An ingrown toenail recurring after surgery can be frustrating. While surgical intervention aims to provide a lasting solution, several factors can cause the nail to grow back into the surrounding skin. Understanding these reasons, both related to the procedure and individual habits, is important for preventing future occurrences and maintaining foot health.
Common Reasons for Post-Surgical Recurrence
An ingrown toenail can return if any part of the nail-producing tissue, known as the matrix, is not completely removed. Even a small remnant of matrix cells can regenerate a nail spicule that grows into the skin, leading to a new ingrowth. This incomplete removal is a common reason for recurrence following procedures like a matrixectomy.
Another surgical issue is a retained nail spicule or fragment. A small piece of nail left behind during the procedure can act as a foreign body, causing irritation, inflammation, or directly leading to another ingrown nail as it continues to grow. Post-surgical complications, such as infection or improper wound healing, can also predispose an individual to recurrence. An infection can alter the nail bed or surrounding soft tissues, potentially guiding the regrowing nail into an abnormal path.
Sometimes, even with effective matrix removal, the nail plate may regrow in an abnormal pattern or shape. This altered growth can cause the nail to press against the skin, leading to renewed symptoms. Scar tissue formation after surgery can also affect the nail’s growth, potentially contributing to recurrence.
Contributing Factors Beyond the Surgery
Beyond the surgical context, certain habits and predispositions can contribute to an ingrown toenail returning. Improper nail trimming, such as cutting toenails too short or rounding the corners, encourages the nail to grow into the surrounding skin rather than straight out.
Ill-fitting footwear is another significant contributor to recurrence. Shoes that are too tight, narrow, or pointed can compress the toes, forcing the nail plate into the adjacent skin. High heels also increase pressure on the toes, exacerbating this issue.
Individual foot structure and biomechanics play a role. Some people naturally have toenails that are more curved or thick, increasing their susceptibility to ingrown nails. Genetic predisposition means individuals may inherit a tendency for certain nail shapes or toe deformities that make them more prone to this condition.
Underlying medical conditions can also influence recurrence. Conditions like diabetes can impair circulation and nerve function in the feet, making individuals more susceptible to infections and slower healing, which complicates ingrown toenails. Fungal infections can also cause the nail to thicken or deform, increasing the likelihood of ingrowth.
Proactive Steps for Long-Term Prevention
Implementing proper nail care techniques is a fundamental step in preventing ingrown toenail recurrence. Toenails should be trimmed straight across, avoiding rounding the corners or cutting them too short. The nail edge should be roughly even with the tip of the toe.
Choosing appropriate footwear is equally important. Shoes should have a wide toe box that allows toes to move freely and comfortably. Avoiding tight, narrow, or pointed-toe shoes and high heels can significantly reduce pressure on the toenails.
Maintaining good foot hygiene helps prevent infections that can contribute to recurrence. This includes washing feet daily with mild soap and water, and thoroughly drying them, especially between the toes, to prevent moisture buildup. Regular foot inspection allows for early detection of any signs of irritation, redness, or swelling around the nail. Moisturizing the skin around the nails can help keep it supple and prevent cracking.
When to Consult a Specialist
Consult a podiatrist or general practitioner if signs of infection develop around the ingrown toenail. These signs include increased redness, swelling, warmth, or the presence of pus or drainage. Prompt medical attention is important because infections can spread and lead to more serious complications.
Consulting a specialist is also recommended if persistent pain or discomfort continues despite consistent home care measures. If ingrown toenails repeatedly recur even after surgical treatment and adherence to preventive steps, professional evaluation can help identify underlying issues. Individuals with underlying health conditions, such as diabetes or poor circulation, should seek professional care for any ingrown toenail, as these conditions can make foot problems more serious and prone to complications. Regular check-ups with a podiatrist can help manage risks and ensure proper foot health.