Ingrown Toenails

An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders which are the sides of the nail. This can lead to pain, redness, swelling, and warmth within the skin. If the nail border breaks the skin, bacteria may enter and cause an infection. This is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing. In many instances, the condition is inherited. However, the most common cause is improper trimming where cutting the toenail too short may lead to the adjacent skin folding over the nail border. An ingrown toenail may also develop due to trauma such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or short can also cause ingrown toenails. Putting pressure on the big toe while walking due to having flatfeet or having a bunion where the big toe and 2^nd toe are in constant contact are biomechanical reasons that lead to developing ingrown toenails.

Treatment for an ingrown toenail depends on severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and palliative care. Most cases require evaluation by a foot and ankle surgeon. Surgical removal of the offending nail border may be the best option to relieve the irritated and or infected skin. To prevent recurrence of the ingrown nail, destruction of the nail root is warranted to prevent regrowth of the offending nail.  Antibiotics may be prescribed along with surgery as well. Most patients who undergo nail surgery experience minimal pain afterward and are able to return to normal activity the following day.