Ingrown Toenails
An ingrown toenail is a term used when a nail is "digging in" to the skin. This can most commonly be caused from increased in curvature of the nail or thickness of the nail. Other causes would include thickening of the skin of the peri-nail border, increased pressure either directly or laterally from shoegear, callus formation, debris deposition, trauma, or improper trimming of the nails.
When this occurs pain, redness and drainage may be present. At this point the nail border may actually lacerate or penetrate the skin increasing chance of infection by bacteria.
Although home treatment is not recommended it is important that if you suspect an ingrown toenail that you take steps to reduce the chances of infection as much as possible. This would include cleaning the foot using soap and water, Epsom salts soaks to reduce swelling, keeping the foot clean and dry (avoiding hot tubs, swimming pools, etc.), wearing socks and appropriate shoegear, and topical antibiotics, and schedule an appointment to see your Doctor. Do not use hydrogen peroxide, bleach, or other caustic agents that may traumatize the affected area. If there is pus, foul odor, or fever see your doctor urgently.
Once evaluated by your foot and ankle surgeon they will be able to provide you with options for the best course of action. Options may include manually trimming the nail border back, anesthetizing the toe in the office and removing the nail border(s) either temporarily or permanently, or transferring care to a hospital setting for appropriate medical treatment.
Important notes about prevention: notching the center of the nail has not shown to reduce the tendency of ingrown toenails. Placing objects such as cotton or toothpicks under the corners of the nails does not reduce your chance of reoccurrence and may actually cause damage to the nail and skin increasing your chances of infection. Aggressive trimming to the borders/corners of the nails may actually cause increased chance of an ingrown toenail as the nail is no longer acting as a barrier/border for the skin. Over-the-counter medications/devices have been shown to be ineffective.
When this occurs pain, redness and drainage may be present. At this point the nail border may actually lacerate or penetrate the skin increasing chance of infection by bacteria.
Although home treatment is not recommended it is important that if you suspect an ingrown toenail that you take steps to reduce the chances of infection as much as possible. This would include cleaning the foot using soap and water, Epsom salts soaks to reduce swelling, keeping the foot clean and dry (avoiding hot tubs, swimming pools, etc.), wearing socks and appropriate shoegear, and topical antibiotics, and schedule an appointment to see your Doctor. Do not use hydrogen peroxide, bleach, or other caustic agents that may traumatize the affected area. If there is pus, foul odor, or fever see your doctor urgently.
Once evaluated by your foot and ankle surgeon they will be able to provide you with options for the best course of action. Options may include manually trimming the nail border back, anesthetizing the toe in the office and removing the nail border(s) either temporarily or permanently, or transferring care to a hospital setting for appropriate medical treatment.
Important notes about prevention: notching the center of the nail has not shown to reduce the tendency of ingrown toenails. Placing objects such as cotton or toothpicks under the corners of the nails does not reduce your chance of reoccurrence and may actually cause damage to the nail and skin increasing your chances of infection. Aggressive trimming to the borders/corners of the nails may actually cause increased chance of an ingrown toenail as the nail is no longer acting as a barrier/border for the skin. Over-the-counter medications/devices have been shown to be ineffective.