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Ingrown toenails are one of the most common and painful complaints

Ingrown toenails are one of the most common and most painful nail complaints seen by podiatrists. Ingrown nails are often a splinter or spike of nail that is left after the nail is cut and it continues to grow, digging into the soft tissue on the side of the nail. Often this also leads to redness, swelling and can be extremely painful. In more severe cases, it can become infected, producing pus and bleeding. Usually, toenails grow straight out, but sometimes one or both corners of the nail curve and grow into the side of the toe. Any of the toenails can become ingrown, but it is most common in the big toe.

Causes of ingrown toenails

• The most common cause of ingrown toenails is improperly trimmed nails.

• Heredity – the size and shape of the nail is too large for the toe and have curled edges.

• Tight shoes causing pressure and crowding the toes.

• Repeated trauma or injury to the feet from normal or sporting activities.

• Tight socks can push the soft tissue onto the nail so that it pierces the skin.

• Having a fungus in the nail can cause it to grow thick and into the side of the toe.

Who gets ingrown toenails

• Ingrown toenails are more common in teenagers, especially those who are active in sports like soccer.

• Persons who pick their nails or cut them too low.

• Persons who wear socks/tight support hoses or narrow mouth shoes with tight toe boxes.

• Pregnant women or mothers who recently had their babies seem to be at higher risk for ingrown toenails.

How to prevent
ingrown toenails

Cut the nails straight across, but don’t cut nail too low – no longer or shorter than the edge of the toe. The corner of the nail should be visible above the skin at the sides of the toe. It’s better to cut the nails after a bath or shower when they are softer and easier to cut. Good hygiene can go a long way to preventing ingrown toenails. Avoid moist feet if you sweat on your feet by rotating your footwear so they can dry out. Choose cotton socks and leather shoes or other breathable material that fit well. Protect the feet from trauma and wear shoes and socks with lots of room for the toes. Keep the feet clean and dry at all times.

If left untreated, and they become infected, the infection can spread to the rest of the toe and foot. Diabetics can get a bone infection that can sadly result in an amputation. The quicker you treat the ingrown toenail, the less painful the toe will be and the result will be better.


Treatment depends on the severity of the ingrown toenail. Many persons will try to cut the ingrown nail out themselves or maybe go to the nail salon. The ingrown toenail will return and they will have to constantly dig and cut the nail every couple of weeks when it grows back. This is because the cause of the ingrown toenail is more extensive and further back on the nail than they can reach.

For the most basic ingrown toenail, the podiatrist will carefully remove the spike of nail that’s causing the problem. The podiatrist will use a local anesthetic to numb the toe, before removing the portion of nail that is ingrown. The podiatrist will cut the ingrown portion of the nail and the matrix area where nail grows from. Topical or oral medication may also be ordered to treat the infection and help the toe to heal. Very seldom are antibiotics needed to treat this condition as long as the ingrown portion of the nail is removed.

If ingrown nails are a chronic problem, the podiatrist will perform a procedure to permanently remove the ingrown nail and prevent them from coming back. The corner of the nail along with the matrix or root of that piece of nail, is removed and medication is added to prevent re-growth. This procedure was developed by podiatrists and is shown to be over 97 percent successful. After the procedure, the nail will be narrower but this often goes unnoticed. You will have to return to the clinic so the podiatrist can make sure the toe heals correctly.

If you have an ingrown toenail you should see a podiatrist as soon as possible. While you are waiting to see the podiatrist, if the toe is painful or having a lot of drainage (pus, blood), soak the toe in cool tap water and vinegar or a basin of soapy water, then apply an antiseptic and a Band-aid to the area. Other do-it-yourself treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided. Rest your foot as much as possible and wear shoes with plenty of room, or open toes. People with diabetes and poor circulation should not try to treat the ingrown nail at home, but visit the podiatrist as soon as possible.

• For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820; or email foothealth242@hotmail.com; or visit www.apma.org.


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