Ingrown Toenails

Symptoms: Most people have a red toe, that is very painful to touch. These toenails can hurt in shoes or with bed sheets. They can be swollen and possibly infected. But if pain is present without these other signs, it can still be considered an ingrown toenail.

How this happens: For most people, it is a change in activity, a change in shoe gear, or natural foot mechanics. Some people’s toenails are just naturally more of a curve four sometimes I tell will swell up and give the toenail the appearance of an ingrown nail.

What to do: the day you notice the ingrown toenail it is best to make an appointment to have a podiatrist look at the toenail. If you wait, the ingrown toenail could get worse and could lead to an infection. This is a very painful condition which can require urgent nail removal or antibiotic.

In the meantime, until you can get into the podiatry appointment here are a few suggestions. Soaking in warm water and Epson salts can make the skin around the nail soft and can loosen some of the tension on the toenail. You can also apply Neosporin to the toenail. Comfortable shoes are important. I do not recommend cotton under the toenail nor do I recommend splitting the toenail as these things are rarely effective and can lead to other problems.

Trying to cut the toenail yourself and also be a big problem. This can lead to more pain and worse in the ingrown toenail. Rarely is this effective long-term and you’re more likely to see the toenail come back and grown again. Once you have an ingrown toenail you’re very likely to have another one very soon.

What can a podiatrist do for you? I will emphasize the importance of the podiatrist in treating your toenail. The foot specialist will use a product called phenol. It is a very strong acid which works 95% of the time. The procedure is done in the office. The patients get to go home the same day and are able to resume normal activities as tolerated.

The podiatrist will first number toe with an injection. Then a toe tourniquet will be used to reduce bleeding. The offending toenail border will be removed and the phenol will be applied and for about a minute and a half. Any infection is also removed. The toe is then dressed with a dry dressing.

Results: The majority of patients are very happy with this procedure. Often the patients say, “I wish I had done this sooner.” The healing process is pretty simple and the results are long-term. It is rare but there are times that the acid doesn’t kill all of the toenail and a small part will grow back. The good news is that this can be resolved with a revision toenail procedure.