How to Handle an Ingrown Toenail

When the sharp corner of your toenail enters the sensitive skin of your toe, you end up with an ingrown toenail along with all the accompanying nasty symptoms — swelling, pain, redness and maybe even an infection. It's usually the big toe that is affected, but all toes are fair game, even your little pinky toe.

How does this painful problem arise? There are several key opponents in the war against your tootsies.

The problem could be your shoes. Are they too tight in the toe area? If you're a runner, did you know that your running shoes should be at least 1 size larger than your regular shoe size? Your toes need room to move. Crowded toenails are pressured to grow abnormally.

When you clip your toenails, do you try to shape them into cute little curves? Unfortunately, that's a bad idea. Toenails should be cut straight across, and they shouldn't be cut too short. Cutting corners can force your toenail to bite into your skin.
If you have athlete's foot or another type of foot fungus, the fungus could make your toenails grow wider and thicker and pierce your skin.

How many times have you stubbed your toe on the coffee table? Repetitive injuries can also be to blame for an ingrown toenail.

You can also thank your Aunt Harriet for your ingrown toenail, because if rounded toes run in your family, your risk for ingrown toenails increases.

Signs and Symptoms of an Ingrown Toenail

Now that you know what causes ingrown toenails, you need to know the signs and symptoms.

If you're at risk for an ingrown toenail, be on the lookout for the following:

- pain along either or both sides of your toenail;
- redness at the end of your toe;
- swollen and warm digits;
- extra skin growth around the sharp part of your toenail; and
- infected toenail tissue (if it is infected, the pain will increase in intensity, swelling will continue, redness will spread and there is the rare possibility that you will become feverish; an untreated infection could lead to a bone infection).

If you have diabetes, do not try any of your great-grandmother's home remedies for ingrown toenails. You should see your physician right away. (Not next week - now!) Diabetes puts you at an even greater risk for infection than the average Jane because diabetes impairs your circulation and causes wounds to heal slowly.

Home Remedies for Ingrown Toenails

If you're fairly healthy, you can try your great-grandmother's home remedies, which may include the following:

- Fill a basin with warm water and soak your feet up to 4 times a day for about 20 minutes each time. It's not necessary to add anything to the warm water. This should reduce swelling and ease any tenderness.
- Use soap and water to wash your foot twice a day. When you're not washing or soaking your feet, keep them dry.
- Break off a few snippets of a clean cotton ball, roll them into a small wick and place them under the ingrown edge of your toenail after you have soaked your feet. Although this is painful, it's important because it will help nudge the nail back above the skin. After each soaking, bite the bullet and push a snippet of cotton farther under the nail. Use a clean piece of cotton each time and do this daily until the redness and pain stops. It might take up to 15 days for your nail to stop piercing your skin.
- Buy an over-the-counter topical antibiotic ointment and apply it to the painful area, then apply a clean bandage.
- Avoid wearing high heels or tight shoes while your ingrown toenail heals. In fact, this would be a good time to wear sandals or some other form of open toe shoes.
- If the pain is severe, try some over-the-counter pain medication such as Tylenol or ibuprofen. Meanwhile, make an appointment to see your doctor, but if you have diabetes, go straight to the emergency room.

For an infected ingrown toenail, home remedies may provide relief, but they are not the solution. Medical attention is necessary. You should especially see a doctor if you have not had a tetanus shot in 5 years or if your toenail has not improved after 3 days of home care.

A Few Things Stronger than a Home Remedy

Your podiatrist or family practitioner will decide whether you have an infection by examining your ingrown toenail and asking questions about how it developed, any pre-existing medical conditions you may have and your most recent tetanus shot. You may have to get a new tetanus shot because there is a chance that an ingrown toenail could lead to tetanus.

The doctor might even order an X-ray and blood tests if a severe infection is suspected. Then, you would receive an anesthetic injection at the point where your toe connects to your foot. This will numb your toe so your doctor can drain the infection, which will likely eliminate the need for antibiotics.
Next, your doctor might trim or remove the ingrown part of the toenail, especially if your pain and redness are accompanied by pus. This will allow the skin to heal without being bothered by the nail. Sometimes, a chemical (phenol) or lasers may be used to destroy cells that would allow the nail to grow back.

For recurrent infections, a lateral matricectomy may be performed by a specialist. This procedure removes part of the nail bed.

It's important that you keep your wound clean and follow all of your doctor's orders and maintain follow-up appointments. One major concern is whether your condition will revert back to an ingrown toenail, which is possible even after nail cells have been destroyed.

The best thing to do is take preventive measures. Remember, clip your toenails straight across, and tell your tell your pedicurist to do the same. Also, keep the end of your toenail longer than the edge of the skin on your toe. Toenails that are too short have a good chance of growing into your skin.

Additionally, wear shoes that fit well (no fancy toe pinchers), and keep your feet dry and clean.