Ingrown toenails (also known as onychocryptosis) occur when a piece of the nail grows into the surrounding skin. This can often cause discomfort and, if left untreated, may result in the nail piercing the skin and becoming infected.
Here are some of the risk factors that can increase your chance of developing ingrown nails:
Cutting the nail too short or digging down the side of the nail
Wearing shoes that are tight on the toes
Nail changes secondary to a fungal nail
Nail shape – broad and/or curved nail
Trauma to the nail
Sports that cause increased pressure on the toes (dancing, soccer, etc)
Certain medications causing changes to the nail (ie. chemotherapy drugs)
Ingrown toenails can be categorised into three stages, according to severity:
Stage 1 (Mild)
– The surrounding skin of the nail is red and perhaps swollen – Direct pressure on the nail may be painful – No pus or drainage
Stage 2 (Moderate)
– The toe becomes increasingly red, swollen and painful – Pus discharge – An infection may be present
Stage 3 (Severe)
– Symptoms of pain, redness and swelling have increased, possibly with the redness moving further toward the base of the nail – Hypergranulation tissue forms at the nail fold between the toenail and skin – A severe infection with fever may follow
How to treat ingrown toenails
Initial conservative treatment at Shellharbour Podiatry involves removing the segment of nail that is causing the issue. Depending on the expected level of discomfort, this can be performed with or without the use of local anaesthetic. Normally, patient’s are able to undergo this procedure with very little pain. We may also speak to you about preventative measures you can take to avoid it recurring in the future.
If the ingrown nail becomes an ongoing issue, we may recommend a procedure which involves the permanent removal of the troublesome nail piece. This is known as a partial nail avulsion. The procedure is performed within the clinic in a sterile environment to reduce the risk of infection. Local anaesthetic is administered so that the procedure is pain free. Once we remove the problematic section of nail, a topical solution is applied to the base of the nail ensuring that it does not grow back again. We will then provide you with post-operative instructions and review the patient at regular intervals for the following 2-3 weeks.
Kids’ feet are always growing which means that their current shoes may become too tight, causing increased pressure at the nail as their feet continue to develop. They are also common in children who play sports where greater pressure is placed on the toes in sports such as soccer, ballet, netball and football. Ingrown toenails also occur commonly in teenagers due to the increased oil and sweat production on their skin, making the skin more soft and prone to breaking.
If the toenail is left untreated, it may not resolve on its own. The pain and inflammation can progress further as mentioned in the stages above, increasing the chance of infection. If not dealt with appropriately this infection can continue to fester and result in severe enough pain that will even make daily activities miserable. Antibiotics may help manage the skin infection, however for an ingrown nail to fully resolve it requires the offending portion of the nail to be removed. This is why treatment is especially important for people with diabetes and poor circulation, as their risk of developing serious complications is greater.
This is an old fashioned remedy that was thought to prevent ingrowns by encouraging the nail to grow toward the centre. We do not recommend this technique as this will not affect the direction of nail growth, nor will it reduce the pressure of an ingrown nail. Cutting a “V” will only encourage the nail to catch onto socks and bed sheets, potentially causing the nail to tear.