Ingrown Toenails

What Is an Ingrown Toenail?

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor.

Ingrown toenail and normal toenail

What Causes an Ingrown Toenail?

Ingrown toenails can develop for various reasons. In many people, the tendency for ingrown toenails is inherited.In other cases, 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 or running.

The most common cause of ingrown toenails improper trimming. Cutting your nails too short encourages the skin next to the nail to fold over the nail. Another cause of ingrown toenails is wearing shoes that are tight or short.

Treatment

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 feet at high risk, such as diabetes, nerve damage in the foot or poor circulation.

Home Care

If you do not have an infection or any of the above medical conditions, you can soak your foot in room-temperature water (adding Epsom salt may be recommended by your doctor) and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it is time to see a foot and ankle surgeon.

Physician Care

After examining the toe, the doctor will select the treatment best suited for you.

Preventing Ingrown Toenails

Many cases of ingrown toenails may be prevented by:

• Proper trimming. Cut toenails in a fairly straight line, and do not cut them too short. You should be able to get your fingernail under the sides and end of the nail.
• Well-fitting shoes and socks. Do not wear shoes that are short or tight in the toe area. Avoid shoes that are loose because they too can cause pressure on the toes, especially when running or walking briskly.

What You Should Know About Home Treatment

• Do not cut a notch in the nail. Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.
• Do not repeatedly trim nail borders. Repeated trimming does not change the way the nail grows and can make the condition worse.
• Do not place cotton under the nail. Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.
• Over-the-counter medications are ineffective. Topical medications may mask the pain, but they do not correct the underlying problem.