What are ingrown toenails?
Ingrown toenails occur when the edges or corners of your nails grow into the skin next to the nail. Your big toe is most likely to get an ingrown toenail.
You can treat ingrown toenails at home. However, they can cause complications that might require medical treatment. Your risk of complications is higher if you have diabetes or other conditions that cause poor circulation.
What causes ingrown toenails?
Many things can cause an ingrown toenail, including:
- cutting toenails incorrectly (Cut straight across, since angling the sides of the nail can encourage the nail to grow into the skin.)
- irregular, curved toenails
- footwear that places a lot of pressure on the big toes, such as socks and stockings that are too tight or shoes that are too tight, narrow, or flat for your feet
- toenail injury, including stubbing your toe, dropping something heavy on your foot, or kicking a ball repeatedly
- poor posture
- improper foot hygiene, such as not keeping your feet clean or dry
- genetic predisposition
Using your feet extensively during athletic activities can make you especially prone to getting ingrown toenails. Activities in which you repeatedly kick an object or put pressure on your feet for long periods of time can cause toenail damage and increase your risk of ingrown toenails.
What are the symptoms of ingrown toenails?
Ingrown toenails can be painful, and they usually worsen in stages.
Early-stage symptoms include:
- skin next to the nail becoming tender, swollen, or hard
- pain when pressure is placed on the toe
- fluid building up around the toe
If your toe becomes infected, symptoms may include:
- red, swollen skin
- oozing pus
- overgrowth of skin around the toe
Treat your ingrown toenail as soon as possible to avoid worsening symptoms.
What are the treatment options for ingrown toenails?
Ingrown toenails that aren’t infected can normally be treated at home. However, if your toenail has pierced the skin, or there is any sign of infection, seek medical treatment. Signs of infection include:
- redness and swelling
To treat your ingrown toenail at home, try:
- soaking your feet in warm water for about 15 to 20 minutes three to four times per day (At other times, your shoes and feet should be kept dry.)
- pushing skin away from the toenail edge with a cotton ball soaked in olive oil
- using over-the-counter medicines, like acetaminophen (Tylenol), for the pain
- applying a topical antibiotic, such as polymyxin and neomycin (both present in Neosporin) or a steroid cream, to prevent infection
Try home treatments for a few days to a few weeks. If the pain worsens or you find it difficult to walk or perform other activities because of the nail, see your doctor.
If the toenail does not respond to home treatments or an infection occurs, you may need surgery. In cases of infection, stop all home treatments and see your doctor.
There are different types of surgical treatments for ingrown toenails. Partial nail removal only involves removing the piece of nail that is digging into your skin. Your doctor numbs your toe and then narrows the toenail. Partial nail removal is 98 percent effective for preventing future ingrown toenails.
During a partial nail removal, the sides of the nail are cut away so that the edges are completely straight. A piece of cotton is placed under the remaining portion of the nail to keep the ingrown toenail from recurring. Your doctor may also treat your toe with a compound called phenol, which keeps the nail from growing back.
Total nail removal may be used if your ingrown nail is caused by thickening.Your doctor will give you a local pain injection and then remove the entire nail in a procedure called a matrixectomy.
Preventing ingrown toenails
Ingrown toenails can be prevented by making several lifestyle changes:
- Trim your toenails straight across and make sure that the edges do not curve in.
- Avoid cutting toenails too short.
- Wear proper fitting shoes, socks, and tights.
- Wear steel-toe boots if you work in hazardous conditions.
- If your toenails are abnormally curved or thick, surgery may be necessary to prevent ingrown nails.