What are the initial signs of an ingrown toenail. How can you identify the early stages of this condition. What home remedies can help prevent ingrown toenails from worsening. When should you seek professional medical help for an ingrown toenail.

Understanding Ingrown Toenails: Causes and Stages

Ingrown toenails are a common foot condition that can cause significant discomfort if left untreated. They occur when the edge of the toenail grows into the surrounding skin, leading to pain, inflammation, and potentially infection. Understanding the causes and stages of ingrown toenails is crucial for early detection and proper treatment.

What causes ingrown toenails?

Several factors can contribute to the development of ingrown toenails:

• Improper nail trimming techniques
• Wearing tight or ill-fitting shoes
• Trauma to the toe
• Genetic predisposition
• Excessive sweating of the feet
• Certain nail conditions or deformities

The three stages of ingrown toenails

Ingrown toenails typically progress through three distinct stages:

1. Early stage: Mild discomfort, redness, and swelling
2. Intermediate stage: Increased pain, possible discharge, and swelling of skin folds
3. Advanced stage: Severe pain, infection, and potential fever

Recognizing the Early Signs of an Ingrown Toenail

Identifying an ingrown toenail in its early stages is crucial for preventing more severe complications. Are you experiencing any of these symptoms? If so, you may be in the beginning stages of an ingrown toenail:

• Redness around the edge of the toenail
• Mild swelling of the affected area
• Tenderness or discomfort when pressure is applied
• Slight pain when wearing shoes

It’s important to differentiate these symptoms from other foot conditions. Unlike a bunion, which presents as a bump on the outside of the toe, or a fungal infection characterized by nail discoloration and brittleness, an early-stage ingrown toenail primarily affects the skin around the nail’s edge.

Home Remedies for Early-Stage Ingrown Toenails

Catching an ingrown toenail early allows for effective home treatment. Here are some steps you can take to manage the condition and prevent it from worsening:

Proper nail trimming technique

How should you trim your toenails to prevent ingrown nails? Follow these steps:

1. Soak your feet in warm water with Epsom salts or Castile soap for 20 minutes to soften the nails
2. Gently push back the swollen skin from the nail edge
3. Cut the nail straight across, avoiding a curved shape
4. Ensure you can see the entire leading edge of the toenail

Foot soaks and essential oil treatments

Regular foot soaks can help reduce pain and prevent infection. Consider adding tea tree oil or lavender essential oil to your foot soak for their antimicrobial properties. You can also create a homemade ointment using these oils mixed with a carrier oil like coconut oil to apply directly to the affected area.

Proper footwear choices

Choosing the right footwear is crucial in managing and preventing ingrown toenails. Opt for shoes that provide ample toe room and avoid high heels or tight-fitting shoes that put pressure on your toes. When at home, go barefoot or wear open-toed shoes to allow your toes to breathe and heal.

When to Seek Professional Help for an Ingrown Toenail

While home remedies can be effective for early-stage ingrown toenails, there are situations where professional medical intervention is necessary. At what point should you consult a podiatrist? Consider seeking professional help if:

• Home treatments haven’t improved symptoms after a few days
• You notice signs of infection, such as pus or excessive redness
• The pain becomes severe or interferes with daily activities
• You have diabetes or other conditions that affect circulation in your feet

A podiatrist can provide more advanced treatments, including partial nail removal or prescribing antibiotics if an infection is present.

Advanced Treatment Options for Ingrown Toenails

When home remedies and conservative treatments fail to resolve an ingrown toenail, more advanced medical interventions may be necessary. What are some professional treatment options for persistent or severe ingrown toenails?

Partial nail avulsion

This procedure involves removing the ingrown portion of the nail under local anesthesia. It provides immediate relief and allows the nail to regrow properly.

Matrixectomy

For recurrent ingrown toenails, a podiatrist may perform a matrixectomy. This procedure involves removing part of the nail matrix (the tissue responsible for nail growth) to prevent the problematic portion of the nail from regrowing.

Antibiotics

If an infection is present, oral or topical antibiotics may be prescribed to combat bacterial growth and reduce inflammation.

Preventing Ingrown Toenails: Long-Term Strategies

Prevention is always better than cure when it comes to ingrown toenails. Implementing these long-term strategies can significantly reduce your risk of developing this painful condition:

• Maintain proper foot hygiene by washing and drying your feet thoroughly daily
• Trim your nails straight across and avoid cutting them too short
• Wear shoes that fit well and provide adequate toe room
• Use protective footwear in public areas like locker rooms to prevent fungal infections
• Address any underlying foot conditions, such as excessive sweating or nail fungus
• Consider regular visits to a podiatrist for professional nail care if you’re prone to ingrown toenails

The Impact of Ingrown Toenails on Daily Life

Ingrown toenails, even in their early stages, can significantly affect a person’s quality of life. How do these seemingly minor foot problems influence daily activities and overall well-being?

Physical limitations

The pain associated with ingrown toenails can make walking, running, or even standing for extended periods uncomfortable. This discomfort can lead to reduced physical activity and potential weight gain if left unchecked.

Psychological effects

Chronic foot pain can contribute to mood changes, increased stress, and decreased overall life satisfaction. The fear of exacerbating the condition may also lead to social isolation or avoidance of certain activities.

Work and productivity

For individuals whose jobs require prolonged standing or walking, ingrown toenails can significantly impact work performance and potentially lead to lost workdays.

By addressing ingrown toenails early and implementing preventive measures, you can avoid these negative impacts and maintain a healthy, active lifestyle.

Ingrown Toenails in Special Populations

While ingrown toenails can affect anyone, certain groups may be at higher risk or require special consideration when it comes to treatment and prevention. How do ingrown toenails affect different populations?

Diabetic patients

Individuals with diabetes are at increased risk for foot complications due to potential nerve damage and poor circulation. Even minor foot issues like ingrown toenails can lead to serious infections if left untreated. Diabetic patients should seek professional care at the first sign of an ingrown toenail.

Athletes

Athletes, particularly runners and those involved in sports that put stress on the feet, are more prone to ingrown toenails due to repetitive trauma to the toes. They may need to pay extra attention to their foot care routine and choose appropriate footwear for their activities.

Elderly individuals

Older adults may have difficulty trimming their toenails properly due to reduced flexibility or vision problems. They may benefit from regular podiatric care to prevent ingrown toenails and other foot issues.

Pregnant women

Hormonal changes and weight gain during pregnancy can increase the risk of ingrown toenails. Pregnant women should be cautious about their footwear choices and may need assistance with foot care as their pregnancy progresses.

Understanding these special considerations can help individuals in these groups take appropriate preventive measures and seek timely treatment when necessary.

What are the Beginning Stages of an Ingrown Toenail?

Dr. Brian Nagy | March 1st, 2018

Posted In: Ingrown Toenails

If you have pain in your toe but don’t know what the problem is, you might be suffering from the beginning stages of an ingrown toenail. There are many conditions that might cause discomfort in your feet and toes including a bunion, stubbed toe, fungal infection, sprain, or other injury, so how do you know if you are getting an ingrown toenail?

Early Stages of an Ingrown Toenail

There are three stages of an ingrown toenail. In the earliest stage your symptoms will include redness, swelling, and discomfort or pain where your toenail meets the bed of your toe.  If you are experiencing these symptoms in the absence of a bump on the outside of your toe (bunion), rotting nail and oozing pus (fungus), and have not stubbed your toe or injured your foot in some other manner, you could be getting an ingrown toenail.

During the second stage of an ingrown toenail, you’re likely to have even more pain and may see a little discharge at the edge of your nail. You might also notice swelling in the folds of skin along the affected toenail. If you are in the early stages of an ingrown toenail, there are a few things you can do at home to try and prevent it from getting to an advanced stage.

Treating Ingrown Toenails at Home

It is imperative that you trim the affected toenail very carefully (there’s a right way and a wrong way!), soak the foot, use ointment you can make yourself from essential oils to reduce pain and prevent infection, and wear proper footwear. You should not wear socks and shoes when you’re at home, and try wearing flip-flops when you go out. This allows your toe to get air while protecting your foot from dirt that can lead to infection.

When cutting or trimming an ingrown toenail, begin by soaking your foot for 20 minutes in Epsom salts or Castile soap. Make sure your fingers are clean as you push the swollen skin carefully away from the nail being careful not to force the skin farther away from the nail than it will go. Beginning at the sides of the toenail and finishing in the middle, carefully cut the nail. Avoid trimming your toenails with too much of a curve as this can cause the corners to be cut too far back. Follow the natural curve of the toe but make sure that when you are finished you can still see the entire leading edge of the toenail from one side to the other. Gently place a small bit of clean cotton between your skin and the ingrown toenail. This helps the toenail to grow back in the right way and prevents ingrown toenails from coming back. Apply ointment and put a bandage on the toe.

It’s Time to See Your Podiatrist

If you notice excessive growth and redness, or oozing pus where your toenail meets your toe bed, it is time to make an appointment with your New Hampshire podiatrist. This is the third stage of an ingrown toenail during which you have an infection. An infection must be treated with antibiotics prescribed by your podiatrist. You might have a fever by this point, and the toe will probably feel warm and tender to the touch. It is best if you can see your foot doctor before your ingrown toenail gets to this stage if home treatment has not worked.

Nagy Footcare Can Help You

When you are experiencing toe pain or discomfort, you might be in the early stages of an ingrown toenail. You should immediately begin the home treatment methods mentioned above in order to prevent the problem from getting worse. If you have any questions or concerns, or are unable to properly cut the ingrown toenail by yourself, call Nagy Footcare. We firmly believe you should not have to suffer from foot or toe pain; offer the most advanced treatment options available in a professional, caring environment; and make it our mission to exceed your expectations in every way. Are you in the beginning stages of an ingrown toenail?  Contact Nagy Footcare today!

At Nagy Footcare, our best day is when you wake up with no foot pain.

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Ingrown toenail: Overview – InformedHealth.

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Created: June 28, 2018; Next update: 2021.

Introduction

Ingrown toenails are a common problem, especially on the big toes. They arise if the toenail grows into the skin next to it. That area becomes inflamed and painful.

The medical term for ingrown toenails is onychocryptosis or unguis incarnates.

They are more likely to occur if you wear tight shoes, have very sweaty feet, or cut your toenails the wrong way.

Symptoms

Ingrown toenails cause the affected skin to become inflamed. The blood supply to that part of the toe increases, and it becomes red, swollen and painful.

Sometimes new tissue starts growing over the toenail. Doctors call this a granuloma, because the surface of the new tissue looks a bit like tiny granules. The inflamed area may weep, bleed or release pus and have an unpleasant odor – especially if bacteria get into the wound.

Causes and risk factors

The symptoms are caused when the edge of the toenail presses into the skin and continues to grow. If this edge injures the skin and the soft tissue underneath it, inflammation will occur.

A toenail is more likely to become ingrown if

• it’s cut too short or rounded at the edges,

• you wear shoes that are too tight,

• your feet are very sweaty,

• you have a certain genetic toenail growth shape, such as “pincer” toenails, which are so curved that they look like part of a tube when seen from the tips of your toes,

• you are overweight (obese),

• you have diabetes or a condition that can cause water retention in your feet, such as heart or kidney failure, or chronic venous insufficiency in your legs, or

• you are taking medication to treat cancer.

Prevalence and outlook

Ingrown toenails are common. 20 out of 100 people who see their family doctor because of foot problems have an ingrown toenail.

Teenagers and young adults often develop them. This is because they tend to sweat more, for instance due to hormonal changes during puberty or when doing sports. But ingrown toenails are common in older people, too. They may have a higher risk because of medical conditions such as diabetes. Also, many older people are less flexible, making it difficult for them to take care of their feet and toenails. Because toenails get thicker with age, it’s harder to cut them, too.

Doctors distinguish between three stages of severity:

• Stage 1: The nail has grown into the skin on the side. The skin hurts and has become inflamed.

• Stage 2: New, inflamed tissue (granuloma) has grown at the edges of the ingrown toenail. The tissue is weeping and producing pus.

• Stage 3: The skin around the toenail is chronically inflamed and keeps oozing pus. The granuloma has already started growing over the nail.

Ingrown toenails of various degrees of severity

Effects

Ingrown toenails usually become noticeable early on because they hurt. If treated in time, it is often possible to manage the inflammation on your own. It will then heal without any consequences.

But the inflammation can spread in people who have a weakened immune system and if bacteria infect the wound: That can cause an inflammation with pus around or under the entire nail. It’s then advisable to see a doctor, especially if you also feel tired and have a fever, and the infection has spread along the toe and developed into cellulitis (an infection of deeper layers of skin).

Diagnosis

An ingrown toenail can be diagnosed without any complex examinations. Doctors take a close look at the affected toe, and ask about the symptoms and any possible causes.

Additional tests – like a blood test, for instance – may be needed if they think that the ingrown toenail has already led to complications, such as cellulitis.

Prevention

There are several ways to prevent ingrown toenails. Good foot care is important – especially cutting your toenails. XXX It’s best not to round the toenails on the edges, and to leave them long enough so that the corners of the nails can freely rest against the skin to the side of them.

Make sure that your shoes aren’t too tight and leave enough room for your toes. Open or “breathable” shoes help to prevent sweaty feet.

Treatment

The most suitable treatment for an ingrown toenail will depend on how severe it is. If the inflammation is mild and doesn’t hurt much, the toe can be soaked in a soapy footbath and then the sore part of the toe can be treated with antiseptic or anti-inflammatory tinctures, gels or creams. It’s important to dry the foot thoroughly after the footbath, wait a while before putting on shoes, and avoid putting pressure on the ingrown toenail.

The use of special gutter splints or braces can also help the nails to grow freely again. A podiatrist (foot specialist) can help apply these devices. If you have a higher risk of foot problems due to diabetes, you should talk with your doctor first. It’s generally a good idea to see a doctor if these measures don’t help or if the skin around the ingrown toenail is producing pus and is severely inflamed. Surgery is usually recommended in that case. Various surgical procedures and techniques may be considered.

Everyday life

An ingrown toenail can hurt a lot when you walk or stand. Open shoes and loose-fitting socks can reduce the pressure on the affected toe. At night, too, it’s best to give the toe enough room to move and make sure that the sheets aren’t right on top of it. If your bed has a footboard, you can hang the bottom of the sheets over it to leave space between your toe and the sheets.

Some people find it hard to take care of their own feet and toenails – for example, because they have difficulties reaching their feet due to problems with their joints. If you can’t – or would prefer not to – have someone you know help you out, you can seek professional care:

• As long as your feet and toenails are healthy, and you don’t have any risk factors like diabetes, you can have a professional pedicure to trim your nails and remove calluses. You have to pay for this kind of treatment yourself.

• If you already have health problems related to your feet, then medical care by a podiatrist is an option. Some treatments may then be covered by your health insurer – for example, if the ingrown toenail problems were caused by diabetes.

Sources

• Eekhof JA, Van Wijk B, Knuistingh Neven A, van der Wouden JC. Interventions for ingrowing toenails. Cochrane Database Syst Rev 2012; (4): CD001541. [PubMed: 22513901]

• Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician 2009; 79(4): 303-308. [PubMed: 19235497]

• Mittenzwei B. Orthonyxiespangenbehandlung in der podologischen Praxis. Der Fuß 2015; Sonderheft: Arbeiten am Fuß: 6-15.

• Moll I. Duale Reihe Dermatologie. Stuttgart: Thieme; 2016.

• Schumpelick V, Bleese N, Mommsen U (Ed). Kurzlehrbuch Chirurgie. Stuttgart: Thieme; 2010.

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Ingrown nail – stages of the disease, methods of treatment

16.02.2021

There will be no doubt that this is a serious and not at all trifling problem only for those who know firsthand what excruciating pain occurs if the case is neglected.

Approximately 10% of the country’s population suffers from an ailment – an ingrown nail, in other words, onychocryptosis. Typically, the toenail grows into the soft surrounding tissue.

How does a nail work?

A horn formation (plate) is called a nail. The nail is located in the nail bed. At the root of the nail is a matrix – due to it, the nail grows. If the matrix is ​​damaged, then the nail will grow incorrectly or stop growing altogether. On the sides of the nail are skin folds, they are called the nail roller.

Causes of onychocryptosis

• genetic predisposition,
• overweight,
• wearing tight shoes,
• shoes with heels,
• incorrect pedicure,
• diabetes,
• vascular disease of the lower extremities,
• fungal diseases,
• non-compliance with personal hygiene,
• injury

Most often, an ingrown toenail occurs in young people. They try, during a pedicure, to round off the corners of the nail plate as much as possible, thereby disrupting the natural growth of the plate, it begins to grow into the soft tissue.

Stages of the disease

• The first stage is redness around the nail, swelling and slight discomfort when walking.
• The second stage – part of the nail cuts into the skin, swelling occurs. A person experiences obvious pain and not only when walking.
• The third stage – in addition to pain in the focus of inflammation, purulent discharge appears. The nail thickens. The so-called “wild meat” appears – tissue grows.
• Fourth stage – soft tissue granulation occurs. The disease becomes chronic. Difficult to treat.

Consequences

If an ingrown toenail is not treated promptly, complications can occur. Inflammation can go to the bone (ostiomyelitis), up to gangrene and amputation of the toes.

At risk are people with diabetes, the elderly.

Prophylaxis

First of all, it is necessary to cut the nails correctly, the cut should be even (parallel to the nail roller), when carrying out a pedicure, it is necessary to hold the legs in a warm bath, and follow the rules of hygiene daily. Wear loose, comfortable shoes.

Conservative treatment

If the stage of the disease is first or second, then nail softeners are recommended. Orthopedic inserts, staples, springs, plates are also recommended. Devices are fixed on the nail in order to correct the deformation of the nail. The procedure is painless. Delivers a minimum of inconvenience. The use of cosmetic varnish is allowed. It is recommended to wear the devices for 3-4 months.

With fungal diseases, appropriate medications will help.

Laser treatment

Gentle, painless method. As a rule, the nail plate is not completely removed. Remove only the ingrown part of the nail. Also, the infected tissue is cleared by the laser, preventing the process of further inflammation.

Radio wave treatment

No less popular method than all the others. When using it, the immune properties of the skin and tissues increase. No bleeding, no scarring.

Surgical treatment

The most radical. The ingrown edge of the nail, the nail bed and part of the nail root dry out. Either a wedge-shaped resection of the nail plate or a selective resection of the nail matrix is ​​performed. In advanced cases, the nail is completely removed. The disadvantage of this procedure is that the nail plate is restored within six months.

ingrown nail

Ingrown nail (“onychocryptosis”) in Kyiv – private clinic Oberig. Ingrown nail (“onychocryptosis”)

Ingrown nail (“onychocryptosis”) is a disease associated with the ingrowth of the nail plate into the lateral part of the nail fold, more often on one side, less often on both sides. The disease is accompanied by inflammation of the soft tissues, namely redness, swelling of the nail fold or finger, pain. With the progression of the disease, purulent discharge, hypergranulation appear (growth of “extra” tissue of the nail fold). (Figures 1-4) An ingrown toe grows in size, making it difficult to walk and making it difficult to wear your normal shoes.

Growth of “extra” tissue of the nail fold

Most often, the nail grows on the big toe, but sometimes it also happens with nails on other fingers. Ingrown nails are most common in pubertal patients and pregnant women.

The causes of an ingrown nail may be heredity, various types of nail deformities (for example, “pincer nail”) (Fig. 5), hormonal changes in the body, improper pedicure (very deep cutting of the nail near the edges), fungal diseases (onychomycosis) (Fig. 6, 7).

The possible causes of an ingrown toenail include the constant wearing of narrow, uncomfortable and poor-quality shoes, which causes excessive sweating of the feet. Sometimes the disease can be the result of an injury to the toe.

“Pinch nail”

Depending on the degree of ingrowth and duration of the disease in adults, three stages of ingrown nail are distinguished.

Stage 1 – Redness, swelling, pain and pressure in the nail folds.

Stage 2 – Attachment of infection. The ingrown part of the nail plate behaves like a foreign body, maintaining inflammation with the separation of pus from the wound.

Stage 3 – Growth of granulation tissue in the area of ​​the nail fold. Acute inflammation is replaced by chronic, it takes months, and sometimes years.

Fungal diseases (onychomycosis)

Conservative treatment is possible at the first stage of the ingrown nail. This treatment is long-term, it consists in removing the corner of the nail from under the nail fold with the help of cotton turundas, special plastic tubes, or correcting the shape of the nail with the help of special plates. Throughout the course of treatment, you need to wear wide, loose shoes, limit physical activity.

The effectiveness of conservative treatment is low, relapse often occurs. Why most often conservative treatment is ineffective can be understood by looking at the photographs of the nails removed during marginal resection (Fig. 8, 9) – ingrown nail does not begin from its corner, but from the base of the nail plate, and in addition to the visible part of the nail, there is also a hidden nail roller, and it is often impossible to remove this part without surgery.

Indications for surgical treatment are:

• ingrown nail plate;
• development of hypergranulations of the nail fold, inflammation of the nail fold (paronychia).

There are many methods of surgery for ingrown toenails, but the most recognized and most effective are two methods: marginal resection of the nail plate with growth zone and electrocoagulation of the wound and marginal resection with growth zone phenolization. The latter technique is practically not used in the CIS, in particular, this is due to the fact that phenol is not registered as a drug in Ukraine (information as of 21.08.2012). In addition, the technique with phenolization has more complications and quite a lot of relapses (in some publications up to 17%).

Marginal nail resection

Removal of the entire nail plate is rarely used, usually for fungal diseases, although with the advent of modern antifungal drugs that can cure onychomycosis without removing the nail, this technique is gradually becoming history. The simple removal of the nail plate without treatment of the growth zone, which, unfortunately, is still performed very often, leads to almost 100% recurrence.

Marginal resection surgery with electrocoagulation of the growth zone (Fig. 10) narrows the nail plate and reduces the periungual fold, with a recurrence rate of less than 1% when performed correctly.

The operation is performed under local anesthesia. Under the tourniquet, 4 ml of a 2% lidocaine solution is injected into the base of the finger (conduction anesthesia according to Lukashevich-Oberst). After 3-5 minutes, numbness of the finger occurs, it becomes possible to perform an operation in which the patient does not feel pain at all.

Electrocoagulation of the growth zone

After surgery on the first day, bed rest, maximum restriction of the load on the leg, and analgesics are recommended. The next day, dressing is performed, then, depending on the condition of the wound, dressings are performed either every other day or every day.