An ingrown toenail occurs when the toenail edge/corner starts to grow into the surrounding skin rather than over the skin. While onychocryptosis (the medical term for an ingrown toenail) mainly affects the big toe, it is not exclusive to that toe and can happen to any nail on any toe. An ingrown toenail can cause mild discomfort or be extremely painful. Often, ingrown toenails create a tender, inflamed area, which can develop into an infection or a more serious medical condition if left untreated.
Podiatrists are specialized foot & ankle doctors who treat the symptoms and the cause(s) of problematic ingrown toenails. Ingrown toenail issues rank among the top nail problems that are treated by podiatrists and other medical professionals.
Primary Causes Of Ingrown Toenails
An ingrown toenail may cause tenderness, pain, redness, inflammation, and swelling in and around the affected toe and toenail. In certain instances, a tender bump/overgrowth may form on the nail’s side in response.
A toenail may begin to grow into the surrounding skin for these reasons and more -
- Trimming Toenails Improperly – nails that are too short or not cut straight across can create a situation where the nail, as it begins to grow, digs into the skin – causing pain and discomfort.
- Poor-Fitting/Tight Footwear – wearing ill-fitting shoes/ski boots (too tight or too narrow for your foot’s width) can put pressure on your toes, resulting in a toenail that grows abnormally.
- Excessive Sweating – excessive sweat can soften the skin, ultimately making the skin more vulnerable to irritation which often develops into an ingrown toenail.
- An Injury/Trauma - dropping something heavy on your toe or stubbing it can create an ingrown toenail.
- Family History – some people will find they have a genetic predisposition or increased likelihood of developing a problematic ingrown toenail simply because of the natural, inherited structure/shape of their toes or their toenails.
It is vital to note that people with diabetes have an increased risk for the complications associated with an ingrown toenail for several reasons –
- People with diabetes may have peripheral nerve damage, impacting their ability to feel sensations in their extremities, so they may not detect the early warning signs sent by their body.
- People with diabetes may have poor blood circulation, which slows the healing process and makes them more susceptible to infection.
Podiatric Treatment Options for Ingrown Toenails
The specific treatment/medical approach a podiatrist may select depends on several factors, including the severity of the ingrown toenail and the patient’s overall health condition. A podiatrist’s most conservative approach to treating the problem would include –
Soaking the Foot
A warm water soak can reduce inflammation and pain.
Proper Nail Trimming
Educate the patient on properly trimming their toenails to prevent future problems.
Antibiotic Treatment
An infection from the ingrown toenail can be treated with topical/oral antibiotic medicine.
Guidance on Prevention & Education
Podiatrists are great sources of knowledge and guidance concerning how to properly take care of your feet – and choose appropriate footwear to help prevent future ingrown toenails.
If necessary, because the above approaches do not provide the desired relief, a podiatrist may recommend one of the following options –
Partial Nail Plate Removal (a.k.a., Partial Nail Avulsion)
The partial removal is typically performed under local anesthesia in a doctor’s office. It involves removing a portion/edge of the nail that is causing pain, inflammation, and other symptoms.
Total Nail Plate Removal (a.k.a., Total Nail Avulsion):
When severe enough, or the problem and painful symptoms keeps returning, a podiatrist may recommend the removal of the entire affected toenail. This, too, is done with local anesthesia. Note that the nail may or may not grow back.
Matricectomy
In the most severe ingrown toenail cases, a matricectomy (permanently destroying the nail matrix - the area from which the nail grows) is done to prevent the regrowth of the nail.