What Causes An Ingrown Toenail
There are many causes of an ingrown toenail, these include
- Cutting technique Your podiatrist will encourage you to cut straight across your toenail, as cutting down the edges of the nail may cause a spike or encourage the nail to grow into the skin. If there is a break in the skin you are at risk of infection.
- Genetics Unfortunately your genetics can be a factor in development of an ingrown nail. If your parents have experienced ingrown nails it is likely that you too, will get them at some stage. A wide, curved nail is also a genetic risk factor.
- Trauma , for example, stubbing the toe, dropping something on it, being stepped on if the nail has been damaged it may change the way the nail grows in the future.
- Footwear choices If footwear worn is too small or narrow it may influence the way the nail grows and cause it to change direction and go into the skin.
- Poor circulation People who have compromised circulation may be more susceptible to developing an ingrown toenail.
How Will I Know If I Have An Ingrown Toenail
The signs and symptoms of ingrown toenails can and generally tend to vary from person to person, but it is likely that you will notice pressure or pain, redness, swelling and pus. If you have any of these signs or symptoms make sure you seek professional health advice as soon as possible. Your Podiatrist can guide you as to whether you require antibiotics and ongoing treatment to resolve your ingrown.
Soak In Apple Cider Vinegar
Apple cider vinegar is a folk remedy for almost everything these days, including ingrown toenails. Its believed to have antiseptic, anti-inflammatory, and pain-relieving abilities, although scientific evidence is limited at best.
To try this remedy, prepare a basin of warm water combined with 1/4 cup apple cider vinegar. Soak the affected foot for up to 20 minutes daily. Dry your foot thoroughly after soaking.
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Common Causes Of An Ingrown Toenail
Some of the most common causes of an ingrown toenail include:
- Wearing shoes that crowd the toenails, such as heels or any shoes that are too tight )
- Cutting toenails too short or not straight across
- Injuring the toenail
- Subungual exostosis
- Use of isotretinoin in the treatment of severe acne
There are many risk factors involved in the development of ingrown nails, such as anatomic and behavioral mechanisms. Some experts suggest that wider nail folds and thinner, flatter nails may increase the risk of ingrown toenails. A case-control study with 46 patients found no difference in the anatomic shape of toenails in patients with and without ingrown toenails.
Repetitive trauma, such as running, kicking or inadvertent trauma like stubbing the toe, may be other ingrown toenail causes. Without any strict evidence basis, its thought that a genetic predisposition and family history, hyperhidrosis, and poor foot hygiene increase the likelihood of ingrown toenails. Diabetes, obesity, thyroid, cardiac and renal disorders that may predispose to lower extremity edema can also increase the likelihood.
I want to note that an ingrown fingernail is similar in terms of how it happens. The usual causes of ingrown fingernails are due to improper trimming of the nail, an injury and even nail biting. And, like the toenail, sometimes the natural shape or thickness of the nail can make it more susceptible to becoming ingrown.
Whats Happening When A Nail Grows In
Ingrown toenails happen when the side or top corner of your toenail grows in to the flesh around the nail. One or both sides of the big toenail can be ingrown.
This can happen when the nail becomes damaged, bent, or has been growing against external pressure. One example is if you wear the same shoes every day and those shoes compress your toes together or put pressure on the side of your toe and nail. Instead of growing straight, the toenail edge curls down, digging into the skin and flesh.
Several things can put pressure on or damage the nail, increasing the risk of an ingrown toenail. These include:
- a fungal or bacterial infection in the nail
- constantly sweaty or damp feet
- damaged or torn nails
- not trimming the nail properly
- wearing high-heeled shoes
- wearing tight, narrow, or poorly fitting shoes
Injuring your nail by stubbing your big toe can lead to an ingrown nail. Other causes include chronic illnesses or not getting the right nutrients in your diet for healthy nail growth. Family history or being on certain medications also increases your risk.
It can also simply be anatomical. The shape and size of parts of your toe may make you more prone to getting ingrown nails.
Ingrown nails are a common nail condition. See your doctor if:
- you keep getting ingrown nails
- it doesnt improve
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Wear Comfortable Shoes Or Sandals
- Wearing too tight shoes or sandals makes your feel too crowded leading to the cause of ingrown toenails.
- To prevent such an occurrence from happening, it is always better to wear socks and shoes that are not too tight to your feet.
- During the time when you are suffering from an ingrown toenail, it is better to avoid wearing such shoes or sandals and keep your feel as relaxed as possible.
What Is The Appearance Of The Nail After Surgery
If a permanent resection of the nail was performed , the nail will appear narrower by a few millimeters on the affected nail border. Unless a large portion of the nail was removed during the procedure, the overall appearance of the nail does not change significantly. If the nail matrix is not removed or cauterized, then the nail should regrow to its original appearance and width.
Is surgery really necessary?
If conservative treatments fail, surgery to remove the offending nail border is recommended. If the condition is recurrent and/or chronic, a matrixectomy may be recommended. Both procedures are usually performed in your doctor or podiatrist’s office.
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Why Does This Happen
An ingrown toenail occurs when the edge of your toenail gets curved or it tends to start growing around the toe area or skin region. The pain is quite acute which might result in swelling and redness. Most the big toe of your foot tends to get in such a problem. When you tend to treat an ingrown toenail, you need to be highly careful and perform it with utmost care under experts advice.
The Best Treatment Option
While conservative therapies may eventually be effective insome cases, the best treatment option is almost always going to be apartial ingrown toenail removal from a podiatrist.
In fact, this is a pretty simple and straightforwardprocedure for a trained specialist like Dr. Yuko Miyazaki, and the relief youfeel afterward is incredible.
Heres how it worksand it only takes about 15 minutes frombeginning to end:
- First, we inject a small amount of localanesthetic into the toe to ensure you dont feel any pain during the procedure.
- Next, well gently cut out and remove the portionof the nail border digging into the surrounding skin.
- Finally, if your ingrown toenails are arecurring problem ,well also remove some of the nail matrix underneath. This prevents that edgeof the nail border from growing back.
After that, your toe will be bandaged, and we may alsoprescribe an antibiotic to prevent or treat an infection if we feel it isnecessary to do so.
There are many significant advantages to this type ofprocedure, many of which weve already highlighted above but will summarizeagain below:
If you still want to try home treatments despite all theseadvantages, thats your choice. But in our opinion, going straight to aprofessional like Dr. Miyazaki really is a no-brainer.
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Approach To The Patient
Surgical Approach to the Ingrown Toenail
Obtain surgical consent after explaining to the patient the risks, benefits, and alternatives. Place the patient in a supine or seated position with the affected toe and foot hanging off the end of the table.
Prepare the affected toe with standard povidone iodine solution. Use lidocaine or bupivacaine without epinephrine for local anesthesia in a digital block fashion.
Use a tourniquet or rubber band around the toe to assist in hemostasis for only a short duration use with caution in patients with known peripheral vascular disease or diabetes .
Identify the lateral 20 to 25 percent of the ingrown nail as the site of the partial lateral nail avulsion. Use a nail elevator under the nail to separate it from the nail bed .
Use a nail splitter to cut from the distal end of the toenail straight back toward the cuticle beneath the nail fold .
Grasp the avulsed lateral nail fragment with a hemostat down to just past the cuticle. Remove it by twisting the avulsed nail outward toward the lateral nail fold while pulling in a straight direction toward the end of the toe. Ensure that the entire nail fragment and flat edge of the nail bed is retrieved to prevent formation of a nail spicule and the potential for recurrence of an ingrown nail.
After surgery, apply a dressing of antibiotic ointment , 4 X 4 gauze, tube gauze, and paper tape, ensuring a comfortable bandage .
Information from references 8, 12, and 17.
What Does The Recovery From Toenail Surgery Entail
The operated foot should be elevated for the remainder of the day. Typically, the dressings are removed the day following the procedure. Cleansing of the wound or soaks in Epsom salts and/or antimicrobial soap followed by application of an antibacterial cream and small bandage twice a day for one to two weeks can help to prevent infection. Open toe or loose-fitting, wide toe box shoes are recommended to avoid pressure to the toe while healing. Your doctor may want to see you return in a few weeks to ensure appropriate healing of the procedure site.
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Home Care: Keep It Simple
If your symptoms are minor and you don’t have a complicating medical condition such as diabetes, you can start at home with conservative measures.
Soak the foot in lukewarm water two or three times a day for 15 minutes . You can add Epsom salts if you wish, although there’s no scientific evidence that this will improve pain relief or healing. Massage the skin at the side of the toenail , gently pushing it away from the nail. After each soak, dry your foot thoroughly. Wear sandals or other low-heeled open-toed shoes whenever possible. When you wear close-toed shoes, make sure the toe box allows room for the toes to move freely. When the toenail grows out, cut it across in a line that mimics the curving line of the toe tip do not round the corners down.
How To Flatten A Curved Toenail
A curved toenail could eventually become a painful ingrown toenail if it’s not dealt with properly 1. The nail becomes inflamed and sore, eventually leading to an unpleasant trip to the doctor. While there is no way to flatten or change the shape of an existing toenail, you can help correct the symptoms and alleviate the pain. The process is done by lifting the curve away from the flesh until it grows out normally, or by properly trimming the nail to eventually remove the curved part completely.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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How Can I Fix My Ingrown Toenail Today
Lets start with addressing a common misconception: that simply soaking it in salty water and leaving it be will eventually lead to it fixing itself. When you consider why your toenail is sore in the first place from a piece of nail that has entered the skin, youll understand why salty water isnt a suitable or effective solution. We see many ingrown toenails that have been left for weeks without success, while its owner struggles with pain while wearing shoes, and may even be unable to tolerate the pressure from the bedsheets.
Fixing your ingrown toenails starts with removing the troublesome, penetrating nail edge and not leaving any spicules or pieces of it behind. The safe, quick and easy removal of these spicules is one of our specialities here at My FootDr and it doesnt require any anaesthetic unless you want it! Its a simple process that is done in your treatment chair and youll feel instant relief though you may have some residual tenderness from the swelling until it settles and heals. Once the nail is removed, the skin can heal, and your toe can return to its former pain-free state.
What Are The Potential Complications Of Surgery
Complications from ingrown toenail surgeries are rare but can occur. Complications include infection after the procedure, prolonged tenderness along the procedure site, a slow-healing wound , and recurrence. You are more prone to post-surgery complications if you do not follow proper instruction to care for the ingrown toenail. Fortunately, these complications are fairly easy to manage. If you are prone to infection, your doctor may prescribe oral antibiotics following the procedure.
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What Can A Doctor Do For An Ingrown Toenail
Your doctor, orthopedic surgeon, or podiatrist can treat an ingrown nail with a minor procedure, or in certain cases with surgery.
This typically involves numbing the toe or foot with an injection. The skin on top of the ingrown nail may be removed with a scalpel.
The ingrown nail section is then partly or completely removed. You will not feel any pain during the procedure expect for the injection.
If you have ingrown nails often, your surgery may include use of a laser or chemical procedure to remove a part of the nail bed permanently so that it no longer grows as wide.
How Are Ingrown Toenail Treated
If you have diabetes, nerve damage in your leg or foot, poor blood circulation to your foot or an infection around the nail, see your doctor or podiatrist immediately.
Otherwise, try this:
- Soak your feet in warm water for 15 to 20 minutes, 3 or 4 times a day.
- Then use a cotton bud to gently push away the skin from the nail.
- Repeat each day for a few weeks, allowing the nail to grow.
- As the end of the nail grows forward, push a tiny piece of cotton wool or dental floss under it to help the nail grow over the skin and not grow into it. Change the cotton wool or dental floss each time you soak your foot.
- Do not pick at the toenail or try to remove it yourself.
An infected toenail may be treated with antibiotics. Your doctor or podiatrist may need to drain the pus. In severe cases, part or all of nail may need to be removed.
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Ways To Treat Ingrown Toenails
Ingrown toenails can be very painful and at times need the attention of a professional, but there are some things you can do on your own.
Ingrown toenails are painful, and they can be tricky to treat because they can easily become infected and are often a recurring problem.
If your ingrown toenail has become infected, you shouldn’t attempt to treat it yourself. “The first thing is, if they’re infected, they need to be seen by a podiatrist,” says Alan K. Mauser, DPM, a podiatrist in Louisville, Ky.
If the ingrown toenail is not infected, you can try some at-home remedies to keep the pain at bay and prevent the ingrown toenail from coming back. Here are some ideas:
What Causes An Infected Ingrown Toenail
The warm, moist environment of the feet can be a breeding ground for bacteria and fungi. These commonly include Staphylococcus, Pseudomonas, dermatophytes, Candida, and Trichophyton. When there is a break in the skin from the offending nail border, these organisms can invade the area and cause an infection. Treatment for these infections is essential to maintain healthy toenails and feet. The medical term for infected ingrown toenail is called paronychia. If not treated, the infected toenail can cause serious problems such as chronic pain and disfigurement, cellulitis, and bone infection.
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What To Do If You Cant Fix And Ingrown Toenail At Home
We would always recommend that you visit your podiatrist immediately if you notice any of the previously mentioned symptoms. Your Podiatrist will likely attempt to manage your ingrown nail conservatively first This usually requires resection of your nail simply using nail clippers and a small blade. Once the offending portion of the nail has been removed, the area will be cleansed with saline and re-dressed with betadine and some sterile dressings. Usually, this can be done without too much pain and discomfort, however, a local anesthetic may be used.
Following your initial appointment you will see your Podiatrist in about 1 week to ensure the toe is healing well.