Overview
Ingrown toenails are a common condition where the corner or side of a toenail grows into the soft flesh surrounding it, causing pain, inflammation, swelling, and sometimes infection. They usually affect the big toe and can be caused by wearing shoes that crowd the toenails, cutting toenails too short or not straight across, injuring a toenail, having very curved toenails, nail infections, or certain medical conditions.
Understanding the disease
Symptoms
Symptoms of ingrown toenails include pain and tenderness, inflamed skin, swelling, and infection. If you experience severe discomfort in a toe, pus or inflamed skin that seems to be spreading, or have diabetes or another condition that causes poor blood flow to the feet and you have a foot sore or infection, you should see a health care provider.
Risk Factors
Risk factors for developing ingrown toenails include being an adolescent with increased sweat, having nail care habits that encourage nail growth into the skin, having a reduced ability to care for your nails, and wearing shoes that constrict the toes. Additionally, participating in activities that put your toes at risk of injury and having conditions like diabetes that cause poor blood flow can also contribute to the development of ingrown toenails.
Development
Ingrown toenails develop when the corner or side of a toenail grows into the soft flesh surrounding it, causing pain, inflammation, swelling, and sometimes infection. The most common cause is wearing shoes that crowd the toenails or cutting toenails too short or rounding the corners. Other causes include injuring a toenail, having very curved toenails, nail infections, or certain medical conditions. Risk factors for ingrown toenails include being an adolescent, having nail care habits that encourage the nail to grow into the skin, wearing shoes that constrict the toes, and having a reduced ability to care for your nails. To help prevent ingrown toenails, trim your toenails straight across, avoid cutting them too short, and wear proper shoes that fit well.
Assessment and Diagnosis
Triage
You should see a doctor if ingrown toenails are suspected when:
- You experience severe discomfort in a toe, along with pus or inflamed skin that seems to be spreading.
- You have diabetes or another condition that causes poor blood flow to the feet, and you have a foot sore or infection.
Diagnosis
Your health care provider can diagnose an ingrown toenail based on your symptoms and a physical examination of the nail and the surrounding skin.
Management and Treatment
Complications
Complications of ingrown toenails may include:
- Infection: When an ingrown toenail penetrates the skin, it can become infected with bacteria, leading to cellulitis or even sepsis in severe cases.
- Inflammation: The affected area may become inflamed and swollen, causing discomfort and difficulty walking or moving.
- Pus-filled abscess: In some cases, an ingrown toenail can lead to the formation of a pus-filled abscess, which may require drainage by a healthcare provider.
- Gangrene: In rare cases, ingrown toenails can cause gangrene, a serious condition that involves the death of tissue due to lack of blood supply. This can result in the need for surgical removal of the affected toe or even amputation in severe cases.
- Nerve damage: Prolonged pressure from an ingrown toenail can cause nerve damage, leading to numbness or loss of sensation in the affected area.
- Permanent deformity: Repeated infections or improper treatment of ingrown toenails can result in the development of a permanent deformity, such as a curved or misshapen toenail. If you have diabetes or another condition that causes poor blood flow to the feet, the risk of complications from ingrown toenails is increased. It is essential to seek prompt medical attention if you experience severe pain, inflammation, or signs of infection.
Prevention
ingrown toenails can be prevented by following certain measures. To prevent ingrown toenails, you should:
- Trim your toenails straight across, avoiding curving them to match the shape of the front of your toe.
- Keep your toenails at a moderate length, ensuring they are even with the tips of your toes.
- Wear shoes that fit properly, avoiding those that place too much pressure on your toes or pinch them. If you have nerve damage to the feet, be especially cautious about fitting shoes properly.
- Wear protective footwear for activities that put you at risk of injuring your toes, such as wearing steel-toed shoes.
- Check your feet regularly, especially if you have diabetes, to detect signs of ingrown toenails or other foot problems. By following these steps, you can significantly reduce your risk of developing ingrown toenails.
Home Remedies
Home remedies can help alleviate the discomfort of ingrown toenails, but it's essential to consult a healthcare provider if the pain is severe or spreading. Some suggested home remedies include:
- Soaking the foot: Soak the affected foot in warm water with Epsom salt or regular salt for 15-20 minutes, several times a day. This can help reduce inflammation and alleviate pain.
- Elevating the foot: Elevate the affected foot to minimize swelling.
- Gentle massage: Gently massage the affected area to help relieve pain and promote drainage.
- Padding the toenail: Use foam toe pads or cotton balls to pad the affected area and help reduce pressure on the ingrown toenail.
- Over-the-counter pain relief: Apply an over-the-counter anti-inflammatory cream or take pain relievers (such as ibuprofen) as directed, to help alleviate pain and reduce inflammation.
- Proper foot hygiene: Keep the affected foot clean and dry, and avoid putting pressure on the affected toenail.
- Proper trimming: Trim the toenail straight across, and avoid cutting it too short or rounding the corners. Remember that if your condition worsens or does not improve with home remedies, it's essential to consult a healthcare provider for proper diagnosis and treatment.
Treatment
There are several treatments for ingrown toenails. If the condition is mild, you can often take care of it at home. Some self-care treatments include:
- Soaking the foot: Soak the affected toe in warm water for 15 to 20 minutes, 3 to 4 times a day. This can help reduce pain and inflammation.
- Elevating the foot: Elevate the foot to help reduce swelling.
- Applying a cold compress: Use a cold compress, such as a cotton ball or cloth, soaked in ice water, and apply it to the affected area for 15 to 20 minutes at a time, several times a day.
- Gently removing the ingrown part of the nail: Use a pair of clean tweezers to gently remove the ingrown part of the nail. Be careful not to press too hard or puncture the skin.
- Applying antibiotic ointment: Apply an over-the-counter antibiotic ointment to the affected area to prevent infection. If the pain persists, the infection worsens, or you have a pre-existing medical condition like diabetes, it's essential to consult with your healthcare provider. They may recommend additional treatments, such as antibiotics, corticosteroid injections, or surgical intervention to remove the affected portion of the nail. Remember to trim your toenails correctly and wear well-fitting shoes to help prevent ingrown toenails from occurring in the future.
Preparing for medical consultation
To prepare for an appointment for ingrown toenails, you should:
- Make a list of questions to ask your health care provider or foot doctor (podiatrist) during the appointment. Some basic questions to consider include:
- Is my condition temporary or long term (chronic)?
- What are my treatment options and the pros and cons of each?
- Gather information about your symptoms and the history of your ingrown toenail. Note when the issue started, any home remedies you have tried, and any changes in your footwear or activities that may have contributed to the problem.
- Take care of your foot in the lead-up to the appointment. Soak your foot in warm, soapy water for 10 to 20 minutes 3 to 4 times a day, and apply petroleum jelly to the tender area, bandaging the toe as needed.
- Consider wearing open-toed shoes or sandals to accommodate your foot, especially if the ingrown toenail is causing discomfort or pain.
- If you have any relevant medical history or conditions, prepare to share that information with your health care provider to ensure they have a complete understanding of your situation. Remember to follow the advice given by your health care provider or podiatrist, and ask for clarification if anything is unclear.