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Ingrown Toenails

Updated: Oct 6, 2022

What is an ingrowing nail?

An ingrowing nail is any nail that is growing into the skin. Sometimes this can be the corner of the nail growing into the skin; other times, it can be the skin is being pushed onto the nail.

Ingrowing nails are usually very painful. Imagine the point of a knife being pushed into your skin; that's pretty much the same effect as the nail being pushed into your skin. They are also at risk of getting infected due to broken skin. This is because your feet are often in an area with excess bacteria, such as sweaty shoes or dirty floors.

What causes ingrown toenails?

Many ingrowing nails that we see are caused by a combination of different factors. The main ones are:

Genetic nail shape - Wide and fan-shaped nails are at more significant risk than straight-sided nails. This is predetermined by genetics but does not necessarily mean the nail will definitely become ingrown.

Faulty nail cutting - Cutting nails too short or cutting down the sides is a massive cause of ingrowing nails, especially if the nail's corner is not cut correctly and a spike is left.

Picking or biting the nails - This is a habit that we see a lot of in younger people and can often produce quite severe cases of ingrown toenails due to the nail edge being jagged.

Footwear - Tight-fitting shoes and/or socks can push the skin onto the nail. In these cases, pain is felt along the entire nail edge rather than in the corners. They are often linked with wide and fan-shaped nails.

Trauma - damaging the nail by dropping something on it or kicking something can damage the nail in such a way that the nail ends up growing into the skin.

Change in nail shape, age, medication - Nails can change shape and thickness due to trauma, changes in circulation and as a side effect of medication. Often a nail will change from relatively flat to U-shaped. Sometimes people end up with a pincer nail where the edges of the nail meet. Both U-shaped and pincer nails are at high risk of ingrowing.

Home treatment of ingrown toenails

Prevention is always better than cure. The best prevention is stopping habits causing the issue, such as cutting nails too short and picking at them. If you find a particular pair of shoes causing discomfort, stop wearing them.

Be cautious with home treatments as ingrowing nails can turn very bad very quickly, and it is easy to make them worse. But if prevention does not work, there are things you can do at home:

  • Saline wash. If the nail is hurting, soak your toe in warm salty water for 10 minutes. This will help prevent infection and soften the nail.

  • Oil or nail softener. Warm olive oil or nail softener can help remove dead skin that can get trapped next to the nail. Often when the dead skin has been removed, the toe feels much better. DO NOT go prodding down the side of the nail too much, as this can worsen the situation and cause infection.

  • Remove anything that is aggravating the issue, mainly tight footwear.

Things you should not do at home when suffering from an ingrown toenail:

  • Cutting a V-shaped notch into the nail will do nothing at all.

  • Do not cut down the side of the nail trying to remove spikes. You may successfully remove the spike, but 9/10 people end up making the situation a lot worse by making the spike bigger or causing infection.

  • Do not put anything such as cotton wool or dental floss under the nail or between the nail and skin. Although this can reduce pain, it can also induce infection and get stuck under the nail.

Professional ingrown toenail treatment

It is best to get help earlier rather than later. The longer you leave it, the more painful it will be, and there will be a greater chance of infection.

It is best to get help when:

  • The toe becomes red and inflamed, there is puss present, the area is constantly weeping or bleeding, or the toe has a bad smell.

  • It is super important to get help if you see red 'spider leg' lines travelling up the toe or if the inflammation starts to spread.

  • You have tried the above home treatments for more than 2-3 days without a significant improvement.

What can a podiatrist do to treat ingrown toenails?

A HCPC registered podiatrist is the best person possible to treat ingrown toenails. We can:

  • Perform a more extreme nail cut that is safer than at home. We have all the right tools and experience to ensure the nail's edge is smooth and has no spikes. This can be painful, but thankfully we can use local anaesthetic if needed. This completely numbs the toe so that you do not feel any pain.

  • A podiatrist can issue antibiotics if there is an infection. If there is an infection present, we can give you antibiotics without you having to see your doctor.

  • Nail surgery. If needed, a podiatrist can carry out surgery to permanently remove a section of the nail. We only do this if the nail has become a persistent issue. We will always try more conservative treatments first, and we will rarely carry out this procedure on your first visit.

*This blog contains general information about medical conditions and is not advice. You must not rely upon the information in this blog as medical advice. Medical advice should always be sought from an appropriately qualified podiatrist such as ourselves.

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