Common Foot Problems

Ingrown Toenail

An ingrown toenail is a common nail condition in which the nail is curved and grows into the skin, cutting into one or both sides of the nail bed. The penetration of the nail irritates the skin and causes pain, redness, swelling and warmth in the toe.

An ingrown nail that causes a break in the skin may allow bacteria to enter and result in an infection. Drainage and a foul odor are often signs of an infection. An infection can still result, however, from an ingrown toenail not accompanied by pain, redness, swelling and warmth in the toe.

Ingrown toenails may be caused by:

Heredity. Ingrown toenails are often the result of genetics.
Trauma. Stubbing the toe, dropping an object on the toe or playing sports that cause repeated pressure on the toes, such as running or soccer, can result in an ingrown toenail.
Improper trimming. Clipping the nails too short makes the bordering skin to fold over the nail. This is the most common cause of ingrown toenails.

Ill-fitting footwear. Wearing socks and shoes that are too tight or short can result in ingrown toenails.
Nail conditions. Losing a nail due to trauma, or fungal infections may encourage an ingrown toenail.

Ingrown toenails may often be treated safely at home. Professional care is strongly encouraged, however, in the case of a suspected infection, or in patients with high risk medical conditions, such as diabetes, nerve damage in the foot or poor circulation.

In the absence of an infection or any high risk medical conditions, the foot can be soaked in lukewarm water and Epsom salts. Gently massaging the side of the nail fold may reduce the inflammation.

Repeatedly cutting the nail to ease pain and swelling may worsen the condition over time. If home treatments do not relieve symptoms over time, then make an appointment with Dr. Radovic.

Dr. Radovic will examine the toe and recommend a suitable treatment plan. An oral antibiotic may be prescribed to supplement treatment if there is an infection.

A minor surgery, usually performed in the office, will remove the ingrown toenail and relieve the pain. Dr. Radovic first numbs the toe with a local anesthetic, then partially removes the nail's side border. Nails that become ingrown again may require removal of the nail root.

A light bandage will be applied after the nail procedure. Very little pain is often felt after surgery, allowing patients to begin normal activity the following day. If Dr. Radovic prescribes an antibiotic, make sure to finish the series of medication even if all symptoms have subsided.

Ingrown toenails can often be prevented by:

Proper trimming. Trim toenails in a fairly straight line and avoid cutting them too short. Your fingernail should easily slide under the sides and end of the nail.
Proper footwear. Wear shoes that are long and wide enough to prevent pressure on the toes. Shoes that are too short, too tight or too loose will compress the toes, especially during running or brisk walking.
Avoid cutting a notch in the nail. This does not alleviate an ingrown toenail and may be harmful if cut too deeply.
Avoid repeatedly trimming nail borders. Nail shape is not determined by the end of the nail, and repeated trimming may cause further complications.
Avoid placing cotton under the nail. Cotton does not ease the pain, and may in fact cause harmful bacteria to grow, leading to infection.

Over-the-counter medications are ineffective. Ointments may temporarily relieve the pain, but the ingrown toenail will still remain.

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