What causes ingrown toenails?Various factors can encourage ingrown toenails, the most important common of which is an improper nail-cutting technique. Nails should be cut in a straight, clean line with no fraying or split edges and no curves. Curving or ‘rounding’ the edges of the nail down the side can encourage the nail to grow curved down into the skin. Another common culprit is pulling or picking the nails. Pulling the top of the nail off, instead of cutting them in a straight line with a tool, can leave a spicule at the edge of the nail where it is ripped off, often deep down the side of the nail where it is not visible or felt – until it starts growing and pierces the skin. Tight footwear creates pressure on the sides of the toes that can push the nail into the surrounding skin. The shape of the nail can also play a role, especially where the nail is particularly involuted or curved. This is often linked to uncontrollable genetic factors that dictate the features and shape of the nail.
What are the symptoms?Ingrown toenails are usually easy to spot because of the marked swelling at the sides of the nail. Common symptoms include:
- Mild to severe pain on touch
- Occasional bleeding at the pierced site
- Yellow/clear discharge if an infection is present
The risk of infectionAs with any opening in the skin, ingrown toenails carry with them the risk of infection, which is amplified by the location of the wound down at the feet. This makes seeking appropriate treatment for ingrown toenails very important, especially if you have diabetes, nerve damage or poor circulation, all of which increase your risk for adverse effects. Individuals with these conditions should not attempt to treat their ingrown toenails at home and should seek the help of their Podiatrist as soon as possible.
How is an ingrown toenail treated?Ingrown toenail treatment ranges from a one-off conservative treatment to remove the ingrowing section of the nail and alleviate painful symptoms, or can be corrected permanently. When non-conservatively correcting an ingrown toenail, either a small section of the edge of the nail may be removed (none or a minimal change in appearance, called a partial nail avulsion) or the entire nail may be removed (total nail avulsion). Toenail surgeries are procedures that we often carry out in our clinic as a solution to toenails that have become ingrown, involuted, disfigured, thickened or are affecting a patient’s quality of life, comfort, their risk of injury, or other negative effects. The two main procedures we carry out are the:
- Partial Nail Avulsion (PNA), for ingrown toenails
- Total Nail Avulsion (TNA), for a variety of conditions