or nail plate, which can occur such as when you bump your feet on a hard surface. Such conditions can cause injury to the flesh, and irregular growth of the nail, which will then grow into the side skin.
  • Pre-disposing factors such as nail beds that have abnormal shapes and deformities that occur due to diseases. While these factors increase the chances of getting an ingrowth, they are usually accompanied by factors such as increased shoe-pressure.

As you can see, there are many 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.

Best Ways to Manage Ingrown Toenails

Being able to manage ingrown toenails involves decision-making and discipline on your part. Keeping your nails clean and comfortable at all times is perhaps the most important factor to consider. That said, there are several equally useful techniques for you to consider:

Proper Footwear

Perhaps the leading factor that causes ingrown toenails relates to the fact that you wear incredibly tight shoes. As such, the feet, particularly the toes, lack sufficient space for optimal growth and development. The condition can be exacerbated by intense physical activity such as workouts or running sports. The other complication is also a lack of sufficient ventilation with the shoe. If shoes don’t get adequate ventilation, they tend to get slightly sweaty and soft. Such an issue can lead to easy damage of toenails. Choosing the ideal shows for preventing ingrown toenails requires informed decision making. You may have to invest in spacious shoes, that provide adequate ventilation in the toe box – mainly if you are prone to ingrown toenails.

Use Cotton Balls

If you feel any discomfort, or you are perhaps worried that your toe might grow unnaturally, then using cotton balls is a good solution. The cotton wool helps to act as a shock-absorbent material, and it also promotes optimal ventilation. You can start by wedging a small piece of wet cotton wool, under the corner of the ingrown nail. This process will help to release the nail from the skin area. To make this process simpler, apply some coconut or olive oil around the skin area. Besides that, you can also disinfect the cotton using some of medical antiseptic to help kill an bacteria that might cause infection. Using such a method will help separate the skin from the nail while also helping to reduce pain.

Dental Floss

Yes, that`s right! Using dental floss is an essential approach for managing ingrown nails. To be specific, dental floss helps to reduce the pain and swelling associated with the ingrown nail. More so, dental floss also has antibacterial properties, which can be highly beneficial. The first step is to soak your foot in some water, to help soften the nail and to remove any collected dirt. Then, use some waxed dental floss and use it to lift the nail upward. Use this technique in relation to the nature of pain experienced and damage to the nail.

Get Some NSAIDs

Medication is also an essential aspect of the treatment and recovery process of ingrown toenails. The Non-Steroidal Anti-Inflammatory Drugs help to manage the pain, thus making recovery a convenient process. The common ones for foot health complications might include ibuprofen, naproxen and more. That said, use these drugs only in relation to the level of pain experienced. Such medications tend to be powerful pain relievers and can lead to dependency issues. Your doctor can help recommend a suitable medication plan to suit your recovery needs.

Cut your Nails Correctly

Taking good care of your nails is also a useful technique of preventing toenails. Using clean nail cutters is equally essential to ensure you don’t transfer any dirt or bacteria to the nail. There are many schools of thought when it comes to cutting your nails correctly. While some recommend cutting the nails in an upside-down V shape, not many benefits are associated with this process. Cutting nails to take up the “V” shape does not have many benefits. It is recommended that you cut the nails in a reasonably straight line while ensuring that you don’t affect the nail bed. Any deep cuts on the nail section can lead to issues such as infections and increased nail damage.

Essential Oils

These are nail care supplements that have been used for many years and many different purposes. The first recommendation critical is tea tree oil, which is famous for providing anti-fungal and antiseptic benefits. A good suggestion would be to combine a cup of Epsom salts and some tea tree oil into some water. Then, soak the feet in the water for a few minutes. Using this process will help to control any inflammation or pain issues. Furthermore, the Oregano Oil is also an excellent essential oil for treating ingrown toenails. However, consider using a carrier oil such as coconut oil, because Oregano is potent and can cause irritation.

Use the Taping Method

According to many foot health professionals, the taping method is the least invasive approach when it comes to conservative treatments. It involves using a strip of tape to detach the lateral nail fold from the affected area. Following this, you will wrap the tape around the lower section of the toe, to maintain a proper position. Additionally, you might also have to clean the affected are using some form of antibiotic or alcohol-based substance. Cleaning is vital to remove any dirt, debris, or bacteria that might lead to secondary issues such as infections. If you feel any pain, during the taping process, consider getting a helping hand for the procedure. That said, you might have to apply the tape a severally through the course of the week, as you monitor your healing progress.

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.

When is Surgery Required?

Otherwise referred to as onychocryptosis, ingrown toenails affects many people around the world. When most DIY and basic treatment options have failed, then the final option is usually surgery. Most ingrown toenail complications will require some basic form of the surgical process. This is because the damage often requires medical intervention due to the advanced nature of the unwanted toenail. Usually, the tell-tale sign that you need surgery is when the issue persists or when you perhaps get an infection. The ingrown toenails can lead to skin irritation. Even more, the ingrown nails can lead to the development of bacteria, which might lead to secondary infections in the body.

Surgical Procedures

The surgical process for an ingrown toenail is an outpatient technique that requires the use of local anesthesia. The local anesthesia helps to numb the affected area, such that the individual feels no pain as the nail is removed. Some medical health professionals provide sedatives to help easen the recovery process. Once an ingrown nail subsides, it’s crucial that you maintain the proper foot-care practices.

The most common surgical procedures for ingrown toenails include:

  • Wedge re-section – the wedge resection is a process that involves removal of a section of the toenail. The removal process helps to reduce the likelihood of the nail compromising the skin. The procedure is also referred to as a partial nail avulsion.
  • Toenail removal – the doctor may recommend complete toenail removal. The surgical process involves the use of local anesthetic. That said, growing a new nail might require over 12 months to achieve the best results.
  • Surgery on the tip of the toe – this technique is used if other medicines are not useful for your needs, or perhaps if additional procedures are not effective. It might involve the removal and reshaping of the soft tissue that exists on the tip of the toe.
  • Matrixectomy – this process might be useful when the wedge resection surgery is not practical. The process involves the removal of the nail bed and the nail itself. The medical health professional might also make some special incisions on the nail to relieve swelling and drain infected tissue.

Once your doctor completes the surgery, you must apply the correct recovery techniques to avoid any future damage. For instance, consider using antibiotic treatment, or perhaps using over the counter medication as recommended by the doctor. More so, maintain the affected area, and dress the wound as required.

Consider asking the doctor about when it’s appropriate to resume normal activities such as sports. That said, for the first two weeks, ensure that you keep the affected area clean and dry. More so, avoid wearing any tight shoes that might compromise the structure of the nail bed or lead to further toe pain. During the recovery process, consider wearing shoes with open structures such as flip flops or sandals.

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.

ingrown-toenail-onychocryptosis-wedge-resection

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.

Summing it Up

Now you have all the useful information about ingrown toenails, which can help you avoid costly surgeries and days of excruciating pain. Ingrown toenails are a common toe health complication, and the most critical factor is to address the primary causes of the condition. Failing to do so can cause remittance of the condition in the future. Most importantly, applying the proper toe and foot care techniques is also vital in avoiding ingrown toenails. This applies especially when you want to invest in new shoes for your day to day activities. Treatment might involve some basic form of surgery, to help address the underlying cause of the ingrown nail.

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Author Biography

This page was authored by , who represents the Boot Bomb. Brian is backed up by an expert team, made up of experienced family and friends, all of which are knowledgeable in the ways of footwear and/or hiking. His ancestors used to own a shoe store for almost a century. He has lived and breathed footwear for as long as he can remember.

This page was last updated on .

2 Comments

  1. I agreed when you said that ingrown toenails are not a pleasant experience to go through. Frankly, I think my cousin’s toenails have not grown correctly which is why she has been complaining of foot pain lately. Since the symptoms are now very obvious to me, I’ll make sure to tell her to go to a clinic to get some treatments so that it would go away.

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