When a toenail is trimmed too short, especially when it happens on the corners of the big toenail, it can easily become an ingrown nail. What happens is that the nail grows into the skin and soft tissue surrounding the nail. Other common causes of an ingrown toenail include tight-fitting or ill-fitting shoes, or if there is trauma to the toe that causes the nail to grow inward.

An ingrown toenail can cause symptoms such as swelling and redness and may lead to an infection. When this happens on the big toe, it can be especially painful.

Sometimes, an ingrown toenail can be treated at home. Other times, a doctor or podiatrist may need to prescribe an antibiotic to treat an ingrown toenail that has become infected. Or, he or she may need to remove all or part of the nail using a surgical treatment, likely through a procedure called nail avulsion. Fingers can develop ingrown nails too, although ingrown fingernails are less common than ingrown toenails. Ingrown fingernails will also show symptoms similar to ingrown toenails, namely redness, swelling, and pain.

Anatomy of the Nail

If you have foot pain due to a nail that is ingrown and are discussing surgical options with your doctor, he or she may reference the following areas of the toenail:

• Nail Border: Sides of the nail where the nail and skin meet
• Nail Fold: The skin that overlaps the toenail
• Nail Matrix: Soft tissue underneath the toenail that produces tissue that becomes the nail plate
• Nail Plate: The hard part of the toenail—the actual nail itself

Ingrown Toenail Surgery Options

The goal of toenail surgery is to maintain foot health by stopping the nail edge from growing inward and painfully cutting into the skin surrounding the nail. It is also performed to reduce the risk of infection. If the tissue is already infected, the doctor will treat the infection by prescribing an antibiotic in addition to offering other treatments. Here are two surgical options your doctor may recommend:

• Partial Nail Avulsion: A removal procedure where the doctor cuts away the portion of the toenail that is ingrown while not disturbing the nail bed. An anesthetic is used in avulsion and other ingrown toenail removal procedures before a doctor begins the removal process.
• Complete Nail Plate Avulsion: Removing the entire ingrown toenail.

Self-Care to Avoid Ingrown Toenails

• If you have poor circulation or problems related to blood flow due to diabetes, you are at a greater risk for ingrown nails. Be aware of these risk factors and know the signs of infection, such as pus, redness, and swelling, and check your feet daily to maintain good foot health.
• If you notice pus in the area of the ingrown toenail, the toe is infected. Make an appointment to see a doctor.
• Protect your toes and feet from trauma by avoiding footwear like flip-flops.
• Cut nails straight across using a clean, sharp nail trimmer. Do not round the corners of the nails, and do not trim them shorter than the edge of the toe.

Self-Care to Treat Ingrown Nails

If you identify an ingrown toenail before it gets worse and becomes infected, you may be able to treat it at home so no surgical treatment is needed. Here are steps you can take to treat this foot problem:

• Soak the ingrown toenail in warm water for about 15 minutes, several times daily. Adding Epsom salt to the water may help reduce pain and swelling even further.
• You may use a bandage or Band-Aid to protect the ingrown toenail, but make sure your skin is completely dry before applying it.
• Wear open-toed shoes, sandals, or comfortable shoes with plenty of space for your toes. However, shoes should always have good support and not be loose-fitting.
• Take an over-the-counter pain reliever, such as ibuprofen.
• If your ingrown toenail worsens, make an appointment with a podiatrist.

Note: It may help to gently manipulate the skin near the edge of your nail to help loosen it from its embedded position. Insert a small amount of packing material, such as cotton or even clean dental floss, between the nail and skin. Keep the area clean and dry, and change the packing daily. While this ingrown toenail treatment is often used as a home remedy, a doctor should perform it if the ingrown toenail symptoms are severe.

Keeping You in Motion at Lakeshore Bone & Joint Institute

Our specialty-trained podiatrists,Brian T. Damitz, D.P.M., and Hassan Usmani, D.P.M., can diagnose and treat your ingrown toenail. Our podiatrists also provide any follow-up care you may need to maintain your foot health. While it may be possible to use nonsurgical treatments for your condition, if surgery is required, our doctors can expertly perform the procedure that is required.

To schedule an appointment with one of our experienced podiatrists, please call (219) 921-1444 or request an appointment online.