| By :
Brandt R Gibson DPM
Copyright (c) 2009 Mountain West Foot & Ankle Institute Does your toe hurt? Is it red and swollen? Maybe it is draining blood or yellow fluid on socks or shoes. Quite regularly, I see ingrown nails in both adults and children. Although the problem is common, many people attempt to self treat and usually make the problem worse. Ingrown toenails can become a big problem and often can interfere in even normal activities and normal shoes. An ingrown toenail is easily diagnosed by curving of the edge of the nail into the skin and causing inflammation, redness and significant pain. Ingrown toenails are primarily caused by an inherited tendency for the nails to curve, but may be aggravated by tight shoes, tight socks and incorrect nail trimming (nails should be trimmed straight across as opposed to curved like fingernails). In fact many people without an inherited tendency for nails to curve, will never have ingrowing even with tight shoes, poor nail trimming and other causative actions. In my experience, many kids will hide their painful toenails from their parents, men will try treating with a pocketknife or other "bathroom surgery", and then women may self treat with clippers, etc. or may get it treated. My recommendation for all involved is to be evaluated and treated as quickly as possible, because there is no reason to suffer with pain and swelling. Over time, the nail may become increasingly red, swollen and painful and may even break the skin and lead to dangerous infections. I will provide 7 ways to limit and/or prevent ingrown toenails: 1. Nails should be regularly trimmed straight to minimize trauma to the nail during athletics or simple walking. A cracked or broken nail can often lead to ingrowing of the nail. 2. Toenails should not be trimmed as are fingernails (with a curve). Trim toenails in a fairly straight line, and don't cut them too short. I commonly trim my toenails straight and then remove the corners so there are no sharp edges. 3. Correct shoes should be utilized for any activity. Don't wear flip flops or go barefoot for athletic activities as injury to the nail and even the toe can occur. 4. Treat nail injuries aggressively to allow proper healing and limit ingrowth as the nail regrows. 5. If someone develops a painful ingrown toenail, the inflammation can be reduced by soaking the foot in warm water (not hot) with epson salts. While in the water, gently massaging the side of the nail fold to help remove any infectious drainage. 6. Antibiotics may often not be necessary if the ingrown nail is treated properly. A majority of the inflammation occurring is due to the nail being treated by the body as a "sliver". Once the nail is removed from the area, the inflammation improves. Soaking as mentioned above will then usually remove any remaining infection. 7. The best treatment for an ingrown toenail is with a minor surgical procedure at a doctor's office. It is not recommended that an individual try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection and may increase the pain associated. Although ingrown toenails are a common problem, you need not suffer through "bathroom surgery" or other self treatments. Through a simple same day procedure, the painful nail can be treated under local anesthetic and may provide long-term pain relief and especially return to regular activities.
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