Toenails are generally pretty innocuous. They’re rarely threatening
(except, of course, when toenail clippings fly across the room like tiny
bits of organic shrapnel at slightly less than the speed of sound).
Usually, toenails grow straight out, keeping a nice noninterference policy
with the rest of the toe. There are times, however, when nails begin to
turn on you. One or both of the sides or corners of the nail begin to curve
downward into the toe, causing the skin around the nail to become irritated
and painful. At times, the nail may even penetrate the skin, letting in
bacteria that decide that the toe is a fabulous place to live (and these
are guests you definitely don’t want to have around).
There are many possible causes or contributing factors for ingrown
toenails. If you have a family history of malevolent nails, or if you have
nails that already seem to curve down on the sides, you may be susceptible.
Pressure on your toes from too-tight shoes or socks may also lead to
ingrown toenails, as can trauma (like stubbing your toe on the corner of
your bed in the middle of the night, dropping a brick on your foot, or
kicking a soccer ball (or bowling ball, for that matter) a bit too hard).
Certain nail conditions, such as fungal infections in your nail bed may
Improper trimming of your toenails may also be a significant factor.
Cutting nails too short (you should be able to get your fingernail under
the sides and end of your newly trimmed toenail) or trimming down the sides
of the nail (you should trim straight across) can lead to problems. Peeling
or tearing the corners of the nail can also be harmful.
Oh. And keep in mind that, while ingrown toenails most commonly occur on
the big toe, any toenail may be affected.
Your first clue that your nail has gone from friendly to malicious is
inflammation around your toenail. This will manifest itself as pain,
warmth, redness, and swelling. You may also develop a callus along the side
of your nail in response to an increase in pressure from your ingrown
toenail and the associated swelling. Or, it’s possible that you’ll just
have a toenail that appears to go pretty deeply down into your skin. If an
infection develops, things usually get a little more nasty. You may notice
drainage accompanied by a bad smell, and there may be a collection of pus.
(Yes. It’s pretty gross.)
If you suspect you have an ingrown toenail, it’s probably best to go see
your podiatrist about it, especially if infection is present. Definitely
see your foot doctor if you have diabetes, nerve damage, or poor
circulation in your foot. Your podiatrist should be able to make the
diagnosis by performing a physical exam of your toe. (X-rays and such are
pretty much unnecessary in diagnosing an ingrown toenail.)
If you do not have an infection in your toe, you may be able to get away
with just doing some home treatments (unless you’re diabetic or have nerve
or circulation problems in your foot). You can soak your foot in warm water
or salt water three or four times a day, and gently massage the sides of
your nail to help reduce inflammation. Then, apply antiseptic and a bandage
over your toe. You may want to wear shoes, like sandals, that put no
pressure on your toe while it heals. Don’t try to perform the endearingly
named “bathroom surgery” by attempting to cut out the ingrown portion of
your nail yourself. Also, (although you may have heard different from your
best friend’s mother-in-law’s cousin’s wife) doing things like cutting a V-
shape in the end of your toenail is pretty much useless. (Some believe that
it allows the edges of an ingrown nail to grow together, but nail growth
depends on the nail root, not the end of the nail. The V-method simply
If your nail fails to improve, or if you have an infection in your toe or
other medical problems, your podiatrist can help bring your ingrown toenail
back from the dark side. He or she will likely inject a local anesthetic
into the area and remove the side of the nail that’s causing the problem.
Your podiatrist may also opt to destroy the portion of your nail root
that’s contributing to the ingrown nail (especially if this is a recurring
problem for you). This may be done by using acid to destroy the root, or by
using a laser. (Who knew treatments for ingrown toenails could be so close
to science fiction?) Your podiatrist will also likely prescribe an
antibiotic to clear up the infection in your toe. (Be sure to take all of
the prescribed medication, by the way, even if your symptoms appear to have
You’ll probably want to stay off your foot and keep it elevated for a few
hours, but you should be able to resume many normal activities the next day
(although you’ll want to avoid vigorous movements like running for about
two weeks). Occasionally, the entire nail may fall off after surgery; a new
nail will grow over the next few months, although it will probably be a bit
more narrow if your podiatrist has destroyed a portion of the nail root.
With the ingrown portion and accompanying infection taken care of, your
toenail should reassume that harmless nature we love so well. Just treat it
as well as you can, or it may show its destructive side once again.
Call 719-543-2476 today to schedule your appointment!