Ingrown toenail / Ingrowing toenail

Overview

 

An ingrown toenail develops when the sides of the toenail grow into the surrounding skin and pierces it causing inflammation.

The big toe is often affected, either on one or both sides. The nail curls and pierces the skin, which becomes painful, red, swollen and tender.

Common symptoms include:

  • pain if pressure is placed on the toe
  • inflammation of the skin at the end of the toe
  • a build-up of fluid (oedema) in the area surrounding the toe
  • an overgrowth of skin around the affected toe (hypertrophy)
  • bleeding
  • white or yellow pus coming from the affected area

What causes ingrown toenails?

The following can contribute in causing an ingrown toenail to develop :

  • badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin
  • wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail; the skin may be pierced if it’s pressed on to your toenail
  • sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and embed itself within it
  • injury – for example, stubbing your toe can sometimes cause an ingrown toenail to develop
  • natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail

Treatment for ingrown toenail :

Left untreated, an ingrown toenail can become infected, so it’s important that you:

  • keep your feet clean by washing them regularly and keeping them clean and dry.
  • change your socks regularly
  • cut your toenails straight across to stop them digging into the surrounding skin
  • gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin)
  • wear comfortable shoes that fit properly

Surgery may be recommended if your toenail doesn’t improve. Depending on the severity of your symptoms, this may involve removing part or all of your toenail.

1. Partial nail avulsion

Partial nail avulsion removes part of your toenail under local anaesthesia and is the most commonly used operation for treating ingrown toenails.

A local anaesthetic medicine is used to numb your toe and the ingrown part of your toenail is cut away. Any pus is drained and dead tissue is debrided.

A course of an antibiotic may be prescribed if your nail is infected.

2. Total nail avulsion

Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe on both inner and outer sides in the same toe.

 

After surgery

After toenail surgery, your toe will be wrapped in a sterile bandage. This will help prevent any bleeding and also prevent infection. Rest your foot and keep it raised for 1 to 2 days after the operation.

To help reduce the pain, you may prescribed a pain killer. Wear soft or open-toed shoes for the first few days after surgery.

Preventing ingrown toenails

Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s important to cut your toenails properly (straight across, not at an angle or down the edges).

Wash your feet every day, dry them thoroughly and use foot moisturiser.

Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day.

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