Ingrown Toenail | HealthLink BC

Topic Overview

What is an ingrown toenail?

An ingrown toenail is a toenail that has grown into the skin instead of over it. This usually happens to the big toe, but it can also happen to other toes. An ingrown toenail can get infected. It may be painful, red, and swollen, and it may drain pus. See a picture of an ingrown toenail.

Anyone can get an ingrown toenail, but adults get them more than children do. People who have curved or thick nails are more likely to get an ingrown toenail. This is more common in older adults.

What causes an ingrown toenail?

An ingrown toenail can have a number of different causes. Cutting your toenail too short or rounding the edge of the nail can cause it to grow into the skin. Wearing shoes or socks that don’t fit well can also cause an ingrown toenail. If your shoes are too tight, they might press the nail into the toe and cause it to grow into the skin.

You can get an ingrown toenail if you hurt your toe, such as stubbing it. This can cause the nail to grow inward. Repeating an activity that injuries the nail, such as kicking a soccer ball, can also cause an ingrown nail.

What are the symptoms?

The main symptom of an ingrown toenail is the pain from the nail growing into the skin instead of over it. If the ingrown toenail gets infected, it might be swollen or red, and it might drain pus. The area around the ingrown toenail is often painful.

How is an ingrown toenail diagnosed?

Your doctor will do a physical examination to diagnose an ingrown toenail. He or she will look at your toe where the nail has grown into the skin.

How is it treated?

You can try the following steps at home to relieve the pain caused by your ingrown toenail and help the nail to grow out naturally:

• Soak your sore toe in warm water for 15 minutes 2 to 3 times each day.
• Wedge a small piece of wet cotton, such as part of a cotton ball, under the corner of your ingrown nail. This will help lift the nail off of the skin.
• Soak your toe and change the piece of cotton each day until the nail grows out and can be trimmed.
• Do not use a sharp object like manicure scissors to dig under your nail, because the toe might get infected.
• Do not try to use a needle to drain the pus from your toe. This could make the infection worse.
• While your ingrown toenail is healing, wear comfortable shoes or sandals that do not press on your toe.

Use these home treatment steps for 3 days. If they do not help, you might need to see your doctor. Be sure to see a doctor if your toe gets infected. Your toe might be infected if it hurts more than it did before you tried the home treatment. Call your doctor if your toe is red, warm, swollen, or drains pus, or if there are red streaks leading from your toe.

Your doctor might give you antibiotics. If your toenail is very ingrown, your doctor might suggest minor surgery to remove all or part of the ingrown nail. He or she may refer you to a podiatrist.

During this surgery, the doctor will numb your toe. Then he or she will cut the edge of the ingrown toenail and pull out the piece of nail. To prevent the nail from growing into the skin again, your doctor might destroy all or part of the nail root. This is called ablation. If your doctor removes all or part of your nail but does not destroy the root, it will begin to grow back within a few months.

After the surgery it is important to take care of your toe so that it can heal. Your doctor will give you specific instructions to follow. He or she may tell you to:

• Soak your toe in warm water for 15 minutes 2 to 3 times each day.
• Apply a thin layer of petroleum jelly, such as Vaseline, 2 times each day on the toe where the nail was removed.
• Wear a bandage on your toe.
• Wear loose-fitting shoes that don’t press on the toe where the nail was removed.
• Take pain medicine if your toe hurts. Non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Entrophen), ibuprofen (such as Advil), or naproxen (such as Aleve), might help your toe feel better. Be safe with medicines. Read and follow all instructions on the label.

How can ingrown toenails be prevented?

You may be able to prevent ingrown toenails by wearing roomy and comfortable shoes and socks that do not press on your toes. If you work in a place where your toe might get hurt, wear sturdy shoes such as steel-toed boots to protect your toes.

Be sure to trim your toenails properly. You can do this by cutting your toenail straight across, not curved. Make sure you do not cut your toenail too short. You can also leave your toenail a little longer at the corners to help it grow over the skin.

If you have diabetes or peripheral arterial disease, talk with your doctor before you trim your own toenails. People with diabetes have a hard time feeling their toes and might cut themselves without realizing it. Peripheral arterial disease can cause toes to be very painful.

Many hospitals and health care centres have foot care clinics, where someone can help you trim your toenails. Ask your doctor to recommend a foot care clinic near your home.

Ingrown Toenails (Ingrowing Toenails) | Causes and Treatment

What is an ingrown toenail?

The nail becomes ingrown when the side of the nail cuts into the skin next to the nail. This can become painful. The skin next to the nail may also become infected or inflamed. Any toe can be affected but it is usually the big toe. It is a common problem, especially in teenagers and young adults. However, ingrown toenails can also occur in babies or toddlers.

Ingrown toenail causes

An ingrown toenail is usually caused by a sharp spike of nail growing into the skin beside it. This can happen as a result of various factors. Not trimming your nails correctly, wearing poorly-fitting shoes or tight socks, and sweating a lot (during exercise, for example) can all contribute. Shoes which force the toes towards each other encourage the nail to grow into the skin. For example, tight shoes, high heels and pointed-toe shoes. Active, sporty people may be more prone to ingrown toenails as they sweat more. Ingrown toenails may occur more often in people who have nails which are deformed in some way. Often there is no apparent reason why it occurs.

It is also more common in people who cut their toenails very short and round. The correct way of cutting nails is straight across (see below). This helps the nail to grow normally and may prevent ingrown toenails from developing.

Other possible causes are injury to the nail, a fungal infection of the nail, or possibly, medication such as isotretinoin.

When a spike of nail pierces the skin of the toe, it allows the germs that are normally harmlessly present on the skin to get underneath the skin and cause infection.

What are the symptoms of an ingrown toenail?

Early on, the skin around the ingrown nail may become reddened and feel slightly tender. If it progresses and becomes infected, it may become more swollen, red and painful. If the infection gets worse, there may be some fluid (pus) oozing from around the nail. Ingrown toenail pus is usually yellow or green. The nail will become even more painful and there may be an overgrowth of skin around it.

Ingrown toenails remedy

Ingrown toenails are usually treated by a GP or a person qualified to diagnose and treat foot disorders (a podiatrist). Podiatrist is a newer term for chiropodist. In some cases, surgery is helpful.

If caught early

If the ingrowing part of the nail is small, a non-surgical fix may be possible. It may be prevented from becoming worse, and sometimes cured, by the following. This treatment may be given by a podiatrist or a GP, or you may be shown how to do it yourself.

• Soak the toe in water for 10 minutes to soften the folds of skin around the affected nail.
• Then, using a cotton wool bud, push the skin fold over the ingrown nail down and away from the nail. Do this starting at the root of the nail and move the cotton wool bud towards the end of the nail.
• Repeat each day for a few weeks, allowing the nail to grow.
• As the end of the nail grows forward, push a tiny piece of cotton wool or dental floss under it to help the nail grow over the skin and not grow into it. Change the cotton wool or dental floss each time you soak your foot.
• Do not cut the nail but allow it to grow forward until it is clear of the end of the toe. Then cut it straight across and not rounded off at the end.

There are variations on this method – the principle is to keep the skin from growing over the edge of the nail.

Infected ingrown toenails

If the nail fold becomes infected, symptoms of infection are increasing pain, swelling and redness near the ingrown nail, and yellow or green pus near the nail or under the nearby skin. If the infection is getting worse, you may have a throbbing pain, redness spreading over the toe, or a high temperature (fever).

Antibiotics may be needed to treat infection. It can also help to soak your feet in warm salty water, then carefully dry and rest your feet.

When should I see a doctor?

See a doctor if:

• You have persistent and troublesome symptoms from the ingrown nail.
• You have symptoms of infection (as above). If you also have diabetes or a poor immune system, see a doctor urgently, as infections will need treating quickly.
• You have a condition affecting the nerves or feeling (sensation) in your foot. For example, if you have loss of feeling due to diabetes (diabetic neuropathy) affecting the feet. This is because a loss of sensation can make you unaware of problems in the foot, such as a deep infection. So, you will need careful assessment and monitoring. You may be referred to a foot clinic or a podiatrist.

For persistent ingrown toenails

It may be necessary to remove part of the nail. The usual procedure is as follows:

• The toe is made numb and painless by injecting local anaesthetic into the base of the toe.
• The toenail is then cut with scissors longways a few millimetres in from the offending edge.
• It is cut right up to the base of the toenail and the offending edge can then be pulled out.
• A small amount of acid (called phenol) is often put on the exposed part of the nail bed. This helps to stop the edge of nail regrowing and causing another ingrown nail.
• The nail is then dressed.

Once the anaesthetic wears off, the toe may be sore so you may need mild painkillers such as paracetamol for a day or so. You will probably have to wear a bandage for about two weeks. During this time you will not be able to have a bath or go swimming. You also will not be able to do any strenuous exercise, such as running. After the operation, the nail will regrow but will be narrower than before.

How can ingrown toenails be prevented?

• Cut your nails straight across; do not cut them too short or too low at the sides. The corner of the nail should be visible above the skin. (Tip: it is easier to cut nails after a bath or shower, when they are soft.)
• Keep your feet clean and dry. Let air get to your toes when possible.
• Avoid tight shoes and use cotton socks rather than synthetic.
• If you have diabetes, you should take extra care when cutting your nails:
• Cut the nail straight across or follow the shape of the end of the toe, but be very careful not to cut too low at the sides as above.
• Gently file any sharp edges with a nail file.
• If you have any loss of feeling in your feet, you should visit a podiatrist to have your nails trimmed, rather than doing it yourself.
• If you can’t see your feet or nails very well, you should visit a podiatrist to have your nails trimmed, rather than doing it yourself.

Ingrown toenail – Illnesses & conditions

An ingrown toenail develops when the sides of the toenail grow into the surrounding skin.

The big toe is often affected, either on one or both sides. The nail curls and pierces the skin, which becomes red, swollen and tender.

Other possible symptoms include:

• pain if pressure is placed on the toe
• inflammation of the skin at the end of the toe
• a build-up of fluid (oedema) in the area surrounding the toe
• an overgrowth of skin around the affected toe (hypertrophy)
• bleeding
• white or yellow pus coming from the affected area

When to get professional advice

What causes ingrown toenails?

A number of things can cause an ingrown toenail to develop, including:

• badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin
• wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail; the skin may be pierced if it’s pressed on to your toenail
• sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and embed itself within it
• injury – for example, stubbing your toe can sometimes cause an ingrown toenail to develop
• natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail

A fungal nail infection can cause your toenail to thicken or widen.

Treating ingrown toenails

Left untreated, an ingrown toenail can become infected, so it’s important that you:

• keep your feet clean by washing them regularly with soap and water
• change your socks regularly
• cut your toenails straight across to stop them digging into the surrounding skin
• gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin)
• wear comfortable shoes that fit properly

Surgery may be recommended if your toenail doesn’t improve. Depending on the severity of your symptoms, this may involve removing part or all of your toenail.

Partial nail avulsion

Partial nail avulsion removes part of your toenail and is the most commonly used operation for treating ingrown toenails. It’s about 98% effective.

A local anaesthetic is used to numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future.

A course of antibiotics may be prescribed if your nail is infected, and any pus will be drained away.

Total nail avulsion

Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, you’ll have an indentation where your nail used to be. However, it’s perfectly safe for you not to have a toenail.

After surgery

After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any bleeding and prevent infection. Rest your foot and keep it raised for 1 to 2 days after the operation.

To help reduce the pain, you may need to take a painkiller, such as paracetamol, and wear soft or open-toed shoes for the first few days after surgery.

Preventing ingrown toenails

Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s important to cut your toenails properly (straight across, not at an angle or down the edges).

Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin.

Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day.

Visit your GP or a podiatrist as soon as possible if you develop problems with your feet.

Ingrown toenails (onychocryptosis) | DermNet NZ

Author: Vanessa Ngan, Staff Writer, 2005.

What is an ingrown toenail?

An ingrown toenail is a painful condition of the toe that occurs when the sides or corner of the toenail digs into the skin at the end or side of the toe. The disease mostly affects the outer edge of the big toe, although the nail on both sides of the toe, or nail on any toe can become ingrown.

An ingrown toenail is also known as onychocryptosis.

What causes ingrown toenails?

The causes for ingrown toenails are listed below, but the two most common reasons are ill-fitting shoes and improperly trimmed nails.

• Ill-fitting shoes such as tight shoes, high heels and pointed-toe shoes cause the toes to be compressed together so that the nail curls into the skin and cannot grow normally.
• Improper trimming of toenails can cause the nail edge or corner to dig into the skin. Toenails should be trimmed straight across so that the top of the nail should make a straight line.
• Injury near the nail such as a ripped nail or nail peeled off at the edge can cause an ingrown toenail.
• Fungal infections of the nail can cause a thickened or widened toenail to develop.
• Prescribed medications, particularly oral retinoids such as isotretinoin and acitretin.
• Abnormal nail shape, such as pincer or trumpet nails.

What are the signs and symptoms of an ingrown toenail?

Ingrown toenails can be classified into three stages according to severity.

Stage 1

• End of the toe becomes reddened with mild swelling
• May feel warm and be painful to touch
• No pus or drainage

Stage 2

• Toe becomes increasingly red, swollen and painful
• May be white or yellow coloured pus or drainage from the area
• Infection may have developed

Stage 3

• Symptoms of redness, swelling and pain are increased
• Granulation tissue forms and adds to the swelling and discharge of pus
• Lateral nail-fold hypertrophy (overgrowth of skin tissue around the affected toe)
• More severe infection with fever may follow

Ingrown toenails

Pseudo-ingrown toenail of the newborn

About 2% of newborn babies are noted at birth to have ingrown toenails because the growing nail plate is very short. It is rarely painful. The appearance rights itself within a year or so.

Pseudo-ingrown toenails

What is the treatment for an ingrown toenail?

Treatment is dependent on the stage of the condition. However, at any stage of an ingrown toenail, the patient should avoid tight-fitting or high-heeled shoes. If possible, wear sandals until it has cleared up.

Stage 1 ingrown toenail should be managed conservatively using the following methods.

• Warm water soaks – soak the foot in warm water four times a day.
• Wash the foot including the affected area twice a day with soap and water.
• Cotton-wick insertion in the lateral groove corner – gently lift the edge of the nail that is digging into the skin and place a small piece of rolled cotton, gauze, dental tape or floss, between the nail and the skin to keep it elevated. This may be painful but should be done after every soaking.

Stage 2 ingrown toenail may require the administration of topical or oral antibiotics. Topical antibiotic ointments combined with local anaesthetic agents help to heal the toe faster and also provide pain relief by numbing the affected area. Surgical removal of the ingrown toenail may be required if the condition worsens.

Stage 3 ingrown toenail is often treated surgically. The surgical technique of lateral nail avulsion plus matricectomy is highly successful. A brief description of this procedure is given below.

• Local anaesthetic ring block to numb the affected toe.
• Any pus will be drained from the end of the toe.
• An ingrown toenail is cut out to create a new, straight nail edge.
• Electrocautery or phenol ablation is used to destroy any cells beneath the area where the nails plate has been cut out to prevent any regrowth of the unwanted nail.
• Any excessive granulation or hypertrophied tissue should also be removed.
• Antibiotic ointment may be applied, and the toe is bandaged up until it completely heals (usually within a few weeks).

The following post-surgery procedures should be followed:

• On the second day, remove the bandage and wash the area with soap and water.
• Gently dry the area and reapply antibiotic ointment if prescribed, and a new bandage once or twice daily for at least one week after surgery.
• Paracetamol or other analgesics as recommended or prescribed by your doctor may be taken to relieve pain.
• Try to keep the toe clean and dry. Do not go swimming, take baths or soak the toe for at least two weeks after surgery. Showering is allowed.
• Avoid running, jumping, or any strenuous activity for two weeks after surgery.
• Call your doctor if you develop increasing pain, swelling, redness or drainage from the toe.

Other treatment for an ingrown toenail

An ingrown toenail may also be treated by a gutter splinter using slit plastic tubing to keep the nail, and the lateral nail folds apart. These are held in place by using tape or acrylic adhesive. An artificial nail may be sculptured using formable acrylic solution.

Chemical or medical nail avulsion is a painless, slow way to remove damaged nails. As the process destroys the whole nail, it is rarely used for ingrown toenails.

Alternative surgical procedures are described, for example, removal of the surrounding soft tissue and shortening the bone of the distal phalanx.

Can ingrown toenails be prevented?

Adhering to the following simple rules can easily prevent ingrown toenails:

• Clip toenails straight across – do not cut them too short and do not round off the edges.
• Wear well-fitting shoes.
• Keep the feet clean and dry.

References

• Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
• Zuber TJ. Ingrown Toenail Removal. Am Fam Physician 2002;65:2547-50, 2551-2, 2554, 2557-8.
• The Management of Ingrowing Toenails British Medical Journal Clinical Review, April 2012
• Tian J, Li J, Wang F, Chen Z. A new perspective on the nail plate for treatment of ingrown toenail. Dermatol Pract Concept. 2018;8(1):22-27. DOI: https://doi.org/10.5826/dpc.0801a05. Journal.

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What Causes Ingrown Toenails? – Foot Health Center

Toenails that curve over and dig into the skin of your toe are called ingrown toenails. They can cause significant pain, but are generally not serious if taken care of. If you don’t take good care of your feet though, an ingrown toenail can lead to a severe infection.

An ingrown toenail occurs when the toenail begins growing down into the skin of the toe instead of straight out and above the skin. Sometimes, the skin itself may cover the sides of the toenails, causing the nail to become embedded in the skin. An ingrown toenail can occur on any toe on the foot, but happens most frequently to the big toe.

You can easily spot an ingrown toenail — the skin actually covers the toenail. The toe may eventually become red, swollen, and quite painful. Sometimes, the skin may even feel hard or tight to the touch. If infection sets in, you may also notice a bit of drainage (pus) seeping from the skin where the nail meets it.

What Causes Ingrown Toenails?

Ingrown toenails happen for many different reasons. “The most common cause is improper cutting of the nails,” says Timothy C. Ford, DPM, director of the podiatric residency program at Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky. “Other causes may be hereditary, trauma, or poor shoes.”

Some causes of ingrown toenails include:

• Small toes that are not large enough to accommodate the growth of the nail. Naturally curved or thick nails can also lead to ingrown toenails.
• Damage to the toe, following an injury like running into a piece of furniture.
• Toenails that are cut too short or in a curved line.
• Shoes that are too small and squeeze the toenails.

Risk Factors for Ingrown Toenails

If you have a congenital condition, meaning a problem present at birth, such as very large toenails, you’re at risk of developing ingrown toenails. This means that you should be extra careful to cut your toenails in a line straight across to discourage nail growth into the sides of your toes. You should also make sure that you don’t cut your toenails too short. Additionally, it’s very important to wear comfortable shoes that don’t cramp your toes, which can increase your chances of an ingrown toenail.

Diagnosing Ingrown Toenails

If you suspect you may have an ingrown toenail, it is best to see a podiatrist. He or she can help diagnose an ingrown toenail and figure out what’s causing it — if there’s an underlying problem that needs treatment, or if you’re just wearing the wrong shoes or not cutting your toenails correctly. A podiatrist can also treat the problem, and take care of any infection that may be present, says Dr. Ford. While there are things you can do yourself to ease the pain of an ingrown toenail, such as warm foot soaks, topical or oral antibiotics may also be needed.

Knowing what causes an ingrown toenail can help you prevent the painful condition. If you frequently experience ingrown toenails, see a podiatrist so that you can receive proper treatment.

Ingrown toenails | Beacon Health System

Overview

Ingrown toenails are a common condition in which the corner or side of a toenail grows into the soft flesh. The result is pain, redness, swelling and, sometimes, an infection. Ingrown toenails usually affect your big toe.

Often you can take care of ingrown toenails on your own. If the pain is severe or spreading, your doctor can take steps to relieve your discomfort and help you avoid complications of ingrown toenails.

If you have diabetes or another condition that causes poor blood flow to your feet, you’re at greater risk of complications of ingrown toenails.

Symptoms

Ingrown toenail symptoms include:

• Pain and tenderness in your toe along one or both sides of the nail
• Redness around your toenail
• Swelling of your toe around the nail
• Infection of the tissue around your toenail

When to see a doctor

See your doctor if you:

• Experience severe discomfort in your toe or pus or redness that seems to be spreading
• Have diabetes or another condition that causes poor blood flow to your feet and you experience any foot sore or infection

Causes

Common ingrown toenail causes include:

• Wearing shoes that crowd your toenails
• Cutting your toenails too short or not straight across
• Injuring your toenail
• Having unusually curved toenails

Complications

Left untreated or undetected, an ingrown toenail can infect the underlying bone and lead to a serious bone infection.

Complications can be especially severe if you have diabetes, which can cause poor blood flow and damage nerves in your feet. So a minor foot injury — a cut, scrape, corn, callus or ingrown toenail — may not heal properly and become infected. A difficult-to-heal open sore (foot ulcer) may require surgery to prevent the decay and death of tissue (gangrene). Gangrene results from an interruption in blood flow to an area of your body.

Prevention

To help prevent an ingrown toenail:

• Trim your toenails straight across. Don’t curve your nails to match the shape of the front of your toe. If you have your toenails done at a salon, be sure to tell your pedicurist to trim your nails straight across. If you have a condition that causes poor blood flow to your feet and you can’t trim your nails, see a podiatrist regularly to have your nails trimmed.
• Keep toenails at a moderate length. Trim toenails so they’re even with the tips of your toes. If you trim your toenails too short, the pressure from your shoes on your toes may direct a nail to grow into the tissue.
• Wear shoes that fit properly. Shoes that place too much pressure on your toes or pinch them may cause a nail to grow into surrounding tissue. If you have nerve damage to your feet, you may not be able to sense if your shoes fit too tightly. Take care to buy and wear properly fitted shoes, preferably from a shoe store specializing in fitting shoes for people with foot problems.
• Wear protective footwear. If your work puts you at risk of injuring your toes, wear protective footwear, such as steel-toed shoes.
• Check your feet. If you have diabetes, check your feet daily for signs of ingrown toenails or other foot problems.

Diagnosis

Your doctor can diagnose an ingrown toenail based on your symptoms and a physical examination of your nail and the surrounding skin.

Treatment

If home remedies haven’t helped your ingrown toenail, your doctor may recommend:

• Lifting the nail. For a slightly ingrown nail (redness and pain but no pus), your doctor may carefully lift the ingrowing nail edge and place cotton, dental floss or a splint under it. This separates the nail from the overlying skin and helps the nail grow above the skin edge. At home, you’ll need to soak the toe and replace the material daily.
• Partially removing the nail. For a more severe ingrown toenail (redness, pain and pus), your doctor may trim or remove the ingrown portion of the nail. Before this procedure, your doctor may temporarily numb your toe by injecting it with an anesthetic.
• Removing the nail and tissue. If you have the problem repeatedly on the same toe, your doctor may suggest removing a portion of the nail along with the underlying tissue (nail bed). This procedure may prevent that part of your nail from growing back. Your doctor will use a chemical, a laser or other methods.

Your doctor may also recommend using topical or oral antibiotics, especially if the toe is infected or at risk of becoming infected.

Lifestyle and home remedies

You can treat most ingrown toenails at home. Here’s how:

• Soak your feet in warm water. Do this for 15 to 20 minutes three to four times a day. Soaking reduces swelling and relieves tenderness.
• Place cotton or dental floss under your toenail. After each soaking, put fresh bits of cotton or waxed dental floss under the ingrown edge. This will help the nail grow above the skin edge.
• Apply antibiotic cream. Put antibiotic ointment on the tender area and bandage the toe.
• Choose sensible footwear. Consider wearing open-toed shoes or sandals until your toe feels better.
• Take pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help ease the toe pain.

Preparing for an appointment

Your family doctor or a foot doctor (podiatrist) can diagnose an ingrown toenail. Prepare a list of questions to ask your doctor during your appointment. Some basic questions include:

• Is my condition temporary or long term (chronic)?
• What are my treatment options and the pros and cons of each?
• What results can I expect?
• Can I wait to see if the condition goes away on its own?
• What nail care routine do you recommend while my toe heals?

Your doctor is likely to ask you questions such as:

• When did you begin experiencing symptoms?
• Do you have the symptoms all the time?
• What at-home treatments have you used?
• Do you have diabetes or another condition that causes poor blood flow to your legs or feet?

Last Updated: December 10th, 2019

INGROWN TOENAIL | Sports Medicine Today

Background

An ingrown toenail, or onychocryptosis, occurs when a side of the nail plate begins to burrow into the skin and soft tissue at its edges along the nail bed. The affected area of the toe can become quite painful, red (erythematous), tender and swollen. The most common toe affected is the big toe. There are many different causes of ingrown toenails. Some of the common causes are cutting the toenails incorrectly (rounded instead of straight across the nail), shoes that are too tight, abnormally shaped toenails and fungal infections.

Signs and Symptoms

The symptoms of an ingrown toenail include:

• Toe pain
• Redness (Erythema)
• Swelling (Edema)
• Discharge from the ingrown region – Ingrown toenails have an increased risk of bacterial infection

Evaluation

Ingrown toenails are diagnosed by a clinical exam with a physician. The skin will be swollen, firm, red and/or tender to touch. There may also be a small amount of discharge or pus that drains from the site of the ingrown nail. An x-ray of the toe can be obtained if there was preceding trauma to the area and to rule out other potential problems. X-rays or other imaging are not usually needed for diagnosis.

Treatment

Treatment options:

• Soaking the foot in warm, soapy water, or Epsom salts three to four times a day for 10-20 minutes. After each soaking, dry the toe and place a small piece of wet cotton under the nail near the corner of the ingrown nail. This helps lift the nail from the skin and allow it to grow properly. The cotton should be changed daily.
• During this process wear comfortable, loose-fitting shoes.
• Avoid using a sharp object, such as manicure scissors, to dig under the nail, as this could increase the risk of infection.
• You should seek medical attention if symptoms are not improving after 2-3 days of this treatment.
• Severe infections may require your doctor to place you on antibiotics and remove part of the nail with a procedure called a partial nail avulsion.
• Your physician will perform the partial nail avulsion by first injecting numbing medication into the toe. Scissors are then used to cut along the edge of the nail that is ingrown. The ingrown portion of the nail is then removed. After the procedure, you should continue with regular foot soaks as noted above. The toe should be covered with a bandage. You should also wear loose-fitting, comfortable shoes. The nail will regrow in two to four months.

Prevention

Ingrown toenails are a common problem, but the risk can be reduced with a few basic steps.

• Ensure that your shoes fit appropriately; shoes that fit too tightly can compress toes together and lead to ingrown nails.
• Trimming nails correctly can also decrease the risk. Nails should be cut straight across, not curved, and not too short.
• Picking or tearing at the corners of your toenails can also lead to an ingrown toenail.
• Patients with diabetes or other conditions that can affect vascular circulation should take extreme care when trimming their nails.

Return to Play

Typically, most patients can return to work or school the following day after the removal of the ingrown nail. Most athletes can begin a gradual return to play 10-14 days after the procedure, as long as the pain is well-controlled.

AMSSM Member Authors
Michael Israel, MD, CAQSM, Sean Parham

References
Daniel CR 3rd, Iorizzo M, Tosti A, Piraccini BM. Ingrown toenails. Cutis 2006; 78:407.

Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician 2009; 79:303.

Ingrown Toenails. Patient Education Center. http://www.patienteducationcenter. org/articles/ingrown-toenail/. Accessed January 22, 2017

90,000 Ingrown toenail: symptoms, causes, treatment

An ingrown toenail is a common ailment. It is the ingrowth of the edge of the nail plate into human flesh. This usually occurs on one or two sides, but central ingrowth can also occur.

Main reasons

In the overwhelming majority of cases, pathology is formed on the legs, and one of the main reasons for this is the wrong selection of shoes. It puts pressure on the nail, and it moves towards the skin.

The most common causes of an ingrown toenail are:

• Inability to cut nails correctly;

90,011 genetic facts;

• fungal disease: some types of fungi destroy the nail plate, causing it to change its shape;
• deformity of the foot (often as a result of wearing smaller shoes), flat feet;
• Injury to the finger that touched the nail plate and prevented it from growing as before.

Symptoms of the disease

The first manifestations of the disease are usually not paid too much attention, although it is quite easy to prevent complications at an early stage. Signs of an ingrown toenail are as follows:

• first, the skin surrounding the nail turns red, then puffiness forms in this area, painful sensations appear when you touch it;
• pus and blood begin to ooze from the damaged area, as the nail digs deeper into the skin, provoking an infection;
• If nothing is done, the ingrown nail particle becomes denser, its deformation is almost irreversible; bone tissue is affected.At this stage, the disease becomes chronic. It is no longer possible to completely fix the nail, but there is a chance to avoid relapse with proper care.

Do you have symptoms of an ingrown toenail?

Only a doctor can accurately diagnose the disease.
Do not delay the consultation – call by phone

+7 (495) 775-73-60

Diagnosis of ailment

Having discovered the symptoms of an ingrown nail, it is necessary as soon as possible to go for an examination to a specialist – a surgeon in order to prevent the possible development of the disease.

In an advanced stage, when there is an obvious infection (strong redness and swelling speak of it), laboratory tests may be prescribed:

• general blood test;
• blood sugar test (carried out to exclude diabetes).

In rare, especially advanced cases, an X-ray of the hand or foot is performed to exclude the fact of damage to the bone tissue.

Peculiarities of treatment

Treatment of an ingrown nail begins with getting rid of acute symptoms, namely, with the surgical removal of the interfering edge of the nail plate, removal of inflammation.

Initial treatment

Further, the following options are possible to prevent the occurrence of a recurring situation:

• Correction of an ingrown nail with acrylic – it is carried out approximately once every 6 months. Contrary to popular belief, conventional nail extension performs not only an aesthetic, but also a healing function. With its help, the nail plate acquires the correct shape without growing into the skin of the finger;
• hardware pedicure – can be cosmetic and performed by a pedicure master, as well as medical: with fixation of special plates (performed by a specialist with medical education).

However, both options are effective only in the initial stages of ingrowth of the nail into the skin. In the case when pus has formed or bone tissue has suffered, they are ineffective.

Treatment at an advanced stage

If an ingrown toenail is a serious concern, then you will most likely have to resort to more radical action.

• Correction of the nail with a plate. A special plate is applied to a part of the nail from the outside, which controls the degree of pressure on it.It gently aligns the nail from the edge, thereby giving it a different shape, harmless to the skin.
• Laser correction of an ingrown toenail – allows you to achieve a quick and effective result. The disadvantage of such a procedure is its relative high cost. Does not completely remove the nail plate, gently removing only its excess part. The procedure is completely painless, however, if there is an inflammatory process on the nail, it first needs to be removed with anti-inflammatory drugs.
• Radio wave exposure – is the removal of the regrown part of the nail using radio waves.The procedure is fast, effective, painless and does not require additional preparatory steps. It implies the introduction of local anesthesia, treatment of the nail with a scalpel, the necessary attachments and an antiseptic.
• Surgical treatment of an ingrown toenail – used in advanced cases, when pus accumulates under the skin around. It is carried out under local anesthesia, requires separate preparation (preliminary diet, rejection of antibiotics and a number of other drugs).The entire operation takes about half an hour and requires some postoperative care (in particular, changing the dressing, washing the finger, applying an antibiotic ointment, and visiting the surgeon on time).

Questions-answers

Can an ingrown toenail be cured at home?

It is possible to correct the situation only at the very initial stage, but, unfortunately, in most cases, patients miss it, noticing the problem only when additional help is already required.

What does an ingrown toenail look like?

It is an overgrown nail plate, one edge of which digs into the skin. May cause soreness when pressed.

What preventive measures should be taken to avoid the problem of an ingrown toenail?

You should purchase high-quality shoes that have the appropriate certificates, mainly from natural materials and always in size.Smaller shoes should not be worn. If the shoes are crushing, they should be discarded. You also need to properly trim your nails (use nail clippers or nail clippers) and periodically give your foot a break from wearing any shoes.

Ingrown toenail: which specialist should you contact?

The following specialists are involved in the treatment, depending on the stage of development of the disease: pedicure master, podologist, surgeon.

Ingrown nail

Ingrown toenail is a chronic condition in which the nail
grows into the lateral skin ridges.

Everyday heavy load on the legs, determines the causes
ingrowths:

• Tight shoes – Squeezing toes leads to nail penetration
  in the soft tissues of the lateral ridges of the fingers;
• High heels for women and improper platoon of shoes for men;
• Deformity of the foot: flat feet, valgus curvature of the first
  (thumbs) fingers;
• Improper nail treatment (when excessive
  deep removal of corners) during a pedicure.
• Dysplasia of the nail (abnormal development of the nail plate),
  which are a consequence of diseases such as: diabetes mellitus,
  metabolic disorders, heart disease, etc.

Video interview with the surgeon Vaulin Yu.N.

“Ingrown
nail”

Download presentation

Vaulin Yu.N. – higher surgeon
qualification category in their presentation
on the topic “Ingrown toenail” clearly describes the mechanism of formation
ingrown toenail and its complications from compression of the toes to
the formation of purulent inflammation of the nail fold.

Signs of an ingrown toenail

The nail plate can grow on any fingers, but the most
frequent manifestation is found precisely on the big toes.

• First degree – slight soreness of the nail plate
  and roller when walking, the appearance of redness;
• Second degree – the formed sharp corner of the nail grows into
  lateral cushion, which increases inflammation and redness, and
  provokes the formation of a purulent infiltrate;
• Third degree – bloody and purulent discharge.If not treated
  this condition, then the painful tissue will be prone to adherence
  infections: fungal, human papillomavirus, which deform the nail
  and lead to malignant tumors.

Thus, prolonged manifestation and development of the disease leads to
disability and can turn into much more serious
consequences: amputation.

Ingrown nail treatment

Soreness and complexity of the course of the disease is aggravated by the
what removes from a person’s performance – making it difficult for him
movement and well-being.

The disease itself is characterized by a high relapse rate
(recurrent manifestations) and is difficult to treat, as it requires
long-term attention from the person himself.

The following treatment methods are distinguished:

• Conservative treatment – the main task is to remove
  inflammatory processes and create conditions for unhindered growth
  nail. Estimated:
• Antiseptic treatment: soap and soda baths for feet;
• Dressings with Levomekol;
• Creation of conditions for proper growth of the nail plate;
• Only comfortable shoes.
• Orthopedic treatment is a method of treatment in which
  the nail plate is straightened with special orthopedic braces
  and plates.
• Surgical – a method of treatment that involves excision
  area of ​​the nail and lateral roller, followed by application
  antiseptics and the correct formation of nail growth.

Watch the video interview of the surgeon Vaulin Y.N., where in detail
told about all the nuances that arise during the formation
Ingrown toenail.Provided expert advice on how to prevent
disease and its consequences.

Sign up for a consultation by phone: +7 (812) 303-07-03 ext. 1
+7 (921) 963-85-00 or through the form on the website.

90,000 causes, symptoms and treatment in the article of the surgeon Kostromin R.A. »On Chkalov

Date of publication July 26, 2019 Updated on April 29, 2021

Definition of the disease.Causes of the disease

Ingrown nail, or Onychocryptosis is a disease in which the nail plate grows into the lateral edge of the periungual ridge. The tissues around the nail become inflamed, redden, and painful swelling with pus appears. Most often, onychocryptosis affects the big toes. In the initial stage, it is manifested by pain when walking, and in the future, the discomfort does not go away even at rest. In the absence of specialized treatment, the disease often recurs.The periods of inflammation are replaced by periods of remission for years, and drug treatment (anti-inflammatory, antibiotic therapy) gives a short-term effect.

The main causes of the disease:

1. Improper care of the toes:
2. if the corners of the nail are cut too deep, this will lead to improper growth of the nail plate and ingrowth into the soft tissues of the periungual fold;
3. Wearing tight shoes with a narrow toe mechanically presses the skin roll into the nail plate.This provokes inflammation, which further develops into onychocryptosis. At a young and working age, tight shoes are the main reason for the appearance of an ingrown toenail;
4. Prolonged squeezing of the toes with a plaster cast or other immobilizing or corrective dressing can also lead to ingrowth of the nail.
5. Anatomical features of the foot and toes ^[1] :
6. congenital and acquired bone deformities – flat feet, wide foot, hallux valgus;
7. Physiologically large, fleshy periungual ridges.
8. Factors leading to the secondary development of an ingrown nail:
9. fungal infection of the toes (onychomycosis): the nail plate thickens, deforms and grows into the periungual roller;
10. foot injury;
11. diabetes mellitus, gout, etc.

Onychocryptosis can affect both children and the elderly. However, this disease is most typical for young people: according to statistics, 8-10% of the working population ^[2] face it.

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms of an ingrown toenail

Complaints when visiting a doctor are most often the same: pain in the area of ​​the big toe, which appeared either for no apparent reason, or after an injury or wearing uncomfortable shoes. The disease is characterized by increased pain intensity, edema and hyperemia of the periungual ridge, the appearance of pus and the growth of granulations called “wild meat” (due to the similarity in color to raw meat).

Clinically, there are three stages of development of the disease ^[3] :

1. Moderate or slight edema and infiltration of the nail fold without changing the nail plate, pus and “wild meat”. Pain most often occurs when moving and wearing shoes.
2. Pronounced edema of the periungual ridge, its enlargement and deformation, “influx” of tissues on the nail plate, the appearance of pus, compaction of the nail plate, its dullness;
3. Sharp edema and hyperemia of the periungual ridges, pronounced hypergranulation, “wild meat”, pus.The nail plate becomes thinner, becomes brittle and mobile.

All stages of the development of the disease can be complicated by the inflammatory process.

Pathogenesis of an ingrown nail

When analyzing the pathogenesis (mechanism of the appearance and development of the disease) of onychocryptosis, it is important to take into account the peculiarities of the structure and growth of the nail ^[4] .

Growth of the nail occurs constantly, throughout a person’s life. The growth rate is about 0.1 mm per day, the nail is completely renewed after 100 days.

The nail plate is formed in the germinal zone (matrix) and further moves along the nail bed. When a part of the nail plate is removed and the matrix is ​​preserved, the nail will grow back and cause the same problems, and the disease recurs.

The nail plate does not grow in width, and ingrowth of the nail occurs exclusively due to inflammation of the periungual fold. In the process of the development of the disease, the soft tissues of the periungual roller are injured by the sharp edge of the nail plate.An inflammatory process begins with edema of soft tissues, due to which they are even more pressed into the nail. As a result of constant trauma, granulation tissue begins to grow (rather soft and porous, perceived by an unknowing person as “extra skin”). Gradually, swelling and inflammation build up, causing more and more discomfort. The fungal and bacterial environment joins, there is a change in the color of the affected periungual roller, a local increase in temperature and the release of pus.It becomes almost impossible to wear the usual shoes; attempts to lean on a sore finger cause acute pain. Further, the inflammatory process becomes chronic, the granulation tissue becomes denser, the nail plate is deformed, and inflammation can spread to the bone tissue ^[5] .

Classification and stages of development of an ingrown nail

Classification D.I. Muratova (1972) most fully reflects the causes and pathogenesis of the disease. The author divides the course of the disease into four degrees of severity ^[6] :

First degree : normal nail shape, complaints of pain in the nail phalanx of the toe, moderate swelling and redness of the lateral ridge on the first toe.

Second degree : the shape of the nail is convex, its thickness ranges from 0.5 to 1 mm, the growing edge is visible. The ingrowth angle of the nail varies from 15 to 30 degrees.

Third degree : the nail takes a tower-like shape, the edges grow deep into the surrounding tissue. The thickness of the nail plate is 2.5 mm, and the angle of the growing edge reaches 30-45 degrees.

Fourth degree : the shape of the nail takes the form of a horn or claw, its thickness is more than 2.5 mm, the angle of curvature of the growing edge is more than 45 degrees, clinical symptoms of trophic changes in the matrix, tissues of the nail bed and nail are observed.

Complications of an ingrown toenail

Complications of untimely treatment of an ingrown nail are associated with the development of an infectious and inflammatory process, which manifests itself in the following pathological conditions ^[7] :

1. Toe abscess – formation of a cavity with purulent and purulent contents redness of the entire nail phalanx. Requires surgical intervention.
2. Osteomyelitis of the nail phalanx of the finger – the infectious process spreads to the bone, medical and surgical treatment is necessary.With late treatment, phalanx amputation may be required.
3. Gangrene of the toe – irreversible damage (necrosis) of the soft tissues of the foot. The only way to treat this condition is to amputate the nail phalanx or the entire toe.
4. Lymphangitis or lymphadenitis – spread of infection through the lymphatic system with damage to the lymphatic vessels or lymph nodes. Requires complex treatment with the appointment of anti-inflammatory and antibacterial therapy.

Diabetes mellitus, obliterating atherosclerosis of the vessels of the lower extremities and immunodeficiency increase the likelihood of complications. Also, risk factors include smoking, obesity, old age. A decrease in local defense reactions leads to a more frequent detection of mycoses. In addition, a long-term ingrown nail can cause fibroids and malignant neoplasms.

Diagnosis of an ingrown nail

Diagnosis of an ingrown nail begins with identifying typical complaints, causes of the development of the disease and predisposing factors.During the examination, the doctor determines the presence of anatomical features, the stage of development of the disease, the presence of complications, conducts a comparative examination of the other limb.

The characteristic appearance of the finger, the presence of predisposing factors and anatomical features, signs of inflammation, purulent discharge and granulation allow you to easily diagnose and determine the severity of the process ^[8] .

If you suspect the possibility of complications, as well as to clarify the causes of the development of the disease, the doctor uses additional diagnostic methods:

1. Complete blood count – to exclude signs of a general inflammatory process.
2. X-ray examination of the feet . The X-ray is intended to detect the spread of purulent inflammation, the transition of the pathological process to the phalanx bones, as well as to clarify the anatomical features of the foot (the degree of deviation of the first toe, assessing the degree of flat feet).
3. Sowing of purulent discharge to study the type of pathogen. This is necessary in order to determine the sensitivity of bacteria to antibiotics in case of prolonged recurrent course of the disease and ineffectiveness of therapy.

Treatment of an ingrown nail

At the initial stage of the development of the disease, conservative treatment is prescribed with the elimination of the predisposing factors of the disease. It is recommended to reduce the load on the toe, restrict walking, wearing loose shoes (if possible, walking without shoes), applying cold to the site of inflammation, hygiene of the feet, avoiding trauma, compresses with antiseptic solutions. The use of ointments such as ichthyol ointment or Vishnevsky’s ointment is not recommended.If the inflammation disappears, then the patient is advised to be careful and, if the inflammation recurs, go to the surgeon again.

In case of ineffectiveness of the therapy, a later stage of the disease or recurrent course, surgical intervention is indicated.

More than 150 methods of surgical and conservative treatment of an ingrown nail are currently known ^{[2] [9]} . However, only a few of them give the desired result (minimal risk of recurrence, high cosmetic effect, high recovery rate).

The most effective and frequently used surgical operations:

1. Marginal resection of the nail plate without resection of the periungual ridge – includes the removal of 1-2 mm of the ingrown edge of the nail plate with destruction of the growth zone of the removed fragment to exclude recurrence. The operation of choice with a slightly and moderately altered periungual ridge without pronounced granulations and “wild meat”.
2. Marginal resection of the nail plate with resection of the periungual ridge (surgery according to Bartlett, according to Schmiden) – supplemented with one of the options for resection of the periungual ridge.It is indicated with a pronounced change in the periungual roller, abundant granulations and the presence of “wild meat”. In this case, the resected periungual ridge is sutured with single-row interrupted sutures. This type of operation is more traumatic, however, during the operation, the risk of recurrence is significantly reduced.
3. Complete removal of the nail plate (Dupuytren’s operation) is used less and less due to the high risk of relapse, high pain intensity after surgery and low cosmetic effect.The operation of choice for severe damage to the nail plate, for example, with onychomycosis.
4. Radio wave and laser methods. They are rarely used in their pure form, but they can complement the marginal resection. After removing the ingrown part of the nail by the radio wave method, the doctor acts on a fragment of the growth zone in order to destroy it and prevent relapse. The surgeon can do the same procedure with a laser.

Any operation can be performed in a small operating room, does not require lengthy preoperative preparation and is performed under local anesthesia.An anesthetic solution (novocaine, lidocaine) is injected into the base of the thumb. The full anesthetic effect is achieved within 7-10 minutes after the injection of the anesthetic.

With proper anesthesia, the operation to remove an ingrown nail is absolutely painless and takes from 10 minutes, depending on the complexity and prevalence of the process. Before anesthesia, the doctor must check with the patient if he is allergic to the anesthetic and other medications. After the operation, a tight aseptic bandage with an antiseptic is applied.Dressings in the postoperative period are sufficient to carry out once a day under the supervision of a physician. The stitches are removed in 7-14 days, depending on the volume of the operation and the body’s ability to recover.

The above methods require extremely qualified treatment. If the exposure is insufficient, the likelihood of a relapse of the disease is high. In case of excessive exposure, areas of the growth zone can be damaged, which will cause permanent deformation of the nail for life.

There is a large number of scientific works investigating methods of combined treatment of an ingrown toenail.Methods of cryodestruction, dynamic destruction by phenol, ozone therapy, ultrasound, EHF-irradiation, etc., are considered, however, these methods are not widely used ^{[10] [11] [12]} .

I will answer the most frequent questions of patients:

1. After the operation, you can go home on your own feet, you can drive a car and lead a normal life.
2. The effect of anesthesia lasts up to 2 hours, after which pain appears in the area of ​​the postoperative wound.For the postoperative period, anesthetic therapy is prescribed in advance, taking into account the patient’s allergies and concomitant diseases.
3. After the operation, the dressing may be slightly soaked with blood, but if signs of bleeding persist, it is necessary to urgently consult your doctor.

Forecast. Prevention

With timely access to a doctor, correct operation and adherence to the necessary recommendations, the risk of recurrence remains quite low.

Surgical treatment is the most effective way to treat this disease. Conservative methods are able to eliminate the problem only at the very initial stages ^[2] and are used with the operation in combination.

The operation to remove an ingrown toenail usually does not require special preparation and can be carried out in a private medical center. With the right choice of anesthesia, it is absolutely painless, takes from 10 minutes and has a low relapse rate. The operation eliminates the disease, improves the cosmetic effect and improves the patient’s quality of life without limiting his daily activities.

To prevent an ingrown toenail, it is necessary to eliminate the causes of its occurrence:

• Wear comfortable shoes;
• observe hygiene in nail care;
• To trim nails correctly: in a straight line not below the tip of the toe;
• File the edges of the nail with a file in the corners so that they are smooth and do not injure the skin.

In addition, it is recommended to correct concomitant diseases: normalize blood sugar in diabetes mellitus, control body weight in obesity, cure onychomycosis (foot fungus), wear orthopedic shoes for flat feet and silicone liners for hallux valgus.

Ingrown toenail: the problem to be solved

1. Home
2. Patients
3. Publications

Ingrown toenail is an actual problem for many people; it is a common and unpleasant disease characterized by ingrowth of the nail plate into the lateral edge of the nail fold. Most often, ingrowth occurs on the big toes. Candidate of Biological Sciences, Chief Physician of the Medical Clinic “Academy of Health” Alexander Shaptilei warns that treating an ingrown nail at home can aggravate the problem – there is a risk of introducing additional infection into the inflammation focus! Therefore, there is no need to complicate anything – it is enough to contact a specialist in time.

Possible causes of ingrown toenails:

• Wearing tight, uncomfortable shoes
• Improper nail care
• Deformity of the foot (flat feet)
• Hereditary predisposition
• Fungal diseases of nails
• Toe injury

Unpleasant signs

Pain in the nail area, bleeding from soft tissues and their inflammation are the main signs of the disease.In addition, there may be an increase in temperature and release of ichor.

Leg pain worsens when walking, especially when wearing uncomfortable, narrow shoes. There may also be complications. More serious: discharge of pus from the affected tissue, which may cause swelling. The tissues are bursting and the sore spot begins to throb unpleasantly. It is worth saying that both men and women get sick with the same frequency. Less commonly, the nail grows in children.

An ingrown toenail causes many inconveniences.Due to the constant discomfort when walking, a person can only wear wide and spacious shoes, and they also have to abandon the model options. In general, prolonged stay on the feet leads to swelling and increased inflammation around the nail. But don’t torture yourself! At the first sign of ingrown nail, you should consult a specialist.

Effective treatment

The most effective way to get rid of this ailment today is the procedure for removing an ingrown nail using radio wave surgery.Previously, laser was often used in treatment, but now it has receded into the background. Unlike laser surgery, radio wave surgery allows you to correct the nail plate (nail bed plastic) without injuring the surrounding tissue. Treatment with radio waves guarantees the patient complete disposal of the ingrown nail, as well as the absence of relapses. That is, this method solves the problem once and for all.

The procedure is carried out according to a unique, individually developed technique. The huge advantage of the laser is that when using it, there is no severe tissue edema, as with any other surgical intervention, which entails a longer healing time.This surgical procedure is practically bloodless!

In the clinic “Health Academy”, a lot of similar operations have already been carried out, while there were not a single complication. In addition, a number of physiotherapy procedures are attached to this operation, which contribute to an even faster healing of tissues. When the nails are damaged by a fungus, in addition to radio wave surgery, antifungal therapy is immediately prescribed.

There is nothing to be afraid of!

Many patients are concerned that the operation to remove an ingrown nail will be painful, because they are afraid that the nail plate will be removed completely.In fact, only a part of the nail plate with the growth layer is removed. During the entire operation, the patient only feels the needle stick. As a result, after a short time, it will be impossible to determine that some kind of operation was performed. After the procedure, the patient will only need to come the next day for the doctor to conduct an examination.

Ingrown nail on the hand – exotic in the master’s office | PROPODO – Internet publication about podology

Daria Krukovskaya in the magazine “Nail Service” told how to cope with the problem of an ingrown toenail.Each master in his practice at least once encounters complaints from clients about painful sensations in the area of ​​the lateral rollers. But still, this problem is mainly associated with the foot and is caused by increased stress on the nail and soft tissues of the toe, wearing narrow shoes, deformation of the foot and improper cut of the free edge.

There are many articles and seminars devoted to the topic of an ingrown toenail; there are methods for treating an ingrown toenail and correction systems of various actions. Therefore, the masters are ready to face such a problem, and the specialists of hardware medical pedicure solve it.

But an ingrown nail on a hand is capable of confusing even an experienced specialist. It’s like the law of gravity that stops working in zero gravity.

You know what to do with an ingrown toenail, but all these techniques may not work for the same problem on the hand.

Onychocryptosis is a scientific term for the ingrowth of the nail plate into the lateral ridge. By itself, the deformation of the lateral side of the nail plate cannot be classified as onychocryptosis.

An ingrown nail is considered when certain symptoms are present: pain, redness, swelling of soft tissues, the presence of hypergranulation (overgrowth of soft tissues at the site of injury). Ingrowth has several stages, and the more its signs you see in a client, the more serious the stage of the problem and the more difficult the work ahead.

What is the difference? Let’s make a comparison and identify the differences in the structure and processes occurring on the fingers and toes (Fig. 1, 2).

Figure 1.

Figure 2.

The nail plate on the hand almost always has a free edge extending beyond the distal ridge. In this regard, she is prone to frequent chipping injuries. Treated toenails have a free edge length of 0.5–1 mm.

The lateral ridges on the toes are more pronounced, the lateral sinuses are deeper than on the hands. On the toes, it is possible to seal the ingrown corner with capolin (dressing), on the hand it is rarely possible to do this.

Incorrect treatment of the nail plate is ranked
first in the charts for ingrowth reasons

In the lateral roller of the toe, where the lateral side of the nail plate is located, there is a zone of natural onycholysis – the nail is not anatomically completely adjacent to the bed. This structural feature allows you to cut an ingrown corner of the nail. There is no such thing on the hand and it is rarely possible to excise the corner.

With an inflammatory process on the toe, provoked by ingrowth, the nail is rejected from the bed (onycholysis), as a result, a void is formed, which can be excised together with the ingrown angle.This does not happen on the hand. Even in a neglected state and with hypergranulation, the nail fits snugly to the bed.

The tight fit of the lateral side of the nail to the stock on the hand deprives us of the opportunity to install a corrective bracket, a half-brace, and the adhesive plates will not hold for a long time and will not give the expected result. Even if you manage to put the brace, there is a great risk that the client will catch on to something and tear it off with part of the nail plate.

WHY DOES THE NAIL GROW?

The causes of ingrowth and inflammation on the foot are clear.Why does this happen on the hands? After all, there is no impact of shoes and pressure.

Let’s consider the main reasons (fig. 3).

Figure 3.

Often the client cuts his nails on his own, going deep into the sinus of the lateral roller. The result of this treatment can be onychocryptosis, since over time the lateral sinus flattens out and prevents the nail from growing. Also, an unnoticed sharp piece of the corner can get into the sinus. Resting on soft tissues, it goes deep into the lateral ridge, provoking inflammation.

Assess the situation, arrange the treatment sequence, decide on recommendations for home procedures

Improper handling of an ingrown toenail can be provoked. In pursuit of an aesthetic appearance, in order to make the nail plate visually narrower, the master saws down the sides. The architecture of the nail is disturbed – the lateral side becomes uneven (an angle is formed), the arch and stiffeners disappear, which means that the nail loses strength.Nails of this shape often break, and at the root, and sometimes along the living, there is a great risk of longitudinal spalling.

No one is immune from injury, as a result of even a slight blow, the nail plate can crack or chip. If an acute angle forms in the lateral ridge, there is a risk of ingrowth. You can injure your nails even higher if the length of the free edge is longer than the permissible one. A natural nail should have a length of up to 1/3 of the nail bed, it is aesthetically pleasing and “wearable”.

Classic manicure with cutting tools remains popular.This is the most traumatic type of manicure, often the side bolsters and sinuses are brought to a delicate pink color. As a result of this treatment, the barrier functions of the skin are reduced. She becomes sensitive to mechanical stress. The lateral side of the nail plate can easily damage the delicate lateral roller, ingrowth and inflammation will begin. In my practice, there was a case when a client, after a manicure of a very diligent master, got inflamed lateral ridges of all ten fingers! Keeping sharp tools in hand, the master must work with extreme caution.Remember, it is better to leave more than remove the excess.

Anatomical predisposition to onychocryptosis. Nails with a high arch are prone to ingrowth. With age, clients with this structural feature may deform and twist the nail plate, which increases the risk of ingrowth.

Onycholysis. Detachment of the nail plate from the bed occurs for various reasons – trauma, chemical exposure, mycosis, etc. In the place where such a void appears, the nail becomes dry, and this leads to deformation.

Now let’s figure out what to do if a client comes to you with such a problem.

WE SAVE THE CLIENT

The first thing to do is to assess the situation, build a treatment sequence, and decide on recommendations for home procedures.

Pain and inflammation are caused by a foreign body that presses on soft tissues (in our case, a foreign body is the corner of the nail plate), an infection that quickly enough joins open injuries can complicate the situation.

Hands are exposed to external factors – household chemicals, sudden temperature changes, frequent contact with water and infectious agents. Therefore, the task of the master is not only to remove the cause of the inflammation (the irritating effect of the ingrown corner), to cope with the consequence (edema and suppuration, if any), but also to prevent further infection.

There is a classification of an ingrown toenail that divides the ingrowth into five stages. This classification is applicable to working with hands.

Stage 1 – ingrown nail without inflammation, creates minor discomfort (photo 1).

In this case, it is enough to correctly process the lateral side of the nail plate. If possible, the ingrown part should be cut off or removed with the apparatus. If the nail is thin, you can use artificial material to add thickness, this will increase the side area and reduce the stress on the soft tissue. For such purposes, special prosthetic materials have been developed, but materials for nail modeling can also be used.In a few procedures, you will remove the corner from the side roller. After that, you can do the deformity correction (photo 2).

Stage 2 – ingrown nail with swelling and inflammation (photo 3).

This stage is a harbinger of a purulent process, therefore it is very important to carry out the procedure according to all the rules of hygiene and antiseptics. We make a three to five minute warm bath with salt. We treat the finger with an antiseptic (chlorhexidine, peroxide, octenisept or their analogs must be in the master’s arsenal).The corner must be rounded or removed if possible. Most often, it is possible to completely remove the ingrown corner in the second procedure, after a few days. Then re-treat with an antiseptic, make a bandage. At home, the client must do baths and change the dressing every day, alcohol tinctures can also be used. After a few days, when the swelling subsides and the treatment will be more convenient to carry out in the office, you can re-round the corner. Contact with water must be excluded, as this is a source of infection
(photo 4).

3rd and 4th stages – ingrown nail with inflammation, suppuration and hypergranulation (photo 5).

These are the most serious and dangerous stages for the client’s health, since inflammatory and purulent processes are already underway. Only a highly qualified specialist with deep medical knowledge and rich practical experience can undertake such work. If you are not confident in your abilities or
do not have a properly equipped workplace, the client should be referred to a specialized doctor (surgeon) or podiatrist who works with similar problems.It will not be possible to remove the ingrown part in the first
procedure.

Treatment will include cleaning the wound, antiseptics, applying healing agents and
a sterile dressing (photo 6). At home, it is necessary to exclude contact with water, make antiseptic baths, treat your finger with an antiseptic, you can use alcohol tinctures. And only after the inflammation disappears, the granulation “dries up”, it will be possible to process the corner and start removing it from the side roller (photo 7).

Stage 5 – ingrown nail after surgery, with a relapse (photo 8, 9).

On hands, this phenomenon is extremely rare. Postoperative relapses are quite common in the foot. The operated nail loses its aesthetic appearance forever, so the nail technician must do everything possible to prevent ingrowth and to protect the client from such a situation.

And remember, disinfection, sterilization and antiseptics are vital in the master’s office! Any procedure cannot start if the instrument or the skin of the hands of the master and the client is not properly processed!

In conclusion, I would like to say that the problem is always easier to prevent than to solve at the stage of exacerbation.A professional manicure is a hygienic procedure that not only preserves beauty, but also maintains the health of your hands and nails!

Darya Krukovskaya’s VKontakte page

90,000 Why does a nail grow in and how to treat it

Ingrown nail (onychocryptosis) – ingrowth of the nail plate into the lateral edge of the nail fold (most often on the big toe, most often the outer edge). This is a very common disease. In this case, the nail fold becomes red and swollen, inflammation begins, causing severe pain.In the future, the development of a chronic inflammatory process is possible.

Ingrown nails are at risk of infection, so it is important to identify and treat them early to prevent complications. This is especially important for certain populations that are prone to diseases such as diabetes or other diseases that affect the peripheral nervous system.

What affects the risk of ingrown toenails

Factors that can increase the risk of ingrown toenails are highlighted, including:

• Incorrect nail clipping.
• Incorrect nail shape.
• Unsuitable footwear.
• Thickening of nails.
• Excessive sweating.

Symptoms and complications of an ingrown nail

Initial signs of this condition include tender, swollen and hardened skin surrounding the nail. Liquid may also form around it.

Ingrown toenails are prone to infection, which can cause additional symptoms such as bleeding or pus.Certain populations are at higher risk of complications. These include people with diabetes or poor circulation in the limbs.

Ingrown nail treatment

It is best to diagnose and treat the condition as soon as possible to prevent worsening of the condition. Usually, an ingrown toenail can be treated at home, but for diabetes, consultation with a specialist is recommended.

Treatment of an ingrown toenail at home is possible only at the initial stages of the development of the problem.If the situation is complicated by suppuration and an open wound, you should immediately seek help from a doctor.

The primary task is to “release” the nail plate from under the side roller. To do this, soften the legs in warm water for 20-25 minutes, and gently massage the inflamed area to gently remove the nail plate from under the nail roller. Treat with an antiseptic and apply a medicinal bandage. This procedure must be done twice a day.

Simple pain relievers such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective for immediate pain relief.

Paracetamol

In more severe cases, partial or complete removal of the affected nail may be required. This is usually done under local anesthesia to numb the area. Patients can return home shortly after surgery, although they should avoid pressure or weight on the sock for 24 to 48 hours after the procedure.

Prevention of ingrown toenail

There are several ways to help prevent ingrown toenails and related complications.They include the following actions:

• Trim your nails correctly.
• Keep feet clean and dry.
• Avoid tight shoes and tight socks.

It is important for patients to regularly examine their toenails to check for any changes that could be an early sign of an ingrown toenail. This allows them to start treatment at home as soon as possible and helps prevent disease progression.

Disclaimer : This content, including tips, provides general information only. This is in no way a substitute for a qualified medical report. Always consult a specialist or your healthcare professional for more information.

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90,000 Ingrown toenail – Honey Center

Ingrown nail (onychocryptosis) – a disease in which the nail plate grows into the lateral edge of the periungual ridge.

What worries you:

• Pain in the area of ​​the nail phalanx of the big toe (in the initial stage it manifests itself as pain when walking, and later on, the discomfort does not go away even at rest)?
• Swelling and redness of the periungual fold?
• The appearance of pus and the growth of granulations?

At the Plasma Medical Center, surgeons perform an operation to treat an ingrown nail with a guarantee of no relapse.The nail will never grow in again!

Surgical treatment is the most effective way to treat this disease. Conservative methods are able to eliminate the problem only at the very initial stages and are used with the operation in complex treatment.

Important! In the absence of specialized treatment, the disease often recurs, and drug treatment (anti-inflammatory, antibiotic therapy) has a short-term effect.

Complications of an ingrown toenail:

In case of untimely treatment of an ingrown nail, complications associated with the development of an infectious and inflammatory process may occur:

• Toe abscess – formation of a cavity with purulent contents, edema and redness of the entire nail phalanx.Requires surgical intervention.
• Osteomyelitis of the nail phalanx of the finger – the infectious process spreads to the bone, medical and surgical treatment is necessary. With late treatment, phalanx amputation may be required.
• Gangrene of the toe – irreversible damage (necrosis) of the soft tissues of the foot. The only way to treat this condition is to amputate the nail phalanx or the entire toe.
• Lymphangitis or lymphadenitis – spread of infection through the lymphatic system with damage to the lymphatic vessels or lymph nodes.Requires complex treatment with the appointment of anti-inflammatory and antibacterial therapy.

Diabetes mellitus, obliterating atherosclerosis of the vessels of the lower extremities and immunodeficiency increase the likelihood of complications. A long-term ingrown nail can cause fibroids and malignant neoplasms.

How is an ingrown toenail treated?

• Ingrown toenail surgery usually requires little preparation and is performed on an outpatient basis.
• Absolutely painless (performed under local anesthesia). Before anesthesia, the doctor assesses the patient’s allergies to the anesthetic and other medications.
• The procedure takes from 10 minutes.

After the operation, a tight aseptic bandage with an antiseptic is applied. Dressings in the postoperative period are sufficient to carry out once a day under the supervision of a physician. The stitches are removed in 7-14 days, depending on the volume of the operation and the body’s ability to recover.

At the consultation before the operation, if there is a suspicion of the possibility of complications, as well as to clarify the causes of the development of the disease, the surgeon may prescribe additional diagnostic methods:

• General blood test to exclude signs of a general inflammatory process.
• X-ray of feet . The X-ray is intended to detect the spread of purulent inflammation, the transition of the pathological process to the phalanx bones, as well as to clarify the anatomical features of the foot (the degree of deviation of the first toe, assessing the degree of flat feet).
• Culture of purulent discharge to study the type of pathogen. It is necessary to determine the sensitivity of bacteria to antibiotics with a prolonged recurrent course of the disease and ineffectiveness of therapy.

An operation to treat an ingrown toenail at the Plasma Medical Center eliminates the disease, does not have a relapse, improves the cosmetic effect and improves the patient’s quality of life, without limiting his daily activities.

After surgery:

• The patient can go home on his own feet, he can drive a car and lead a normal life.
• The effect of anesthesia lasts up to 2 hours, after which pain appears in the area of ​​the postoperative wound. For the postoperative period, the surgeon will prescribe anesthetic therapy, taking into account the patient’s allergies and concomitant diseases.
• The dressing may be slightly soaked with blood, but if signs of bleeding persist, it is necessary to urgently consult your doctor.

Ingrown toenail prevention:

• Wear comfortable shoes;
• Observe hygiene in nail care;
• Trim your nails correctly: in a straight line no lower than the tip of your toe;
• file the edges of the nail with a file in the corners so that they are smooth and do not injure the skin.

We also recommend correcting concomitant diseases: normalizing blood sugar in diabetes mellitus, controlling body weight in obesity, curing onychomycosis (foot fungus), wearing orthopedic shoes for flat feet and silicone liners for hallux valgus.

Our specialists:

Vaganov Ilya Grigorievich

Candidate of Medical Sciences, Surgeon

Experience 24 years

Tishchenko Andrey Yurievich

Surgeon

Experience 24 years

.