Ingrown toenails

One of the most common problems seen by foot doctors is ingrown toenails. “Ingrown” technically means that an edge of the toenail is literally cutting or rubbing into the surrounding skin, which incites swelling, pain, and redness.

As the condition progresses, the body will react to the ingrown toenail as if it were a foreign object, like a large splinter, causing the formation of a very tender, red tissue called a “granuloma” (as seen in the photo).

What causes ingrown toenails?

A variety of factors: tight-fitting shoes; trauma to the toenail; improper trimming or tearing of the toenail, often leaving a sharp edge; and inherited shape of the toenail, with the edge growing deep into the nail groove.

What is the treatment?

Some people hear horror stories of ingrown toenail treatments and do not seek help until the problem is severe. This is unfortunate and unnecessary because the proper treatments are not horrific.

Treatment depends on what caused it in the first place. It can be as simple as trimming and smoothing a rough toenail edge. When it is more severe or happens repeatedly, or the shape of the toenail is the obvious cause, there are very effective strategies to remove the problematic toenail edge so that it does not grow back again. This strategy involves numbing the toe with local anesthetic. This is NOT performed by giving a shot in the tip of the toe, as is commonly feared.

severe ingrown toenail

After the toe is numb, special instruments are used to remove just the edge of the toenail causing the problem. Usually it is unnecessary to remove the entire toenail.

The root of the toenail is then effectively “removed” so that the offending edge of the toenail reliably does not grow back. After the treatment, soaking is necessary until complete healing occurs over the next 2-3 weeks, typically. Recovery does NOT typically require time off of work, school, or sports, though resting the toe will be helpful.

After soaking as instructed, coverage with an adhesive bandage is typically all that is needed. After the numbing medicine wears off, nearly all patients report no more than a dull throbbing for the first couple of days with little to no pain medication necessary, especially if soaking instructions are followed.

So, bottom line message: There is no need to continue suffering with an ingrown toenail – just get it taken care of.