Ingrown Toenail: Symptoms, Causes, Prevention, Treatment

An ingrown toenail is a common condition in which the corner or side of a toenail digs deep into the flesh of the toe. This may lead to pain in the toe, inflamed skin, swelling, and sometimes infection.  Frequent ingrown toenails are known to occur in males between the age of 15 to 40 years. 

An ingrown toenail pain can be worrisome, and it usually worsens if left untreated. Some early-stage symptoms of an ingrown toenail are– 

1. The skin next to the nail becomes swollen, hard, or tender
2. The person experiences pain when pressure is applied to the toe
3. There is a fluid building up around the toe
4. There is redness, itchiness, and sensitivity around the toenail

Primary symptoms of infection include– 

1. The skin around the toenail has become red and swollen
2. Pain in the toe
3. Bleeding
4. Pus oozing out of the area near the toenail

An ingrown toenail happens to both men and women. It usually affects people who have sweaty feet, such as teenagers. People at an older age are also at a high risk of ingrown toenails as their nails thicken with age. 

The following are ingrown toenail causes –

1. Cutting the toenail incorrectly. If someone cuts their nail too short or too rounded, then it increases the chances of the nail growing into the skin.
2. Genetics    
3. Irregular or curved toenails.
4.  If the shoes don’t fit properly or are too crowded for toenails and apply too much pressure, then there are chances of the person having an ingrown toenail. 
5. A toenail injury like stubbing the toe, dropping something heavy on foot, or kicking a ball repeatedly.   
6. Improper foot hygiene, such as feet that are not dry and clean.
7. Using feet extensively in athletic activities like ballet, football, kickboxing, etc.

Some factors that increase the risk of an ingrown toenail are-

1. Improper nail-cutting habits like rounding the corners or trimming them extremely short
2. Choosing shoes that restrict toe movement.
3. Excessive perspiration, especially in adolescents, because it makes the nails more soft
4. Taking part in activities that put the toes at a greater risk of injury.
5. Poor blood flow caused by conditions like diabetes

Ingrown toenails can be avoided by making the following lifestyle changes–

1. Don’t curve the nails to match the shape of the toe. Also, while cutting the nails, trim the nails straight across. 
2. Try keeping the nails even with the tips of the toes. Don’t trim much to avoid putting the pressure of shoes on the toes.    
3. If a person does activities with a risk of injuring toes, then wearing protective footwear such as steel-toed shoes is a good option. 
4. Wear shoes that fit your feet properly without applying much pressure on the toes or pinching them. 
5. Keep the foot dry to prevent the toenail from becoming soft. This also helps in avoiding possible infection. 
6. Avoid picking the nails.

An ingrown toenail can be diagnosed at home itself, or the doctor can diagnose it with just a physical exam. A doctor will inspect the skin at the edge of the nail and diagnose an ingrown toenail when the skin around the nail is -  

1. Growing over the nail
2. Swollen, tender, red, and warm

The doctor may also need to perform an x-ray to see how deep the nail has grown into the skin. The x-ray will also tell if an injury has caused the ingrown toenail.

How to prepare for the doctor's consultation?

The healthcare provider will most likely ask the following questions 

1. When did the problem start happening?
2. Do the symptoms occur throughout? 
3. What at-home treatments have been tried?
4. If the patient has any record of medical conditions that affect the blood flow to the legs or feet?

The patients should also consider asking the following questions 

1. Is the condition temporary or long-term?
2. What are the treatment options?
3. What results to expect?
4. If they should wait for some time?
5. What nail care routine to follow?

An ingrown toenail that isn’t infected can generally be treated at home. However, if the toenail has pierced the skin or there is a sign of infection like pus, redness, and swelling, the person will have to seek proper medical treatment. 

Home Remedies for Ingrown Toenail

To treat an ingrown toenail at home, the following practices can be done   

1. Avoid sweating and keep the feet dry for faster recovery.
2. Apply antibiotic creams and protect the toenail by covering it firmly with a bandage. 
3. Opt for pain relievers like Tylenol to reduce discomfort.
4. Try soaking the feet in water for over 15 minutes 3-4 times a day. This will reduce swelling in the toe area. 

Try the home treatments for a few weeks. If the pain worsens and the person finds it difficult to walk or perform other activities because of this condition, then the patient must see the doctor.

If the ingrown toenail treatment at home does not help or an infection occurs, then the person may need to get an ingrown toenail surgery done. In case of infections, one must stop all the home remedies.

Ingrown Toenail Treatment with Surgery

There are various ingrown toenail surgery treatments, but the most effective is partial nail removal which involves removing only that piece of the nail which is digging into your skin. The doctor numbs the toe and then narrows the nail. In the procedure, the sides of the nail are cut away to keep the edges straight, and a piece of cotton is placed under the remaining portion of the nail. This prevents the ingrown nail from recurring. 

Total nail removal may be used if an ingrown toenail is caused due to thickening. The doctor may recommend doing one of the following things for your toenail 

1. For a small case of an ingrown toenail, the doctor may gently lift the toenail edge and place cotton, dental floss, or a splint under it. This will separate the nail from the skin and help in growing the nail above the skin’s edge. This usually takes around 2-12 weeks. At home, the material needs to be replaced daily. 
2. The doctor may pull the skin away with the tape.
3. The doctor may numb the toe and slip a tiny slit tube under the nail. This splint stays in place until the nail has grown above the edge and reduces the pain.
4. For more severe cases, the doctor may suggest numbing the toe and removing the ingrown portion of the nail.
5. If a person keeps having this issue on the same toe repeatedly, the healthcare provider may suggest removing that portion of the nail along with the underlying tissue that is the nail bed. This procedure will prevent the growth of that part.

If this problem is left untreated, the ingrown toenail infection will cause an infection in the bone in your toe. If a person has diabetes, then a foot infection may be more serious. Even a small cut, scrape, or ingrown toenail may become infected due to a lack of blood flow and nerve sensitivity. If the person has a genetic predisposition to ingrown nails, then the ingrown nail may keep coming back or appear on multiple toes at once. 

When to see a doctor?

A problem like an ingrown toenail may seem like a minor foot problem but may cause serious complications in some people. A person should see a doctor if they have an ingrown toenail along with medical conditions like diabetes that affect the blood circulation in the body or have a compromised immune system. See a doctor if the pain and swelling on your toe are severe and causing you problems. For more information and a hassle-free experience, contact expert team of HexaHealth.