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Ingrown Toenail

What is an Ingrown Toenail?

It is a painful condition that occurs when one or both of the side edges of the nail cut into the adjacent skin. The broken skin appears red and inflamed and is usually painful. The toe may become swollen and develop pus. Sometimes a bloody mass of skin known as "proud flesh", which is very painful and bleeds easily, appears in the nail groove. The cuticle can also become sore or inflamed as a side effect of an ingrown nail. An ingrown nail usually occurs in the big toe. Young people between the ages of ten and thirty are most susceptible.

What Causes Ingrown Toenails?

  1. Improper cutting of nails is the most frequent cause: cutting too short, cutting into the corners, and leaving jagged corners.
  2. "Picking" or ripping nails, which is common in children and teenagers. Often a small piece known as a "spicule" is left which can grown into adjacent skin.
  3. Tight and improperly fitting shoes or hosiery. In small children, tight leotards, sleepers, and bed clothes can cause subtle but prolonged pressure that may lead to problems in later life.
  4. Injury to the toe or the nail bed.
  5. Hereditary factors which may result in involuted (horseshoe shaped) nails, can predispose a person to ingrown nails.
  6. Improper bio mechanics, which cause excess pressure on the toe, may be an aggravating factor.

How Can I Avoid Getting an Ingrown Toenail?

Adequate length and proper cutting of nails will prevent an ingrown nail from occurring in most cases. Nail length should not be shorter than the top of the nail when the top is compressed. Trimming should be done with a good nail clipper or proper nail scissors. Nails should be filed smooth and any spicules removed. The nail corner can be gently "rolled out" with a file. A "V" should not be cut into the centre of the nail. This approach is based on the mistaken belief that the nail will grow towards the centre or will take the pressure off the inflamed area. If nails are thick, reducing thickness may alleviate pressure.

What Should I Do if I Have an Ingrown Toenail?

  1. Soak feet in warm water for 15 minutes to soften nail before cutting.
  2. If nail is painful, apply ice before cutting nail.
  3. Cut nail as described above.
  4. To avoid infection, cleanse the nail daily with an antiseptic, preferably after bathing or showering, and before inserting cotton ball.
  5. Pharmacy products that toughen the skin to protect it while the nail grows out may be helpful.
  6. Keep feet dry. Moist skin is "weakened" and may therefore, aggravate the condition.
  7. Professional help may be needed for more severe cases. A portion of the nail may need to be temporarily removed or a "matrixectomy" (removal of nail root to prevent the nail from growing back) performed if remedies described above do not help.

See your doctor immediately if infection is present.

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