The edges of a toenail can sometimes grow into the skin causing inflammation. This pressure from the ingrowing toenail leads to a condition known as onychocryptosis or simply ingrown toenail. In the initial stage, this problem only causes some minor discomfort. It can, however, cause the adjacent skin to be infected or become a recurring problem. This condition usually affects the large toes.
Ingrown toenails causes and risk factors
Who is prone to getting ingrown toenails?
- Athletes are more prone to this condition. Especially the ones participating in soccer
- High heels or tight shoes can force the nails to grow inwards.
- Trimming the nails in a curve or round manner can make the edges dig into the skin. Straight across is the way to trim your nails.
- Abnormal gait or movement can result to ingrown toenails.
- Deformities on the foot or toe such as hammertoes, bunions, and flat foot.
- Fungal infections cause widened or thickened toenails.
- Injuries to the nail, such as the ones sustained in sports, can cause ingrown nails.
- Poor foot hygiene can also lead to this condition.
- If your family has a history of ingrown toenails, chances are you will have it as well.
- Obesity
- Diabetes
- Congenital toenail deformity
- Arthritis
- Kidney, heart, and thyroid problems
- Abnormally long legs
- Excessive feet sweating
- Soft-tissue or bony tumors of the toes
Which nails are affected by ingrown toenails?
The large toes or big toes are usually the most affected by ingrown toenails. Furthermore, if your big toes are shorter than the next toe then the risk is even higher. This does not mean that the other toes are safe, ingrown toenails can affect the edges of any toe.
What will happen if you leave an ingrown toenail untreated?
Leaving an ingrown toenail untreated is risky because it can lead to infection. Worse off it can lead to an abscess that needs surgery. Everyone should look out for the ingrown toenail. It is common in teenagers and adults and not as common in children. The youth, between 20 to 30 years, are also more likely to get ingrown toenails.
Signs and symptoms of ingrown toenails
Ingrown toenails, as discussed, affects the big toes more frequently than the other toes, but any toe can be affected. Swelling at the edge of the nail, pain, and redness are some of the common signs of ingrown toenails. At the initial stages, the ingrown toenails cause a painful, red, mild swelling. At this stage, there is no pus and you will not have a fever. However, the place will be warm to touch.
Afterwards, tissue and extra skin will grow on the sharp end of the nail. This can be accompanied by some yellow pus. This is not an infection, necessarily, it is just how the body responds to the nail irritating the skin. Ingrown toenails become worse when an infection occurs. If infected, there will be yellow or white pus with increased swelling. This can sometimes be accompanied by fever.
What causes infections in ingrown toenails?
Fungi and bacteria such as Pseudomonas, Candida, Staphylococcus, Trichophyton, and Dermatophytes like breeding in moist and warm feet surroundings. In case an ingrown nail breaks the skin, these bacteria invade the area and cause an infection. An infected ingrown toenail is medically referred to as paronychia. Treating it is very important to have health feet and toenails. Moreover, if an infected ingrown toenail is ignored and not treated chronic pain, cellulitis, bone infection, and disfigurement will be the result.
Do you need to go to the doctor for an ingrown toenail?
Make an appointment with your doctor whenever you see signs that your ingrown toenail is infected. Even if the area is only inflamed. The following conditions and signs require medical attention:
- If the previous tetanus booster shot was more than 5 years ago.
- If you have AIDS, poor circulation, diabetes, or chemotherapy. This also include any condition that make wounds hard to heal.
- If home remedies do not cause any form of improvements.
Who treats ingrown toenails?
Podiatrists are the specialist when it comes ingrown toenails, together with any complications in the ankles and foot in general. Family doctors, dermatologists, hand surgeons, and orthopedic surgeons can also comfortably diagnose and treat ingrown nails.
How is ingrown toenails diagnosed?
Any of the professionals mentioned above will diagnose the ingrown toenail and decide whether or not it is infected. They will also decide on how to treat it. You will be asked questions on how the condition started with focus on any foot injuries and lifestyle. Any medical problems you have, allergies, the last tetanus immunization, and any medication you are taking should also be known.
The doctor will also give you a thorough examination of the toenail, foot, and the groin lymph nodes. Your temperature, blood pressure, and pulse will also be checked. A foot X-ray may also be necessary. A serious infection or a history of diabetes may call for blood tests.
What complications can result from ingrown toenails?
An ingrown toenail is initially only a minor inconvenience. However, if it persists, it becomes very harmful. An infection on the nail edge, which is known as paronychia, can grow into a soft-tissue infection, medically referred to as cellulitis. This cellulitis can grow deeper into osteomyelitis, a bone infection. Other complications resulting from ingrown toenails include:
- Thickened toenails
- Deformed toenails
- Scarring on the nail borders
- Fungal toenails
How to treat ingrown toenails?
A conservative treatment for ingrown toenails is recommended if there are no signs of an infection. The nail will be elevated and the doctor will advise you to alway clean your feet properly, wear proper-fitting shoes, and warm soaks.
The doctor can at times use splints that protect the skin from the sharp edges of nails. Splints are of different variety each working with the same purpose. They can be plastic strips, cotton wicks, resins, and even plastic tubes.
The doctor can also attempt to change the shape or direction in which the nail grows, that is, make the nail grow outwards rather than inwards. This is done by trimming the nail to the centre. A hard plastic can be added to force the nail to grow straight and flat.
Sometimes an extra tissue grows in the area, this will have to be removed first so as to help the inflamed area to heal faster. The place will be numbed and removed by the doctor.
How to treat ingrown toenail at home?
Home remedies should be your first option to treat ingrown toenails provided the condition is in the early stages.
- Soak your feet in plain warm water four times everyday. You don't have to add antibacterial agents, epsom salt, or soap in the water.
- Wash the affected area with soap two times a day. Also always keep the feet dry and clean.
- Avoid tight shoes and high heels. Sandals give your feet the best air circulation and hence the best option.
- The most important home remedy for ingrown toenails is the use of a cotton wick or roll. Roll a piece of cotton and after soaking your feet, elevate the bail and put it in between the skin and the nail. This is a little painful but will protect the skin from the pressure of the ingrown nail. Change the cotton daily. After two weeks, you will start to see some improvement, the nail will out and not in anymore.
- You can also take some painkiller such as ibuprofen or acetaminophen.
- If you see no improvements after the third day then visit a doctor.
Is surgery necessary for ingrown toenails?
Surgery may be required if the ingrown toenail is infected. Surgery is done on the entire nail or part of the nail and the pus is drained. The extent of the operation is determined by how severe the infection is, if the problem is recurring, and if the patient has any other medical conditions. This procedure is done at the doctors office.
How ingrown toenails are surgically removed?
To ensure the infection has not reached the bone, an X-ray can sometimes be taken.
- You will first be injected with an anesthesia.
- The pus in the infection will then be drained and if there is an extra tissue it will be removed.
- A part of the nail will then be removed to allow the wound to heal properly.
- At times, the part that is responsible for the growth of the ingrown nail will be destroyed. The doctor can do this by either conducting a direct surgical destruction or by use of a chemical. Destroying the nail matrix will ensure the edge of the nail that is causing the problem will not return.
- If the problem is recurring or severe, and other methods have failed, the entire nail matrix can be removed altogether.
Removing the portion of the nail bed is only considered in severe or recurrent cases. The name of this procedure is lateral matricectomy and is performed by a specialist.
Other procedures, the newer ones, do not involve altering the nail bed. Rather, they involve removing some of the soft tissue under or besides the nail to allow it to grow properly. A tube that is flexible can sometime be used along the side of the nail to help in the healing process. The toe is tied with a bandage after apply an ointment. These studies are yet to be adopted as a standard procedure since they are still under study but the results are promising.
Necessary follow-up after ingrown toenail surgery?
The toe dressing from the doctor should only stay on for two days. After that, the dressing should be removed and the toe cleaned with soap and water. You should then apply triple antibiotic cream which can be found in the drugstores. You then apply a new dressing. This should be repeated two times daily until the toe is fully healed.
The doctor will give you some instructions that you need to strictly follow. He or she may want to check on the would after every five days. They may also prescribe some antibiotics and give you detailed instructions on how to clean, dry and take care of the wound in general. You may also require to keep your feet elevated, that it, above the level of the heart. This is helpful with the pain in the first three days. Your feet should be okay to walk properly after two days to two weeks depending on the type of procedure. However, it won’t be quite well to engage in athletic activities just yet.
How does a nail look like after an ingrown nail surgery?
The nail will become narrower if a matrixectomy was conducted. This is only by a few millimeters from the nail edges. If no large portion of the nail was removed, there will be little to no effect on the general appearance of the nail. If the matrix was not damaged, the nail will grow back to its full width.
What are the likely complications of an ingrown toenail surgery?
Complications from an ingrown toenail surgery are very rare, but they can take place. Such complications include; a wound that heals slowly, infection after the surgery, recurrence of the problem, and prolonged tenderness. If you ignore the proper wound care as directed by your doctor then you are at risk of having complications with your wound. The good thing is that these complications can easily be managed. Prescribed antibiotics can deal with the infections.
The do’s and don’ts of ingrown toenails
Ingrown toenails do’s
- Wear shoes that give your toes room to wiggle without being too big.
- Remember to trim your toenails the right way, straight across.
- Avoid trauma or pressure on the toenails.
- Always maintain proper foot hygiene.
- Wear the right shoes when participating in sports.
- Always seek medical advice if home remedies are not working or if the symptoms persist.
Ingrown toenails don’ts
- The corners of a toenail should not be cut.
- Do not wear shoes that don’t fit you properly.
- Toenails should not be trimmed too short.
- Toenail surgery cannot be conducted at home by yourself.
Prevention of ingrown toenails
To prevent ingrown toenails, you ought to properly trim the toenails. You should cut the nails straight across. Ensure the nail is slightly longer than the skin edge so as not to dig into the skin. Short and rounded toenails are a risk. To be safe, you should also avoid shoes that are tight on your feet and always keep your feet clean and dry.
Conclusion about ingrown toenails
- This condition often occurs on the toenails of the big toes.
- Ingrown toenails is very common in athletes.
- Ingrown toenails can recur if not treated correctly.
- Toe injuries and improper shoes are connected to ingrown toenails.
- Home remedies include; proper nail cutting, proper foot hygiene, soaks, and elevation.
- In case of an infection, antibiotics may be required.
- In severe cases, a doctor can operate to treat ingrown toenails.
