Services & Treatments

Ingrown Toenail Treatment

Do You Suffer From Ingrown Toenails?

An ingrown toenail (or Onychocryptosis) is a condition whereby the growing edge of the nail border penetrates the skin surrounding it. There are varying degrees of involvement, and therefore the signs and symptoms experienced by the client can vary accordingly. The condition can occur on any toe, however most commonly involves the big toe, and can occur on either border of the nail.

Ingrown toenails may seem like a small thing, but they can turn into a big, painful problem! Ingrown nails occur when the edge of the nail curls around and grows into the skin. The edge of the nail pushes on the skin and can cause a build-up of debris and callous in the nail fold. This all leads to increased pressure in the area, which you experience as pain. There is also the danger of the nail cutting into the skin, which can result in a soft tissue infection and make things even more painful!

Cause

There is no one definitive cause of ingrown toenails. However, there are many factors that impact on someone’s predisposition to developing an ingrown toenail.

• Genetics: Unfortunately, in some people, that’s just how the nail grows! If you have an involuted nail shape (where the nail is curled at the edges) you will be more prone to ingrown toenails. Usually all nails will be affected, and close relatives may have the same problem.
• Damage: Injury to the nail matrix (where the nail grows from) is another cause of ingrown nails. This could be from one single incident (e.g. dropping something on your toe) or small amounts of damage over a long period of time (e.g. wearing tight shoes will constantly cause pressure on your big toe).
• Incorrect nail care: Cutting the nail too far down either side of the nail can encourage it to grow inwards. You also put yourself at risk of infection, even when using ‘clean’ tools at home!
• Infection: Fungal infection of the nail plate damages the nail, causes it to thicken, and increases the amount of dead skin build up underneath the nail.

Prevention and Care

There are a couple of things you can do at home to manage pain from an ingrown toenail.

• Proper toenail cutting: Cut the nail straight across the top and not too short. Resist the temptation to cut down the side. If your nails are really bothering you – visit your Podiatrist to have them cut your nails for you precisely and safely.
• Avoid tight fitting shoes: Not only can they cause ingrown nails, but they can also cause changes in foot shape with time! Look for shoes with a wide, asymmetrical toe box.
• Managing infection: You can tell your toe is infected if it is red, hot, swollen, and very painful. Pus is a definite sign of infection, but it is not always present at the surface of the nail. As soon as you notice the infection, bathe your toe every day in warm salty water. Dry the foot and apply liquid betadine, making sure it gets down the edge of the nail and cover with a non-stick dressing. If your toe isn’t looking any better after a few days of this, then make an appointment to see your Podiatrist.

Treatment

In most cases, it is best to visit your Podiatrist if you have an ingrown toenail. They have a number of methods of removing the nail and providing immediate pain relief.

• Simple removal of the ingrown section of nail: This is usually performed easily and with little pain, however a local anaesthetic injection can be used to numb the toe if required. Sterilised instruments are used to prevent development of an infection. Whilst this provides immediate relief, the nail will grow back and in most cases, will ingrow again.
• Removal of debris: Often a large amount of dead skin can build up under the curled nail, which increases pressure over the area. Regular removal of this debris and any callous can provide significant long term pain relief.
• Drainage of pus: If an infection is present, a collection of pus may have developed just underneath the skin. This needs to be drained to reduce pressure on the area and allow antibacterial agents to work.
• Antibiotics: Your Podiatrist will assess your toe and determine if oral antibiotics are required. Some Podiatrists may be able to prescribe you these themselves, however in most cases you will be referred to your GP. It is important to know that even with antibiotics, the infection is much more likely to clear if the ingrown section of nail is removed.
• Regular maintenance of nails: Simply seeing your Podiatrist regularly (usually every 8 – 10 weeks) to have your nails cut and underlying debris removed is the best thing you can do to PREVENT pain and infection. Regular nail cutting may also encourage the nails to grow straighter.
• Ingrown toenail surgery: If you are regularly bothered by painful or infected ingrown toenails, your Podiatrist may be able to perform a surgical procedure that will remove either part, or all, of your nail. A chemical is then applied to effectively destroy part of the nail matrix and stop that section of the nail growing back. The surgery is performed in clinic under local anaesthetic, and you can go home straight afterwards. You may require one day off work or school, but should be able to return to everyday activities straight away. Longer time will be needed to be taken off from strenuous exercise. In most cases, this surgery results in permanent resolution of the ingrown toenail.