Ronald W. Smith, M.D.

Ingrown Toenail

ingrownI.      Definition:  An ingrown toenail is a common disorder that occurs when your toenail grows in a way that the edges curl down into the skin of the toe, causing pain and discomfort.  It can occur on all toes, but most commonly in the big toe.  An infection can result, causing the skin at the side or tip of the nail to become red, swollen, and tender.  In some cases, pus drainage may develop.

II.      Cause:   Tight shoes or stockings can cause a toenail to become ingrown.   Improperly fit footwear can press the sides of the nail and encourage it to curl in to the skin of the toe.  Improper trimming of the toenail can also cause the problem.  Nails that are peeled off, rounded, or trimmed down into the corners are more likely to become ingrown.

III.      Treatment and Prevention:  Several steps can be taken to decrease the risk of developing ingrown toenails.

•    Cut nails straight across with no rounded corners.  Do not pick at toenails or tear them off.
•    Make sure your shoes and stockings are not too tight.
•    Keep your feet clean at all times.

While some ingrown toenails can be treated effectively with proper foot care and home treatment, severe cases may require medical advice.  You should see an orthopaedic specialist if an ingrown toenail develops pus, or infection and/or pain persists for longer than 1 week.  Your orthopaedic specialist may recommend any of the following treatments:

•    Reduce the inflammation by soaking the toe in warm water saturated with table salt.  Repeat several times a day.
•    Wear open-toed shoes or sandals to keep pressure off of the ingrown nail area.
•    Gently lift the ingrown nail from its embedded position and insert a strip of sterilized cotton between the nail and the skin.  Change this packing every day.
•    Minor surgery to remove part, or all, of the nail may be necessary if pain is severe or infection persists.

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