Ingrown toenails are an
extremely common foot problem that occurs when corners or edges of the toenail
grow into the soft tissues of the toe. The nail first pierces the skin and then
continues to grow inward if the problem is not corrected. The medical term for
this condition is onychocryptosis, and it primarily affects the big toe
although it can develop in the other toes as well, though it very rarely occurs
in the fingers.
This condition is often
quite painful and the affected area will often become tender, swollen and red, the
skin surrounding the nail may become hard, and a clear or yellow suppuration
may also occur. If the nail becomes
infected the wound may become warm to the touch, and it may bleed and produce foul
smelling pus. If signs of infection are present or if the patient also suffers
from diabetes or peripheral vascular disease then medical attention should be
sought as soon as symptoms present themselves, as complications and infection
are much more likely to occur.
Ingrown toenails can be
caused by a variety of factors, and the most common causes are nail trauma
caused by athletic activities, wearing tight or constrictive shoes, injury to
the feet or toes, having unusually long toes (which causes uneven ‘hot spots’
to occur), poor foot hygiene, congenital toenail malformation, diabetes, nail
fungus infection, nail surgery (past or present), excessively sweaty feet,
arthritis, and poorly trimmed or cut toenails. Improper cutting of the toenails
causes problems on two fronts: the nails may be cut excessively short and they
may leave behind jagged edges, both of which increase the risk of developing
ingrown nails.
Most cases of ingrown
toenails can be treated at home and will heal without medical intervention. The
best way to treat an ingrown nail is to soak the affected foot in warm water
and Epsom salts until the skin softens, then use the edge of a towel to gently
push back the overgrown skin that is covering the nail. An antibacterial cream
can then be applied to keep the skin hydrated and free from bacteria. If the
ingrown nail requires more care a piece of cotton or dental tape can be used to
very gently lift the ingrown nail out of the skin. Otherwise, this condition
can be treated with regular foot soaks and gently pushing back the skin from
the nail.
If symptoms do not
improve with these treatments then it’s best to seek medical advice before
infection occurs, as antibiotics may be prescribed to treat severe cases. Ingrown
toenails can be prevented by wearing non-constrictive shoes with a wide toe, by
keeping nails evenly and smoothly trimmed but not excessively short, by
avoiding injury to the foot and nails, and by keeping the nails clean. Because
ingrown toenails have a high rate of reoccurrence great care should be taken
with the feet after the nail has healed, and any subsequent injuries or
discomfort occurring in the nail or nail bed should be addressed right away.
If a patient is prone
to the development of ingrown toenails special attention must be paid to foot care,
especially to grooming habits and the type of footwear used.
