It's no fun to take your shoes off after a long day and get no relief because your toe—often your big toe—keeps hurting. You sit down to get a closer look. The skin bordering your nail bed is red, irritated and swollen. It's painful and tender to the touch. You have an ingrown toenail, and if you’re like most people, the next 3-4 days will be filled with an arsenal of nail clippers, antibiotics, and Band-Aids.
Alex Turnipseed, a physician's assistant at Cedars-SinaiUrgent Care, sees a few patients complaining of ingrown toenails per month. For some, the painful problem repeats itself frequently. He usually fixes the nail by using special tools to cut the ingrown part away.
"The good news is they very rarely lead to any serious infections or complications," he says.
Here are some tips to speed recovery, prevent infection, and figure out when it’s time to make a trip to the doctor.
What is an ingrown toenail?
An ingrown toenail (onychocryptus) occurs when the edge of the toenail cuts into the surrounding tissue, resulting in inflammation. It can also happen when the skin grows over the toenail bed. When the toenail has broken into the flesh, bacteria can form and occasionally lead to serious fungal infections. The resulting inflammation is not only painful, but can cause health problems if left untreated.
Causes and culprits
Ill-fitting shoes, trauma to the toenail bed, improper trimming, and poor foot hygiene can all lead to ingrown toenails. Though ingrown toenails can afflict people of all ages, some people are more vulnerable to getting them than others. Those with diabetes or nerve damage caused by circulatory diseases should be particularly vigilant, as lack of blood flow can slow healing. A tendency to develop ingrown toenails can also be genetic.
Ingrown toenail dos and don’ts
Try "bathroom surgery": Treating the irritated skin at home with sharp objects, cotton balls, or by lifting the nail bed with dental floss could land you in the doctor’s office. If you do not have discharge, pus, or similar signs of infection, try soaking your foot in warm water with Epsom salt for 20 minutes. Adding a gentle foot massage can improve circulation and reduce inflammation. Dry your foot and apply an over-the-counter antibacterial cream. Keeping the affected area clean is a must to avoid infection.
Invest in sharp toenail clippers: The difference between fingernail and toenail clippers may seem negligible, but toenail clipper blades are wider and designed to cut straight across your nail, decreasing the likelihood of it penetrating the bordering skin. Keeping clean, sharp toenail clippers handy is the first step in preventing ingrown toenails.
Cut your toenails too short: Avoid tapering the edges of the toenail. Cutting your toenails too short increases the risk of having the nail grow into the exposed skin. A podiatrist can help cut toenails that have become difficult to trim, which often happens as we get older and our toenails become thicker and more prone to curling.
Use the degree of soreness to figure out if you have an infection: If your toe becomes very swollen and sore, and you experience pus or discharge, seek immediate medical attention. You may have a severe infection (paronychia) that needs to be treated with oral antibiotics. A partial nail avulsion—a procedure to remove part of the offending nail—may be necessary for chronic sufferers.
Wear comfortable footwear and keep your feet dry: Wearing shoes that pinch your toes is a big no-no, since compressed toenails are more likely to pierce the surrounding skin. Teens, athletes, and those prone to excessive perspiration should take precautions so they don’t unwittingly create an environment for bacteria and fungal infections. You’re less likely to get an ingrown toenail if you keep the skin surrounding your toenails dry. Feet bear the weight of the entire body, so make sure they are well situated in your shoes and kept dry and well-groomed.