Ingrown Toenails: Causes, Symptoms, and Treatment

The pain that accompanies an ingrown toenail can often become easy to ignore until it leads to something more serious. Ingrown toenails occur when part or all of the toenail curves into the surrounding skin of the foot, causing pain. The condition is very common amongst Americans, especially teenagers. In fact, 20 percent of people who visit their doctor for foot issues have an ingrown toenail. Although ingrown toenails can be painful, their treatment is a relatively simple and painless process.

Ingrown Toenail Symptoms

Always be on the lookout for signs of an ingrown toenail. Some common symptoms can include:

• Redness
• Swelling
• Pain
• Tenderness

It’s best to catch ingrown toenails sooner rather than later. If left untreated, ingrown toenails can become infected, which could lead to small amounts of pus draining from the area and added pain.

Ingrown Toenail Causes

There are four main causes of ingrown toenails:
1. Congental (hereditary) – meaning you developed the trait from birth, or acquired.
2. Maintenance – the manner in which you cut your toenail could lead to an ingrown toenail.
3. Infection – a fungal infection or trauma to the toe can lead to ingrown toenails
4. Accidental Injury – something as simple as stubbing your toe or lacing your shoes too tight can lead to an ingrown toenail.

Infected Ingrown Toenail Treatment

If you are experiencing pain or discomfort, it might be time to see a doctor regarding your ingrown toenail. Ignoring an ingrown toenail or trying to treat it yourself could actually make your condition worse. For those with a mild case, often due to improper toenail trimming or fungal infection, your doctor might give you recommendations on the proper way to cut your toenails or treat the fungus with medication.

More moderate cases where the patient is experiencing pain can be treated using a procedure called a matrixectomy. This is a quick and relatively painless procedure that takes place in-office. Your provider injects a small amount of lidocaine in the toe and then cuts out a small sliver of the side on the nail. Afterward, they chemically cauterize the root of the nail so that it cannot grow back. The procedure is permanent and has a 95 percent success rate with only a five percent chance of recurrence.

There are two different ways to perform a matrixectomy, both are in-office procedures. The first is with a chemical called phenol and the second is called a cold steel procedure, which involves cutting the matrix out entirely and then putting in a couple of stitches. Oftentimes doctors will first try a chemical approach and then a cold steel procedure if someone fails prior chemical matrixectomies.

For more severe cases, often involving those who’ve developed an infection due to lack of treatment, their provider will follow a similar treatment plan. First, you’ll have a small injection of lidocaine and remove a piece of the nail. Then the doctor will allow the abscess (caused by infection) to drain which will help resolve the infection. Afterward, your doctor will prescribe antibiotics. Since a matrixectomy is a permanent procedure, your doctor will often wait until an infection has been resolved to perform one. There is a higher recurrence rate for those with infections that receive both procedures in one day.

“Most, if not all, of my patients are surprised to hear how relatively easy the procedure was to fix the ingrown toenail,” said foot and ankle specialist, Dr. Benjamin R. Proto of TPMG Orthopedics.

Ingrown Toenail Prevention

Ingrown toenails, especially if untreated, can recur. For some, there are ways to prevent future ingrown toenails. Improper nail trimming can be a large contributing factor for ingrown toenails. Nails should be trimmed no shorter than the edge of the toe and straight across. Make sure your shoes and socks aren’t overly tight. Finding shoes with wider toes is helpful.

No one has to live with the pain of an ingrown toenail. If you are suffering from an ingrown toenail, it’s best to find help sooner rather than later. Talk to a TPMG foot and ankle specialist today about ways to relieve your pain and keep your feet healthier and happier.

Benjamin Proto

About Dr. Benjamin R. Proto, DPM, FACFAS

Benjamin R. Proto, DPM, FACFAS, joined TPMG Orthopedics in 2007 and has established himself as one of the Peninsula’s leading foot and ankle specialists, offering his patients the latest advancements in foot and ankle care. In his surgical practice, Dr. Proto utilizes minimally invasive techniques and specializes in partial and total joint replacement of the foot and ankle, ankle arthroscopy, and ankle fusion to address painful and dysfunctional joints.

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