An ingrown toenail, medically known as onychocryptosis, occurs when the edge of a toenail grows into the surrounding skin. This common condition can cause pain and discomfort, leading many to wonder whether professional medical intervention is necessary. Understanding the nature of an ingrown toenail and recognizing specific symptoms can help determine the appropriate course of action.
Understanding Ingrown Toenails
Onychocryptosis typically affects the big toe, developing when the nail plate embeds into the adjacent soft tissue. This happens when the nail’s edge, often due to improper trimming or pressure from footwear, penetrates the skin. The nail then acts as a foreign body, triggering an inflammatory response.
This penetration can lead to pain, swelling, and redness around the affected nail fold. While some people have a natural nail curvature that predisposes them, external factors like tight shoes, repetitive toe trauma, or tearing the nail also contribute.
When to Seek Medical Attention
Seek medical attention if signs of infection appear around the ingrown toenail. These signs include increased pain, spreading redness, swelling, warmth to the touch, or pus/foul-smelling drainage. A fever or red streaks extending from the toe also require immediate professional care.
Individuals with underlying health conditions, such as diabetes, poor circulation, or nerve damage (neuropathy), should consult a healthcare provider promptly. These conditions increase the risk of severe infections and complications, making early intervention important. If home care measures do not improve symptoms within two to three days, or if the pain becomes severe enough to hinder walking, professional evaluation is recommended. Recurring ingrown toenails also warrant a doctor’s visit to identify and address the root cause.
When Self-Care Might Be Enough
For mild ingrown toenails with slight redness and minor tenderness, but no signs of infection, self-care may provide relief. Soaking the affected foot in warm water with Epsom salt or mild soap for 10 to 20 minutes, two to four times daily, softens the skin and reduces inflammation. After soaking, gently lifting the nail edge and placing a small piece of cotton or dental floss underneath guides the nail to grow over the skin.
Applying an over-the-counter antibiotic or petrolatum ointment, followed by loose bandaging, prevents infection. Wearing roomy, open-toed shoes or sandals alleviates pressure on the toe while it heals. Over-the-counter pain relievers like ibuprofen or acetaminophen manages discomfort. It is important to avoid attempting to cut or “dig out” an ingrown toenail at home, as this can worsen the condition and lead to serious infections.
What to Expect at the Doctor’s Office
A healthcare provider, often a podiatrist, diagnoses an ingrown toenail through a visual examination. For severe infection or suspected injury, an X-ray might assess the condition’s extent.
Treatment options vary depending on severity. For slightly ingrown nails, the doctor may lift the nail edge and place a splint or cotton underneath to separate it from the skin. If the ingrown toenail is more severe or infected, a partial nail avulsion may be performed, involving numbing the toe and surgically removing the ingrown portion of the nail. In recurrent or very severe cases, a complete nail removal or a procedure involving a chemical to prevent regrowth of the problematic section might be considered. Antibiotics, either oral or topical, are often prescribed if an infection is present.
Preventing Ingrown Toenails
Preventing ingrown toenails involves consistent foot care practices. Trim toenails straight across, rather than rounding the corners or cutting them too short. The nail should extend slightly beyond the end of the toe.
Wear well-fitting shoes with a wide toe box to avoid pressure on the toes. Tight, narrow, or pointed footwear, as well as high heels, can compress the toes and contribute to ingrown nails. Maintain good foot hygiene, including daily cleaning and thorough drying, especially between the toes, to reduce infection risk. Avoid repetitive trauma to the toes, such as from certain sports, to prevent future occurrences. Regularly inspect feet for any early signs of issues for prompt management.