Ingrown ToeNail Problems

Ingrown Toenail Challenges

An Ingrown toenail is a commonly-occurring problem in which the edges of the toenail grow sideways into the surrounding soft tissue. This can cause large amounts of pain and inflammation, and even infection. Ingrown toenails most frequently affect the big toe.

While it is possible to treat an ingrown toenail at home, worsening or severe pain can be indicative of a need to see your podiatrist. They can treat your ingrown toenail in order to relieve pain and the infection while avoiding future complications or a worsening of the problem.

Some patients, such as those with diabetes or those with poor blood circulation, are at a higher risk of developing various complications due to an ingrown toenail.

Symptoms

Indications of an ingrown toenail include:

  • The area around either side of the nail is painful to the touch

  • Red coloration around the nail

  • The area around the nail is inflamed or swollen

  • Area surrounding toenail has an infection

When to see a doctor

If you notice any of the following, you should contact your podiatrist:

  • Severe or crippling pain around the toenail, or pain/redness that is expanding or spreading

  • If you have diabetes or overall poor blood circulation, you should contact your podiatrist anytime you notice pain or an infection in your foot including your toenail.

Causes

The following can lead to ingrown toenails:

  • Shoes that are too tight or push on your toenails

  • Improper cutting of the toenails or cutting too short

  • Stubbing or injuring your toe

  • Unusual growth shape/direction of the toenail

Complications

When an ingrown toenail is not noticed or not treated, a serious infection can develop. This infection can spread to the underlying bone and be a very serious medical problem.

Diabetes or poor blood flow can lead to improper healing of even minor injuries to the toe or foot. Gangrene, or tissue death, is frequently seen when even a minor wound such as a scrape or bruise is left untreated and never heals on its own.

Prevention

Steps you can take to prevent ing:

  • Cut/trim your nails straight across. It is important that, when trimming your toenails, you don’t follow the curve of your toe. Instead, cut them in a straight line across. If you get your nails trimmed at a salon instead of at home, make sure to inform your manicurist to cut the nails in the proper straight-across fashion.. If you have diabetes or poor blood circulation, see your doctor to have your nails cut as it provides a perfect opportunity for them to check your feet for unnoticed developing problems

  • Trim toenails to the proper length. When you are trimming your toenails, it is important to trim them even with the ends of the toes. Trimming a toenail too short can lead to the nail growing sideways into the skin when it receives pressure from the shoe.

  • Make sure your shoes fit correctly. If your shoes put excess pressure on your feet or toes, it can lead to the nail being pushed into the surrounding tissue.Those with nerve damage to their feet may not even notice this pressure and might not know their shoes do not fit correctly. Make sure to buy shoes that fit well, with no pressure on the toes, and those with foot conditions will benefit from shopping from a store that specializes in fitting shoes to your foot.

  • Make sure your footwear protects you. If you work in a job that requires work boots or you frequently hit your toes, make sure to buy footwear such as steel-toed boots that protect your toes from impact damage.

  • Monitor your foot health. If you have diabetes, poor blood circulation, or nerve damage,  do a daily inspection of your feet and toes in order to notice any developing problems such as cuts, swelling, or an ingrown toenail.

 

Diagnosis

Performing a physical examination of the toes in question, along with knowing your sympotms, will allow your doctor to diagnose your ingrown toenail or foot infection.

Treatment

  • Ingrown toenail treatment

If at-home solutions have not worked, your podiatrist may recommend any of the following:

  • Raising the toenail. For an early ingrown toenail that shows redness but no infection, the podiatrist may choose to raise the nail and insert a cotton or other soft splint  This will prevent the nail frow growing into the surrounding soft tissue. The doctor will show you how to clean and replace this splint daily at home.

  • Removing a part of the toenail. When the ingrown toenail leads to severe pain or infection, your podiatrist may choose to remove part of the nail via trimming. Anesthetic is used to numb the toe prior to this procedure.

  • Preventing poor growth. If ingrown toenails occur frequently on the same toes, the podiatrist may elect to remove both part of the nail and the nail bed. Removal of the nail bed will prevent future sideways growth. This is done via laser, chemical, or other methods.

If there is an infection or risk of infection present, your podiatrist will likely prescribe some combination of oral or topical antibiotics.

Lifestyle and home remedies

Most ingrown toenails can be treated using the following home remedies:

  • Soaking the feet. Soaking the feet and toenails for fifteen to twenty minutes each day in warm water can lead to reduced swelling and redness in the affected area.

  • Raising the toenail. After soaking the nail, you can place small amounts of cotton or waxy dental floss under the nail in order to raise it and stop it from growing into the sides of the toe.

  • Using topical antibiotics. Use a topical antibiotic and a bandage to prevent infections on a ingrown toenail.

  • Change up your footwear. Until your ingrown toenail resolves, it may be ideal to switch to flip flops, sandals, or other open toed shoes.

  • Pain relief. Pain in the toes may be relieved by pain relievers available at your local pharmacy, including Tylenol, ibuprofen, and Aleve.

Preparing for your appointment

An ingrown toenail can be diagnosed by your normal doctor or your local podiatrist. Before your appointment, you may want to ready some questions to ask your healthcare provider. The following are some questions that you may benefit from asking:

  • Is this problem a short term or long term, repeating problem?

  • What are the benefits and downsides of each possible treatment?

  • What will I see improvement in after treatment?

  • Will this problem go away on its own?

  • While my toe is healing, what care routine would you suggest for my nails?

Your podiatrist or doctor may ask the following:

  • When did symptoms first occur?

  • Are these symptoms always present?

  • Have you used any home remedies?

  • Do you have poor blood circulation, nerve damage, or diabetes?

Are some people more prone to ingrown toenails?

There are numerous risk factors to developing frequent ingrown toenails. Some of the more common include:

  • Athletes, especially those with foot contact or stop-and go sports, such as soccer, football, and running

  • Those with shoes that don’t fit properly

  • Those that have suffered repeat trauma or impacts to the toes or feet

  • Improper foot care, nail maintenance, and hygiene.

  • Pronation of the foot or other unusual foot or stride mechanics

  • Hammertoes, flat feet, bunions, or other foot deformities

  • Toe or toenail deformity present at birth

  • Long or larger than normal toes

  • Obesity

  • Diabetes

  • Swelling caused by Heart, kidney, and thyroid problems.

  • Onychomycosis, which is a fungal nail infection

  • Arthritis

  • Tumors of the bone or soft tissue

  • Excessive foot sweating (Hyperhidrosis)

  • Fluid buildup, or edema, of the feet

Which nails are most commonly affected by ingrown toenails?

The nails of the large or great toe are the most frequently affected toenails.  Ingrown toenails occur more often whenever the large toe is shorter than the toes next to it.  Ingrown toenails are possible in any toe, however, on either side of the nail.

What causes infections in ingrown toenails?

Common bacteria and fungi, such as Trichophyton, Pseudomonas, Staphylococcus, Candida, and dermatophytes thrive in humid, moist warm areas such as those found in the feet. A sideways growing nail can pierce the skin, opening a path for infection as the bacteria enter the wound. It is essential to treat the affected area for infection to maintain proper foot health. Paronychia is the medical name for an ingrown toenail that becomes infected . Chronic pain, cellulitis, disfigurement, and bone infection can all arise from an untreated infected toenail.

What are ingrown toenail symptoms and signs?

Inflammation, redness, swelling, and pain are all indicative of an ingrown toenail. Pus or yellow drainage may be seen in the case of an infection.  Kids and small children might be seen walking or running with a limp, possibly due to avoiding walking on the ingrown or infected toenail. While rare, it is possible for an ingrown toenail to resolve itself without needing treatment.  You should see a podiatrist if your ingrown toenails are painful, persistent, or recurring . Granulation tissue, or tissue that bleeds very easily, may form if the toenail is left untreated for an extended period of time.

 

How do physicians diagnose an ingrown toenail?

Tools are usually not necessary for the diagnoses of an ingrown toenail. You dont needDiagnostic labs, x rays, and other modalities.  A thourough history and physical and a good physical examwill uncover the various signs and symptoms. These can have a wide variation between one case of an ingrown toenail and another. And if there is infection present those vary even more. Soreness at the nail borders is often present with an ingrown toenail. The nail border often presses into the skin on the sides of the toenail. Local inflammation – redness and edema- around the nail edges is seen commonly and used to diagnose a patient with an ingrown toenail. Infection presents as inflammation, redness, creamy pus, and a lot of tenderness.