Ingrown toenail

An ingrown toenail is a condition where the edges of the nail plate press down into the surrounding soft tissue, causing swelling, pain and sometimes an infection. It can occur on any toe, but is most common on the big toe. It can make walking difficult and the smallest pressure causes pain. It is rarely seen in children. It can be caused by improper nail trimming, tight fitting shoes, as well as an injury to the nail itself. The condition is painful and nearly always leads to an infection of the surrounding tissue, and if untreated, it can lead to bone infection.

ingrown toenail

What are the most common causes of ingrown toenails?

  • Improper cutting of the nail plate. Nail trimming should follow the shape of the toe.
  • Tight fitting shoes or socks which cause pressure on the toes.
  • Irregularities in the shape of the nail plate, which begins to curve over time.
  • Thickening of the nail plate, caused by genetics or resulting from a fungal infection.
  • Nail injury where the edges of the nail plate cut into the surrounding tissue.

Which health problems are caused by ingrown toenails?

An ingrown toenail which is not timely treated causes the surrounding tissue to swell and can lead to infection. Symptoms of bacterial infections include development of granulation tissue and pus at the infection site. In rare cases, the infection can spread to the bone.
Ingrown toenails are particularly dangerous for diabetics because of the poor blood circulation and the fact that infection can spread easily.

How is the problem of ingrown toenails solved?

The problem can be solved with adequate treatment, if the patient seeks treatment before an infection develops.

Treatment of an ingrown toenail can be done at home if the redness of the surrounding tissue is moderate. Soaking the nail in warm water softens the nail plate and aids the removal of the ingrown part of the nail, with mandatory use of an antiseptic solution.

If the swelling is severe and the redness pronounced, the patient should seek assistance from a dermatologist or a surgeon, who will remove the nail plate from the surrounding tissue and remove the granulation tissue. During the intervention, the dermatologist removes the part of the toenail which is cutting into the tissue.

If the condition recurs, a permanent solution can be ensured with an intervention which removes only part of the nail matrix, while leaving the central part of the nail plate intact. The intervention is carried out under local anesthesia and recovery lasts around 10 days. After the procedure is performed, the problem cannot recur on the treated toe.

The best prevention of ingrown toenails includes maintaining proper hygiene and wearing comfortable shoes.

Spec. Dr. Svetlana Djurisic, dermatologist
Dermatological clinic DERMATIM, Belgrade