Ingrown Toenail
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Definition
An ingrown toenail happens when a portion of the toenail curves into the flesh of the toe. It then imbeds itself in the soft tissue. It can occur on any of the toes. However, it usually occurs on one of the big toes.

Ingrown Toenail

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Causes
Trauma and improper nail care makes the nail curve and overgrow into the flesh of the toe.

Risk Factors
The main risk factor that increases your chances of having ingrown toenails is having family members with ingrown toenails.

Other risk factors include:

  • Improper cutting or trimming of the toenail
  • Wearing footwear that is too tight
  • Repeated trauma to the toes, often due to sports activities
  • Diabetes
  • Fungal infections of the toenails
  • Turner syndrome
  • Arthritis
  • Gout
Symptoms
Ingrown toenails often do not cause symptoms at first. Eventually, the following symptoms may develop:

  • Pain—sometimes severe
  • Redness
  • Swelling
  • Warmth
  • Pus draining from the area
Diagnosis
In almost all cases, you or your doctor can diagnose an ingrown toenail based on the location and the symptoms.

In rare cases, you may need an x-ray . For example, if your doctor suspects an infection may have spread to the toe bone.

Treatment
You may be able to treat an ingrown toenail yourself if you catch it early. If the condition gets worse or does not improve, you will need to seek medical care. If you have diabetes, you must seek medical attention for any infection or wound involving your feet or toes.

Self-care
  • Wear open-toed shoes or sandals until the pain and swelling of the nail subsides. This will reduce any pressure on the toenail.
  • Soak your foot in warm water for 15 minutes, 3-4 times a day.
  • After soaking, dry your foot and toe thoroughly.
  • As the toenail grows out, cut it straight across.
  • Promptly seek medical care for an ingrown toenail if you have any of the following conditions:
    • Fever
    • An ingrown toenail that is severe, worsening, or not getting better
    • Diabetes
    • Age: over 50 years
    • Circulatory problems
    • A disorder of your immune system
    • Any other chronic health problem
Medical Care
Your doctor may recommend the following treatments:

  • Oral antibiotic medication
  • Removing the ingrown portion of the toenail
  • Draining the area that has become infected
  • Using a splint to lift the corner of the nail away from the soft tissue of the toe
If you repeatedly get ingrown toenails, or your ingrown toenail is severe, your doctor may:

  • Remove a portion of the toenail and apply medicine to the site to prevent that portion of the nail from growing back
  • Remove the entire toenail so that the nail will not grow back
Prevention
To help prevent ingrown toenails:

  • Cut your toenails straight across and avoid rounding the edges. The corner of the nail should be visible above the skin of your toe.
  • Wear shoes and socks that fit properly and are not too tight.
  • Keep your feet clean.
  • Keep your feet dry by wearing cotton socks and/or using foot powder.



RESOURCES:
American Orthopaedic Foot and Ankle Society

American Podiatric Medical Association

CANADIAN RESOURCES:
Calgary Foot Clinic

Canadian Podiatric Medical Association

References:
Ingrown toenails. American Podiatric Medical Association website. Available at: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1522 . Accessed May 2, 2013.

Matsumoto K, Hashimoto I, et al. Resin splint as a new conservative treatment for ingrown toenails. J Med Invest . 2010;57(3-4):321-325.

The Merck Manual of Medical Information—Home Edition . Simon and Schuster, Inc.; 2000.

Roberts JR, et al. Clinical Procedures in Emergency Medicine . 4th ed. Saunders; 2004.

Woo SH, Kim IH. Surgical pearl: nail edge separation with dental floss for ingrown toenails. J Am Acad Dermatol . 2004;50(6):939-940.

Last Reviewed February 2014



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