ingrown Toenail: causes, symptoms and treatment

Updated 7/7/2020
Ingrown Toenails

What's an Ingrown Toenail?

An ingrown toenail (onychocryptosis) is a common discomfort that involves the nail curving down, into the surrounding skin as it grows. Interestingly, ingrown toenails are absent in cultures who go barefoot, but that isn't an option for most of us in Southern California.

 

Most prevalent in the big toe, ingrown toenails can be painful, display redness, swelling, and infection (yellow drainage). Ingrown toenails frequently resolve without medical treatment, however, chronic or complicated cases may require treatment by a physician.

Ingrown toenail treaments

What Causes an Ingrown Toenail?

Painful ingrown nails may be congenital. In this instance, they are caused by an over-curvature of the nail, or imbalance between the width of the nail plate and nail bed.

 

Toe injuries that change the nail's contour may also lead to an ingrown toenail. Toe deformities (such as a bunion that forces the big toe to lean toward the second toe), high-heeled or narrow, pointed shoes can put pressure between the nail and soft tissues, eventually forcing the nail to grow into the skin. Poor nail-care such as trimming the nail too short, rounding it at the tip, or peeling the nail off at the edges can cause an ingrown nail.

 

It should be noted that ill-fitting shoes are the number one offender of ingrown toenails.

 

 

Conservative Treatment for an Ingrown Toenail

Conservative treatment for ingrown nails includes warm saltwater soaks, antibacterial ointment, and providing a track for the nail to begin to grow.

 

Ingrown Toenail Surgery

Surgery is often necessary to ease the pain and remove the offending nail. Only a portion of the nail may be removed. If the entire nail is affected or there is a severe nail deformity, the nail plate and matrix (the cells that grow the nail) may be completely removed.

 

Partial nail removal

For some cases of ingrown nails, only the portion of the nail that is growing into the skin is removed. If both sides of the nail are ingrown, they may be removed during one procedure.

 

After the affected portion of the nail (one-eighth to a one-quarter inch) is taken, the nail bed is removed along with any enlarged tissue adjacent to the nail plate. The nail root and matrix are then destroyed by phenol, surgical removal, or laser heat. Finally, the skin may be remodeled around the nail.

 

Permanent Nail Removal

Complete removal of the nail plate is a common remedy for ingrown nails. During this procedure, the nail plate is removed and the nail matrix is destroyed by one of three methods:

  • Phenol - An acidic chemical called phenol is applied only to the nail matrix. This destroys the growth cells of the nail.
  • Surgical removal - The nail matrix and bed is cut away. Stitches are only occasionally necessary.

 

After surgery to permanently remove the nail plate, the body generates a hardened skin covering over the sensitive nail bed. When this covering has developed, normal activities can be resumed. Women can also use nail polish in this area.

 

Removal of Bone Overgrowth

Bone directly beneath the nail plate may become enlarged, developing a spur or outgrowth that can deform the nail plate or lead to an ingrown nail. Removal of excess bone may be performed concurrently with surgery to partially or permanently remove the nail plate.

 

What is Ingrown Toenail Surgery Recovery Like?

Most people experience very little pain immediately following nail surgery, and during the healing process, which lasts about two to three weeks. If bone has been removed during surgery, a longer healing process should be anticipated.

 

Ingrown Toenails and Paronychia

Paronychia is a skin infection that occurs around the fingernails or toenails. It is one of the most common toenail infections is often caused by an ingrown toenail. Common symptoms of paronychia include swelling around the toenail, redness, pus collection and tenderness to touch.

 

Soaking your toe in warm water or a mixture of warm water and antibacterial soap can help reduce pain and swelling. The soaking should be done at the first sign of redness around the nail and repeated three to four times daily for about 15 minutes.

Once an abscess (collection of pus under the skin) is visible, you should see your foot and ankle specialist for possible drainage.

 

University Foot and Ankle Institute, Your Best Treatment Choice for all Toe Nail Conditions

Our podiatrists have extensive experience diagnosing and treating ingrown toenails. We realize this condition can be both painful and unsightly. Accurate diagnosis and treatment are the hallmarks of the University Foot and Ankle Institute care.

 

 

Frequently Asked Questions about Ingrown Toenails and Toenail Removal

 

Q: If it is determined that I should have my toenail removed, how long will the process take?

A: Generally, it will take our doctor an hour or less to perform the procedure.

 

Q: What are the recovery time and procedure

 A: The recovery is about one week and all you need to wear is a band-aid.

 

Q: Is toenail removal generally covered by insurance?

A: Yes, in many cases it is. University Foot and Ankle Institute accepts close to 1000 different insurance plans. You can check our insurance page to see if yours is among them.

 

If you do not see your plan please call the office at (877) 989-9110 and tell them what your plan is and they can confirm if we accept it.

 

 

  • Foot and Ankle Surgeon and Director of University Foot and Ankle Institute
    Dr Bob Baravarian, University Foot and Ankle Institute

    Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as Director of University Foot and Ankle Institute.

     

    Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

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