An ingrown toenail or onychocryptosis as it is also known is a painful condition of the toe. When a toenail is ingrown, it is curved and grows into the skin at the end of or side of the toe. Pain, redness, swelling and inflammation at the spot where the nail curls into the skin occur first.
If left untreated, an ingrown toenail can progress to an infection where the inflamed area can begin to grow extra tissue or drain yellowish fluid which sometimes lets off a foul odour. Worse, an abscess could also develop. Another complication which is rare, but may occur – osteomyelitis, speaks to a situation where the bone itself becomes infected.
Ingrown toenails are common in adults but uncommon in children and infants. They are equally prevalent in men and women. Young adults in their 20s or 30s are most at risk; but any toenail can become ingrown. However, the condition is usually found in the big toe. If you have diabetes or another condition like neuropathy, which causes poor circulation to your feet, you are at greater risk of complications from an ingrown toenail.
Tight-fitting shoes can cause the toes to be compressed together and pressure the nail to grow abnormally; too tight socks can contribute to this also.
Improper trimming may cause the corners of the nail to dig into the skin.
Disorders such as fungal infections of the nail can cause a thickened or widened toenail to develop.
Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking, running or football.
Abnormalities such as oddly shaped nail beds; nail deformities caused by diseases; or a genetic susceptibility.
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected; or for those who have medical conditions that put their feet at high risk.
In the early stages of the ingrown toenail, home care may be successful through utilisation of the following measures:
Soak the foot in warm water, and then lift the corners of the nail with an orange wood stick. This may be painful but is necessary.
Consider wearing open toe shoes, if possible, until the condition clears up.
Spa or Clinic Care
Go to a trained pedicurist, foot health practitioner or chiropodist/podiatrist if the problem is beyond home care level. They would file or cut the nail with a nipper to aid proper growth. Our Clinic also recommends products to minimise infection and aid with nail growth.
On examining the toe, if infected, the doctor would determine whether simply prescribing antibiotic tablets and or an ointment is sufficient, or if nail wedging needs to be administered.
The toe is first injected with a local anesthetic. When the area is numb, the doctor would perform an onychotomy in which the nail along the edge that is growing into the skin is cut away (ablated), and the offending piece of nail is taken out. Any infection is surgically drained. This process is referred to as a “wedge resection” or simple surgical ablation and is non-permanent (the nail will re-grow from the bed).
This procedure can be performed in a doctor’s office, and takes a short period of time. The patient is allowed to go home immediately. Most people experience very little pain after the procedure and may resume normal activity the next day. Sometimes, however, the recovery time may be longer barring any complications such as infection. As a follow-up, a doctor may prescribe an oral or topical antibiotic or a special soak to be used for approximately a week after the surgery.
Some doctors will not perform a complete nail avulsion (removal), except under the most extreme circumstances. In most cases, these doctors will remove both sides of a toenail (even if one side is not currently ingrown) and coat the nail matrix on both of those sides with a chemical or acid to prevent re-growth. This leaves the majority of the nail intact, but ensures that the problem will not recur. Following the nail procedure, a light bandage may be applied.
Follow these basic tips for prevention of ingrown nails:
Trim your toenails straight across. Don’t curve your nails to match the shape of the front of your toe. If you have your toenails done at a spa/clinic, be sure to tell your pedicurist how trim your nails. If you have circulation problems, it’s advisable to see a chiropodist/podiatrist/foot health practitioner/trained pedicurist regularly to have your nails professionally trimmed, if you can’t trim them yourself.
Keep toenails at a moderate length. Trim toenails so they’re even with the tips of your toes. If you trim your toenails too short, the pressure from your shoes on your toes’ tissue may direct your nails to grow into the tissue.
Wear shoes that fit properly. Shoes that place excessive pressure on your toes or pinch your toes may also cause your nails to grow into surrounding tissue. If you have nerve impairment to your feet, you may not be able to sense if your shoes fit too tightly. Take care to buy and wear properly fitted shoes, preferably from a shoe store specialising in comfortable work and other footwear.
Your feet mirror your general health . . . cherish them!