Ingrown Toenail

Definition

An ingrown toenail happens when a portion of the toenail curves into the flesh of the toe. It then imbeds itself in the soft tissue. It can occur on any of the toes. However, it usually occurs on one of the big toes.
Ingrown Toenail
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Causes

Trauma and improper nail care makes the nail curve and overgrow into the flesh of the toe.

Risk Factors

The main risk factor that increases your chances of having ingrown toenails is having family members with ingrown toenails.Other risk factors include:
  • Improper cutting or trimming of the toenail
  • Wearing footwear that is too tight
  • Repeated trauma to the toes, often due to sports activities
  • Diabetes
  • Fungal infections of the toenails
  • Turner syndrome
  • Arthritis
  • Gout

Symptoms

Ingrown toenails often do not cause symptoms at first. Eventually, the following symptoms may develop:
  • Pain—sometimes severe
  • Redness
  • Swelling
  • Warmth
  • Pus draining from the area

Diagnosis

In almost all cases, you or your doctor can diagnose an ingrown toenail based on the location and the symptoms. In rare cases, you may need an x-ray . For example, if your doctor suspects an infection may have spread to the toe bone.

Treatment

You may be able to treat an ingrown toenail yourself if you catch it early. If the condition gets worse or does not improve, you will need to seek medical care. If you have diabetes, you must seek medical attention for any infection or wound involving your feet or toes.

Self-care

It may be possible to care for the ingrown toenail. Some of the following may help:
  • Wearing open-toed shoes or sandals to reduce any pressure on the toenail
  • Soaking the foot in warm water and drying it thoroughly
Promptly seek medical care for an ingrown toenail if you have any of the following conditions:
  • Fever
  • An ingrown toenail that is severe, worsening, or not getting better
  • Diabetes
  • Age: over 50 years
  • Circulatory problems
  • A disorder of your immune system
  • Any other chronic health problem

Medical Care

Medical care may be needed if the ingrown toenail does not respond to self-care. This may include:
  • Oral antibiotic medication
  • Using a splint to lift the corner of the nail away from the soft tissue of the toe
  • Draining the area that has become infected
  • Removing the ingrown portion of the toenail
If you repeatedly get ingrown toenails, or your ingrown toenail is severe, your doctor may:
  • Remove a portion of the toenail and apply medication to the site to prevent that portion of the nail from growing back
  • Remove the entire toenail so that the nail will not grow back

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Prevention

To help prevent ingrown toenails:
  • Cut your toenails straight across and avoid rounding the edges. The corner of the nail should be visible above the skin of your toe.
  • Wear shoes and socks that fit properly and are not too tight.
  • Keep your feet clean.
  • Keep your feet dry by wearing cotton socks and/or using foot powder.

RESOURCES

American Orthopaedic Foot and Ankle Society
http://www.aofas.org

American Podiatric Medical Association
http://www.apma.org

CANADIAN RESOURCES

Calgary Foot Clinic
http://www.foottalk.com

Canadian Podiatric Medical Association
http://www.podiatrycanada.org

References

Ingrown toenails. American Podiatric Medical Association website. Available at: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1522. Accessed Mrach 2, 2015.

Matsumoto K, Hashimoto I, et al. Resin splint as a new conservative treatment for ingrown toenails. J Med Invest. 2010;57(3-4):321-325.

Woo SH, Kim IH. Surgical pearl: nail edge separation with dental floss for ingrown toenails. J Am Acad Dermatol. 2004;50(6):939-940.

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