Ingrown Toenail Treatment 

Ingrown Toenail Treatment 

 

 

Ingrown toenails are commonly seen in our practice. They can be painful, debilitating and can even keep you up at night! 

What Causes an Ingrown Toenail? 

Your anatomical makeup 

Some people have nails that grow with a curvature on the sides, opposed to flat. What can happen is when the nail grows down and into the sulcus. These nails can be called pincer nails. What also happens is skin and callus buildup and develop in the corners, leading to more pain. When the nails are trimmed, people with curved nails cannot see the nail going down on the sides. They end up leaving a piece of the nail in the corner of the nail sulcus. 

 

Trimming Nails 

How one trims and maintains their nails can lead to ingrown nails. Some people tear their nails instead of cutting them. This is not a good idea because the nail can be torn off extremely far back and left jagged. The further back the nail spicule is, the more likely one is to undergo a surgery to remove that spicule. 

Another issue is that people tend to chase the corners when trimming their nails. It is always best to trim the nails straight across and file the corners with a nail file. I suggest filing with a nail file so the corners are not sharp and do not cut the adjacent toe. Another tip is to make sure the nails are not cut too short. Having some length to the nail ensures that you are going to cut across the entire length of the nail. 

 

Trauma 

Dropping something on your toe nail or stubbing your toe is never fun! What makes this situation a bit tricky is that the nail can break or chip leaving sharp corners. These jagged edges or sharp corners can dig into your skin, leading to a wound that can become infected. 

Improper footwear 

Some people wear tight dress shoes or pointy shoes and are unaware how that impacts their nails. This is more problematic in people who already have nail troubles. The constant pressure on the nails can lead to an ingrown toenail. If shoes are too small, that is also a predisposing factor for ingrown toenails. 

Biomechanical issues 

People who have flat feet or pronate a lot can drive their big toe into the shoe leading to trauma. This can be corrected with strengthening, toe aligners, toe spacers, gait retraining, wider footwear, stability footwear or orthotics. 

Medical Conditions 

Underlying medical conditions can make some people more susceptible to this condition. Fungal nails can become thickened and hard to or break off leaving jagged edges. Some people who have excessive swelling in their feet such as lupus, kidney disease, venous insufficiency to name a few, can be prone to ingrown toenails. The soft tissue around the nail can become swollen, making trimming the nail more difficult to accurately see, thus resulting in an ingrown. 

Why Ingrown Toenails Become Painful 

Ingrown toenails hurt due to the nail creating a wound in the skin. Once there is a wound that becomes a portal of entry for bacteria and infection. Your feet have exposure to bacteria and can become easily infected, especially in immunocompromised people.  The pain is due to the nail but also compounded by the soft tissue infection. 

Treatment 

It is best to seek a foot specialist to take care of your ingrown toenail . While you wait for your appointment here are some tips. Soak your feet in Epsom salts for 10 -15 min one to two times a day. Apply antibiotic ointment around the area. I also suggest Betadine prior to the antibiotic ointment. Some literature advised cotton under the nail to lift the nail. That may be tricky and I just advise seeing a medical professional if it is that bad. Use a Band-Aid to adhere on the affected side to pull the skin away from the nail. Toe spacers can help avoid pressure if the nail is close to a digit. Use Tylenol or Advil for pain relief.