An ingrown toenail occurs when the edge of a toenail grows into the soft tissue of a toe. It can happen to any toe; however, it occurs more commonly with the nails of the big (great) toes. When a toenail penetrates the flesh of a toe, it causes pain, redness, and swelling. If left untreated, an ingrown toenail can lead to a bacterial infection of the skin, causing even more pain, redness, and swelling. An infection can also cause an odor-producing pus to form, which may or may not drain on its own. This infection, left untreated, can migrate into the bone of the toe, which requires aggressive IV antibiotics, surgery and possible removal of infected bone. Early intervention is so important!
Improperly trimming the toenails too short or with a curved shape at each corner can cause the nails to become ingrown as they grow out. Wearing tight shoes can crunch up the toes, putting pressure on the nails and forcing them into the skin. Repeated injuries to the toes from certain activities can cause trauma to the nail corners and force them to grow into the skin. Some patients also have a hereditary tendency for toenails to angle the wrong way and grow into the flesh.
If an infection of the skin around the ingrown toenail develops, Dr. Kraft may prescribe antibiotics and warm water soakings of the affected toe several times a day. Cotton inserts may be placed under the toenail to help lift it and provide comfort. If the doctor determines that the ingrown toenail needs to be removed, she numbs the affected area and removes the ingrown toenail and possibly nail root in a painless procedure.
To prevent recurrence of an ingrown toenail, Dr. Kraft suggests avoiding shoes with pointed, tight toe boxes and wearing properly fitting shoes with ample room at the toes instead. Using the appropriate method to trim the toenails is also important. Cutting them straight across without curves at the corners helps prevent the nails from growing into the skin. Patients with diabetes or peripheral vascular disease (poor circulation) need to make an appointment as soon as they notice an ingrown toenail, to prevent the development of serious medical complications.
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