An ingrown toenail occurs when a portion of the nail plate engages in the surrounding soft tissue of the toe. This usually happens at the big toe for a variety of reasons, but ingrown toenails can affect one of the toes. Once the nail sinks into the soft tissue, the affected soft tissue becomes pinched resulting in significant pain. In most cases, the pain is worse with any contact with the area, such as bed sheets or closed shoes. However, at other times, an ingrown toenail can result in constant pain.
Ingrown nails can be caused by various factors, including inherited nail types, trauma, claw cuts, shoe pressure or socks, toe deformities, high heels and physical activities. Many times, ingrown toenails are common in some families because of a shape, width or thickness inherited from the fingernail. Ingrown nails can occur at any age. Children often develop ingrown toenails with their high activity levels, and lack of knowledge regarding proper nail cutting techniques. In adults, curved nails often progress over time and may expose one to an increased risk of ingrown toenails.
Once a nail has become ingrown, it produces an ideal environment for infection. The included nail provides an ideal colonization site for bacteria, hidden benefit to the outer skin. When the infection occurs with an ingrown toenail, it is common to see significant redness, swelling, and drainage at the edges of the affected nails. The pain usually increases with an infection as well. Oral antibiotics can usually control the infection for a while. However, the infection usually returns as soon as the antibiotic is stopped, except that part of the nail that is incorporated is removed.
Many times, ingrown toenails can be invented, even in nails that are noticeably curved. A good fit of the nails is essential. As a rule, the nails should be cut in a straight line, never cut deeply into the corners of the edges of the nail. If the edges of the nails are cut too short, the nail often can not clear the skin of the nail fold as it grows, and sinks into the soft tissue. A straight nail clipper can help nail size. In addition, a nail should not be left too long, because a shoe can create a back pressure on the nail against the soft tissue, which causes it to sink and swell. The shoes should allow a distance of the finger width between the end of the longest toe and the end of the shoe, to prevent pressure against the toes. Sharp pointy shoes are also more likely to cause an ingrown toenail, and should be avoided. Daily foot cleaning is also recommended to reduce sources of infection.
People often avoid providing professional treatment of ingrown toenails for a variety of reasons, and live with the condition for many years unnecessarily. Some have had bad experiences in the doctor's office or in emergency rooms before and are reluctant to seek treatment. Others do not know that a permanent fix is available with a simple office procedure. Many people have tried to painfully dig the edge of the nail at home, which usually results in a return of pain on the regrowth of nails, and exposes to an increased risk of infection and additional damage to the nails.
Fortunately, the treatment of ingrown toenails has evolved over the years towards a few simple office procedures that yield predictable and lasting results. In most cases, the non-painful base of the affected toe is pretreated by cold spraying to significantly reduce any brief injection pain. Once the toe is carefully anesthetized, the patient will not feel any pain during the procedure. The offending nail edge is then removed at the root of the nail, which is then treated to prevent regrowth of the curved or embedded nail edge only. An antibiotic cream can then be applied to the area followed by a light dressing. Home care after the procedure usually require a simple daily cleaning followed by an antibiotic cream and a small bandage. The skin reshapes at the edge of the nail in the next few weeks, giving a normal-looking nail that inadvertently becomes incarnate again.
Other permanent treatments for ingrown toenails are also available at the office, and all can prevent many years of unnecessary pain. Therefore, early treatment is advised. The most common comment during the follow-up visit is "I can not believe I did not have this ingrown toenail set earlier!"