Foot Health

Painful ingrown toenails

Ingrown toenails are one of the most common and most painful nail complaints seen by the podiatrist. Ingrown nails are often a splinter or spike of nail growing into the soft tissue on the side of the nail, often leading 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. Sometimes, however, one or both corners or sides of the nail curve and grow into the flesh. Any toenail can become ingrown, but the problem more often affects the big toe.


What causes ingrown toenails?

• Most common cause is improperly trimmed nails.

• Heredity – the nail is wide and flat, just too large for the toe or curved at the edges.

• Tight shoes causing pressure and crowding the toes. This can push your toe onto the nail so that it cuts the skin and can cause pain and infection.

• Repeated trauma to the toe such as stubbing the toe, having the toe stepped on or playing sports like soccer may also cause ingrown toenails.


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 or into the corners.

• Persons who wear tight socks or support hose or narrow mouth shoes with tight toe boxes that squeeze the toes.

• Pregnant women or mothers who recently had their babies seem to be at higher risk for ingrown toenails because of the swelling in the feet and toes.


Here’s what you can do to prevent ingrown toenails

Cut the nails straight across, don’t cut too low or into the corners. The corner of the nail should be visible above the skin. 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 prevent ingrown toenails. Avoid moist feet by rotating your footwear so they can dry out thoroughly. Choose cotton socks and leather shoes or other materials that are breathable and fit well. Protect the feet from trauma and to wear shoes and socks with adequate room for the toes. Keep the feet clean and dry at all times.


How is an ingrown toenail treated?

Treatment depends on the severity of the ingrown toenail. For the most basic ingrown toenail, the podiatrist will easily cut the offending spike of nail causing the problem. If the ingrown toenail progresses and becomes too painful to touch, the podiatrist may have to use a local anesthetic to numb the toe before removing the offending portion of nail. The podiatrist will cut out the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. 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, your podiatrist can perform a surgical procedure to permanently prevent ingrown nails from coming back. The corner of the nail that grows in, along with the matrix or root of that piece of nail, is removed and a chemical is used to prevent regrowth. This procedure was developed by podiatrists many years ago and is shown to be over 97 percent successful. After the procedure, the nail will be narrower, but this often goes unnoticed and the ingrown will not reoccur. It may take two or more weeks for the toenail to heal, based on the severity of the ingrown. You will have to return to the clinic so the podiatrist can make sure the toe is healing 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 you suspect an infection or if the toe is painful or having a lot of drainage (pus, blood), soak the toe in cool water and vinegar or in a basin of cool soapy water, then apply an antibiotic ointment and a Band-Aid to the area. Other “do-it-yourself” treatments such as attempting to remove any part of the nail or using over-the-counter medications, should be avoided. Rest your foot as much as possible and wear shoes with plenty of room, or with open toes. People with diabetes and poor circulation should take special care, and do not try to treat the ingrown toenail at home, see the podiatrist as soon as possible.

Are ingrown toenails serious?

If left untreated, they become infected and the infection can spread to the rest of the toe and foot. The quicker you treat them, the less painful the toe and the treatment.

  
• For more information, email us at foothealth242@gmail.com or visit www.apma.org. To see a podiatrist, telephone 325-2996 for an appointment, visit Bahamas Foot Centre on Rosetta Street, or call 394-5824 for an appointment; or visit Bahamas Surgical Associates Centre on Hilltop Medical Centre off 4th Terrace Collins Avenue. In Grand Bahama, call Lucayan Medical Centre at 373-7400 for an appointment. 

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