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Ingrowing Toenails

What is an ingrowing toenail?

ingrowing toenail

An ingrowing toenail is a common condition which may cause discomfort and can become infected. Various treatments can be given by a Chiropodist / Podiatrist who is a person qualified to diagnose and treat foot disorders. See your Chiropodist / Podiatrist if you have symptoms of infection, inflamation around the nail, particularly if you have diabetes, a poor immune system or other foot problems.

What causes ingrowing toenails?

The nail becomes ingrowing when the side of the nail cuts into the skin next to the nail. This can become painful. Any toe can be affected, but it is usually the big toe. It is a common problem, affecting all age groups.

Ingrowing toenails are usually caused by a sharp spike of nail growing into the skin beside it. This can happen as a result of various factors.

Not trimming your nails correctly, wearing poorly-fitting shoes or tight socks, and sweating a lot (during exercise for example) can all contribute. Shoes which force the toes towards each other encourage the nail to grow into the skin. For example, tight shoes, high heels and pointed-toe shoes.

Active, sporty people may be more prone to ingrowing toenails as they sweat more and may not tie their laces appropriately. Ingrowing toenails may occur more often in people who have nails which are deformed in some way. Often there is no apparent reason why it occurs.

It is also more common in people who cut their toenails very short and round. The correct way of cutting nails is straight across (see below). This helps the nail to grow normally and may prevent ingrowing toenails from developing.

What are the symptoms of an ingrowing toenail?

Early on, the skin around the ingrowing nail may become reddened and feel slightly tender. If it progresses and becomes infected, it may become more swollen, red and painful. If the infection gets worse, there may be some yellow or green fluid (pus) oozing from around the nail. It will become even more painful and there may be an overgrowth of skin around the nail.

What is the treatment for an ingrowing toenail?

Ingrowing toenails are treated by a Chiropodist / Podiatrist. The offending spike of nail can be removed by your Chiropodist / Podiatrist.

You can also have nail surgery as a permanent resolution for the offending nail following consultation with your Chiropodist / Podiatrist to see whether you are a suitable candidate for the procedure.

If the nail fold becomes infected

Symptoms of infection are increased pain, swelling and redness near the ingrowing nail, and yellow or green fluid (pus) near the nail or under the nearby skin. If the infection is getting worse, you may experience a throbbing pain, redness spreading over the toe, or a high temperature (fever).

Antibiotics are needed to treat the infection. It can also help to soak your feet in warm salty water, then carefully dry and rest your feet.

When should I see a doctor?

See a doctor if:

  • You have symptoms of infection (as above). If you also have diabetes or a poor immune system, see a doctor urgently, as infections will need treating quickly.

For persistent ingrowing toenails

It may be necessary to remove part of the nail. The usual procedure is as follows:

  • The toe is made numb and painless by injecting local anaesthetic into the base of the toe.
  • The toenail is then cut with scissors longways a few millimetres in from the offending edge.
  • It is cut right up to the base of the toenail and the offending edge can then be pulled out.
  • A small amount of acid (called phenol) is put on the exposed part of the nail bed. This helps to stop the edge of nail regrowing and causing another ingrown nail.
  • The nail is then dressed.

Once the anaesthetic wears off the toe may be sore so you may need mild painkillers such as paracetamol for a day or so. You will probably have to wear a bandage for about 4-6 weeks. During this time you will not be able to go swimming, strenuous exercise, such as running, playing football, contact sports or ballet. After the operation, the nail will be narrower than before.

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