Ingrown Toenails

What is an Ingrown Toenail?

Ingrown toenails most often are the result of an inherited tendency for the nail borders to incurvate more and more as you age. If you see redness/swelling along the entire length of the nail border then this condition is likely inherited. This inherited problem will occur over and over and more frequently. Initially, a snug shoe will flare it up, or a soccer game. Eventually, it will just flare up for no reason. I will suggest a simple 10 minute in-office permanent procedure so that incurved part of the nail won’t grow back and you won’t likely have problems with it again.

If you see redness/swelling just at the tip of the nail edge, then it is likely from shoe pressure or how the nail was cut. The most effective treatment for this, before seeing me and if it is not too inflamed, is to work a small piece of cotton under the nail tip with some antibiotic ointment on it. This might allow the nail to grow out over the skin edge. If it is too inflamed, then see me and I can numb the toe and clip off the offending part of the nail. (Yes, often I do NOT have to numb the toe with a needle but rather using a cold spray and then carefully clip the nail edge.)

While they are very common, ingrown toenails can also be very painful. When trimming your nails, avoid tapering the corners so that the nail curves with the shape of your toe. The sides of the nail will curl down and dig into your skin. Shoes that are too tight or short also may cause ingrown toenails.

Antibiotics are sometimes prescribed if an infection is present. Part of your ingrown toenail (partial nail plate avulsion) may need to be surgically removed if an acute infection occurs. The procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

Most ingrown nails are the inherited type described above and can’t be prevented. But you can prevent ingrown nails at the very tip of the nail edge by:

  1. Avoiding shoes with a tight toe box (slip on shoes particularly)
  2. Realize your feet never stop growing (the rate of growth does slow with age) so be ready to go up in size if you do feel some soreness at the nail border.
  3. Realize your feet change daily and seasonally in size. They are smallest in the morning and swell slightly by the end of the day. Activity, such as running, long walks, increase blood flow in the feet and therefore the size. Hot weather, salt intake, fluid retention, etc. increase the size. Shoes that fit in the winter may not fit in the summer. So that running shoe might fit in the store, but not by the end of a long run on a hot day.

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