It is always surprising to those who have never suffered an ingrown toenail how much a small piece of nail stuck in the skin can hurt so much.

Ingrown Toenail

Ingrown toenails left untreated usually cause a lot of pain, can get infected and, in the worst situations, can actually lead to bone infections and loss of the toe. It is always surprising to those who have never suffered an ingrown toenail how much a small piece of nail stuck in the skin can hurt so much. Toes and fingers happen to be able to sense a great deal due to their dense distribution of nerve endings. If you can ever remember having something small like a sliver of fiberglass or a very small splinter in your finger, you can get a sense of how painful an ingrown nail can be.

Causes of Ingrown Toenails

Ingrown toenails have varied causes. When the nail plate is shaped normally ingrown toenails are less likely but can still be an issue. A normal nail plate is flat when you site down the toe. An incurvated nail will look like a staple when you sight down it. Incurvated nails lead to most of the instances of ingrowing nails

Incurvated Nail

If the toenail is cut improperly in the corner leaving a barbed edge, this will lead to an ingrown nail as it grows out and buries the sharp fragment in the flesh. Other causes of ingrown toenail are wearing tight, too small shoes and stockings, trauma to the nail and fungus infection of the nail.

Ingrown Toenail Symptoms

Ingrown toenails can cause impressive amounts of pain. Even if bed sheets touch the toe, for example, it can send waves of pain through the toe. A non-infected ingrown toenail is going to have a reddened, swollen appearance where the nail is digging into the flesh. There may be bleeding from the area and a great deal of pain. If there is pus, a bad odor or red streaking coming from the toe then it has become infected. There may appear to be a blister around the side of the nail that most likely contains pus. This is known as an abscess. This “blister” may not be a blister at all but something known as “proud flesh”. This proud flesh can engulf the nail edge and sometimes the entire nail becomes covered by this easy to bleed tissue.

Treatments for Ingrown Toenail

Due to the pain of ingrown toenail and the often extremely scary look and smell of an infected ingrown toenail, people often head to the emergency room. This is appropriate for diabetics, people with peripheral vascular disease and those who are suffering fever and chills or flu-like symptoms along with the ingrown toenail. This is especially true if the condition has been discovered late at night when their doctors’ offices or urgent care centers are closed. In most instances, the professional treatment of an ingrown nail can wait to the morning. The use of Epson salt soaks, application of triple antibiotic cream (e.g. Neosporin®), taking some ibuprofen or acetaminophen along with using a slipper or roomy shoe can give the otherwise healthy ingrown toenail sufferer some relief until the morning.

Home Treatments for Ingrown Toenail

If the ingrown toenail is not infected and minor and the sufferer is otherwise healthy, clipping of the ingrown nail segment can be attempted at home with sterilized or disinfected clippers. The edge should be filed smooth and triple antibiotic cream can be applied. Alternatively, cotton can be wedged underneath the ingrowing nail edge to guide it out of the flesh along with triple antibiotic cream applications. If the ingrown toenail is infected professional help should be enlisted.

Surgery for Ingrown Toenail

Most surgery for ingrown toenail is a minor affair in the podiatrists’ office. Usually a local anesthetic is used and the ingrown nail section, any proud flesh and abscesses are removed or drained. If the nail is severely incurvated and the person has had multiple instances of ingrown nails, a matricectomy is recommended.

A matricectomy involves removing the incurvated section of nail followed by application of carbolic acid with a cotton stick and an alcohol rinse. After one to two weeks, the nail edge heals and the nail section usually never returns to cause problems again. The cosmetic result is usually very satisfactory with the nail having a normal, flat appearance. Insurance generally will cover the cost of this procedure following the terms of the individuals’ insurance contract. If you suffer from this condition we welcome you to come in for a consultation with our helpful, knowledgeable staff.

What Will Happen If the Ingrown Nail Is Left Untreated?

If the infected ingrown nail is left untreated the infection can spread to the bone beneath the nail or, in extreme cases, enter the blood stream and cause sepsis, gangrene or a flesh eating disorder. For those with diabetes or peripheral vascular disease, an ingrown toenail should never be left untreated. Fortunately there are treatments for ingrown nail that are quick and generally painless.

For more information on ingrown toenails or to schedule a consultation, contact Essex Union Podiatry today.

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Meet Our Doctors

The physicians of Essex Union Podiatry are experienced and dedicated professionals trained in various subspecialties of podiatry care. Click on the pictures below to learn more about our doctors.

Jason P. Galante, DPM,

Jason Galante, DPM, AASPS

Nancy A. Kaplan, DPM, MBA, AACHE, FACFAS


Sarah E. Haller, DPM, AACFAS