Ingrown Toenails

Ingrown toenails are one the more common foot problems treated by the Podiatrist. They can be very painful, with people limiting their activity to keep off their sore feet. Ingrown toenails are caused by impingement of the skin along the margins of the nail by the nail plate. Some ingrown toenails are chronic, with repeated episodes of pain, inflammation, and infection. Infection results when inflamed tissues are colonized by pathogenic bacteria or yeast. Pain can be present without infection, and occasionally infection is present without pain. The usual signs of infection include; redness (erythema), swelling (edema), increased warmth (calor), and pain (dolor).

Symptoms

• Pain along the margin(s) of the toenail
• Aggravated by wearing shoes, particularly those with narrow toes.
• May be sensitive to any pressure, even the weight of the bed clothes.
• There may be signs of infection.
• The drainage of pus, or a watery discharge tinged with blood.

Causes

• Improper trimming of toenails
• Tight fitting shoes which compress the toes together
• Hose or socks that are too tight
• Abnormally shaped nail plate
• Other toenail deformities (e.g.. excessively thick nail plate)
• Trauma to the nail plate or toe

What you can do

• Cut toenails straight across, and leave slightly longer than the end of the toe
• Avoid tight fitting foot wear
• If discomfort develops try soaking the foot in a basin of warm water two or three times a day. If you are diabetic or have poor circulation the water should never be more than 95 degrees Fahrenheit. Contact your podiatrist or physician immediately.
• An infected ingrown nail requires prompt professional attention.

What the doctor may do

• Trim a small spicule of nail to relieve the pressure. Callus (dead skin) may have accumulated in the nail
• groove, which needs to be removed. Routine ingrown toenail care may need to be done periodically.
• Surgically drain an infection
• Prescribe special soaks and/or antibiotics
• Surgically correct a chronic ingrown toenail
• Completely remove a deformed toenail so it will not grow back.

Complications of an ingrown toenail

• Infection, if present, may spread to foot and leg, or into blood stream.
• Loss of nail plate from infection or inflammation of the nail bed.
• Chronic ingrowing nails can cause deformity of the nail plate and/or surrounding soft tissues.
• A small benign tumor called a granuloma can form along the nail margin.
• Diabetics and those with poor circulation to the feet must never attempt to treat an ingrown toenail at home, consult with a podiatrist or physician immediately.