Ingrowing toenails can be a particularly painful condition occurring when the sides of the toenail grow into the surrounding skin. The area becomes very painful, particularly on pressure, inflamed, and eventually may become septic with yellow/white pus being present.
Ingrowing toenails mainly happen to the big toenails but it can affect any toe. Whilst the piece of nail is still ingrowing, the toe will swell but the body will attempt to try and heal itself, so it produces hypergranulation tissue, which causes the toe to look red, swollen and bulbous and very ‘bloody’ looking.
The condition can be caused by a number of factors including injury such as stubbing of the toe which may cause cracks or splits; badly cut toenails; involuted nails which are where the nail grows humped rather than flat; wearing badly fitting shoes, wearing socks or hosiery that is too tight and sweaty feet which can cause the skin to soften so the nail can pierce the skin.
Ingrowing toenails can be prevented by taking a few common-sense precautions. The obvious place to start would be with toenail cutting. If you are not sure you are cutting your nails properly for their natural shape – ask a podiatrist! They will be very happy to show you and advise the correct instruments and methods to use ie, nail clipper, nippers, scissors, easing the skin away from the nail. Also, check your shoe size, do the thumb test on the toe box of the shoe and as always, wash your feet regularly and change hosiery daily.
If the condition is infected then it will need a course of antibiotics but if it is caused by a spike or shoulder of the nail, it will need to be removed. If you act quickly then a podiatrist may be able to remove it conservatively by clipping out the offending piece of nail. If left, nail surgery may be required under local anaesthetic. This surgery can take two forms. Firstly, partial nail avulsion which is when a section of the nail is removed and a chemical called phenol is applied to stop that section of nail re-growing (98% effective). And secondly, total nail avulsion when the whole nail is removed and again phenolised.
Following nail surgery, it is imperative to keep the nail dry and sterile and to rest to aid the healing process. It will take approximately 6 – 8 weeks to heal completely and sterile aftercare is essential, this should be explained post surgery.
Patient feedback frequently reports immediate relief and little or no post-operative discomfort.
Look after your feet – you’ll never get another pair!
