Ingrown Toe Nails: Treatment Facts & Myths

Ingrown toe nails are common, particularly in the adolescent population.  The most common causes are narrow/tight shoes, sweaty feet and trimming the nails too short.  Some people have a genetic predisposition to ingrown toenails because the nail itself is curved on the sides.  Often times, the nail starts to grow in and then the patient tries to “dig it out,” thereby making it worse and/or causing it to get infected.

 

Signs of an ingrown toenail include redness, swelling and tenderness. As it progresses, it can become a darker red or even purplish.  Sometimes a growth of tissue develops that overgrows the nail – this is called a granuloma.  The presence of pus indicates a worsening condition that should be treated by a podiatrist.

 

In the early phase of an ingrown toe nail when there is mild tenderness and redness, applying antibiotic ointment and a band-aid to the toe, along with wearing wider shoes can resolve the problem.  Soaking in Epsom salts may provide some relief and occasionally oral antibiotics can help clear up an infection; however, the source of the pain and/or infection is the nail itself and thus the best way to treat the problem is to remove that part of the nail.  This involves numbing the toe and removing a small portion of the nail which will grow back in 9-12 months.

 

For patients who struggle with ingrown nails more than three times per year, it is recommended to have that portion of the nail permanently removed.  The procedure for that also involves numbing the toe, removing a small sliver of the nail and then applying a chemical called phenol which kills the cells that make the nail so that it does not grow back in that area.

 

Preventative measures can include using a band-aid or tape to pull the skin away from the nail, placing a piece of cotton between the nail and the skin or using Vaseline to massage the skin away from the nail as the nail grows out.  The goal is to allow the nail to grow beyond the skin edge and then keep it that length so it can no longer grow into the skin.  Cutting the nail straight across is preferable.  Cutting a “V” into the center of the nail is a myth and does not prevent ingrown toenails.  Wearing wider shoes can provide pain relief and prevent ingrown nails.

 

If you suspect you have an ingrown toenail you should see your podiatrist to discuss appropriate treatment options.  Please resist the temptation to be a bathroom surgeon!

 

Leave a Comment

  • Suzi Pitts

    I enjoyed your article on the “tightrope.” How do you deal with bunionectomy post op ROM?

  • Jeff Hurless

    Nice post Dr. Gifford!

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