Ingrown Toenail Removal & Treatment
An ingrown toenail can feel like a literal torn stuck in your toes. It's unsightly. It's painful. And it can lead to serious complications along the way if you ignore it.
If you have chronic health issues that cause poor circulation, such as diabetes, then you should definitely pay close attention to this condition.
What Is an Ingrown Toenail?
An ingrown toenail (or onychocryptosis) is an unpleasant foot condition where the edge of the nail digs into the skin. As the nail grows, so do the pain and discomfort. It most commonly occurs in the big toe.
It sounds simple enough, but ingrown toenails can lead to serious complications if left untreated. The condition can make it painful to stand or walk. And you can forget about jogging or engaging in sports. Even yoga is a challenge (and not for the usual reasons).
In short, your quality of life suffers a lot.
What Causes Ingrown Toenails?
An ingrown toenail is an incredibly common condition. As such, they have plenty of causes. Some of them include:
- Genetics. Ingrown toenail occurs more broadly in some families, suggesting a genetic component to the condition.
- Cutting your toenails too short. The shorter you cut your toenails, the greater the chance the toenail curves and digs into the skin.
- Improper footwear. This is a broad category. It includes wearing shoes that are too tight and narrow, socks or stockings that put pressure on your toenails, or other footwear that compresses your toes.
- Toenail injuries. Any kind of toe-related injury (such as stubbing your toe or dropping something heavy on your foot) can cause your nail to dig into the skin.
- Improper foot hygiene. If your feet sweat a lot, you need to put extra care into your foot hygiene, otherwise, you risk developing an ingrown toenail.
This is by no means a comprehensive list of potential causes. Once you come in for an exam, we can help you determine the cause of the condition in your particular case.
Risk Factors
The biggest risk factor in regards to ingrown toenails is partaking in athletic activities that involve the feet. Any activity that has to do with kicking or heavily involves your feet puts you at risk, including:
- Soccer
- Ballet
- Kickboxing
- MMA
Taking good care of your feet and toenails if you engage in any of these activities can offset some of the risks.
Symptoms
The symptoms of ingrown toenails vary depending on whether an infection has set in yet or not.
In the early stages, symptoms include:
- Pain. Ingrown toenail pain is the first symptom people notice. The pain is sharp but it's not constant at this stage. It's usually present when you put pressure on your toe.
- Hard skin. The skin around the toe becomes harder and more tender.
- Fluid buildup. You may notice fluid building up around the toe.
Because your toenail digs into the skin, it makes it vulnerable to infection. The symptoms of infected ingrown toenails include:
- Throbbing pain. Now the pain is throbbing and constant. It still hurts more when you put pressure on the toe.
- Redness and swelling. The skin around the affected areas will become red and swollen due to inflammation.
- Pus discharge. If things get particularly bad, you'll notice unpleasant ooze coming out of the skin.
Ingrown toenails are common but they can create serious health issues. You don't have to stoically endure these symptoms as your condition worsens. Especially if there's an infection, we commend you to seek out immediate medical assistance from your local podiatrists - we can help.
How Is an Ingrown Toenail Diagnosed?
A physical examination is enough to diagnose ingrown toenails in most cases. In more severe cases, especially when the infection has set in, we may need to use an X-ray to see the extent of the damage or draw cultures to determine the type of infection. An X-ray would also allow us to identify the cause.
How to Treat Ingrown Toenails
There are plenty of home remedies you can try to treat an ingrown toenail. Be sure to only treat your condition at home if there's no sign of infection. If there is (or if you aren't sure), it's better to be safe than sorry—please seek medical attention.
This advice also applies if you have diabetes, nerve damage, or poor blood circulation because complications can be severe and time is of the essence.
With the clarification out of the way, let's look at some ingrown toenail treatments you can try at home:
- Soaking your foot in warm water. A great way to reduce swelling and provide temporary relief. Soak your foot in warm, soapy water two to three times a day for 20 minutes. You can add some Epsom salts for extra relief. Thoroughly dry your feet when you're done.
- Keep your feet dry. While you're not soaking, keep your feet dry. Even a little moisture in your shoes or socks can be a problem—from making your ingrown toenail worse to giving you athlete's foot.
- Antibiotic ointment. Applying an antibiotic ointment to the affected area can prevent infection and promote healing. Make sure you follow the manufacturer's specified application and bandage the toe when you're done.
- Change your footwear. Since footwear can be a cause of your condition, changing your footwear can prevent it from worsening. Wear comfortable shoes that leave enough room for your toes and try to limit pressure as much as possible.
- Toe protectors. Simple devices that act as a barrier between your toes and your shoes. They can help keep the pressure off your ingrown nail.
- Do not attempt to cut or remove the affected toenail on your own.
A common piece of advice is to self-treat with OTC pain relief medication. We don't recommend this. If you're at the point where you need medication, it's best to schedule a visit with a foot specialist without delay.
Another common piece of advice is tucking dental floss under your ingrown toenail to gently lift the nail edge and promote proper growth. However, this practice may lead to infection so we don't recommend it.
If you're set on trying this method, soak the floss in alcohol to reduce the risk of infection.
Surgical Toenail Removal
If you've tried some of the treatments above but your toenail doesn't seem to be getting better, surgical toenail removal may be the only solution left.
There are two options - partial or complete toenail removal. Partial toenail removal works for most patients. Complete removal is rarely necessary.
Partial removal is called lateral nail avulsion. During the procedure, your orthopedic surgeons will cut away and remove the sides of the nail plate that cause the issue.
Even though it sounds painful, the procedure is performed under local anesthesia (numbing medicine). You'll barely feel a thing.
If the condition is recurring, the matrix (the root of the nail) may be neutralized to prevent regrowth. The result is a narrower toenail, which dramatically lowers the chances you'll deal with this condition in the future.
In severe cases, complete removal of the nail may be required. This is especially true when your condition is caused by a thickening of the nail.
Are There Any Risks?
As with all other surgical procedures, nail avulsion is not without risk. Possible complications include:
- Infection
- Swelling
- Recurrence
The success rate of surgical toenail removal is very high, so there's nothing to worry about. You can discuss the potential risks with your doctor.
How Long Does It Take to Recover?
Recovery time after nail avulsion is a lot shorter than most other surgical procedures. You can usually go home the same day as the procedure.
In a day or two, you'll come back so we can remove your bandages and check up on the healing process. If all is well, you'll have to wear special footwear for a few weeks to protect your toe.
You'll have to soak your feet daily. We'll probably prescribe oral antibiotics to ward off infection and some pain medicine so your healing process is relatively pain-free.
After partial nail avulsion, you'll be able to get back to normal (if there aren't any complications) in two to four weeks. You'll have to wear sandals or open-toed shoes during this period.
However, it will take a few months before your toenail grows back. This is considering we haven't treated the matrix. If we've treated the matrix, it will never grow back and your nail will be narrower.
Are you having trouble with ingrown toenails? Don't hesitate to book your appointment with us! There's no need to wait for complications.