• Ingrown Toenail

    Definition

    An ingrown toenail happens when a portion of the toenail curves into the flesh of the toe. It 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

    The most common causes of an ingrown toenail are:
    • Improper cutting or trimming of the toenail (rounding the edges of the nail rather than cutting the nail straight across)
    • Wearing footwear that is too tight
    • Repeated trauma to the toes (toe jamming), often due to sports activities

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. The main risk factor for ingrown toenails is having family members with ingrown toenails.

    Symptoms

    Ingrown toenails often cause no symptoms at first. Eventually, the following symptoms may develop at the site of the ingrown toenail:
    • 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.

    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

    Self-care

    • Wear open-toed shoes or sandals until the pain and swelling of the nail subside. 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

    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 http://www.aofas.org

    American Podiatric Medical Association http://www.apma.org

    CANADIAN RESOURCES

    Calgary Foot Clinic http://www.foottalk.com

    Canadian Podiatric Medical Association http://www.podiatrycanada.org

    References

    American Podiatric Medical Association website. Available at: http://www.apma.org.

    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.

    Revision Information

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