Ingrown toenails are found only in shoe-wearing cultures and do not occur with barefoot people. Downward shoe pressure on the nail leads to ingrown toenails.
Ingrown toenails are one of the most common and most painful nail complaints seen by a podiatrist. Ingrown nails are often a splinter or spike of nail digging into the soft tissues on the side of the nail. Usually, the toenails grow straight out, however, sometimes one or both corners or sides of the nail curve in and grow into the flesh, leading to redness, swelling and extreme pain. In more severe cases, ingrown toenails can become infected, leading to pus and bleeding. Any of the toenails can become ingrown, but the problem most often affects the big toe.
Causes of ingrown toenails
o The most common cause is improperly trimmed nails.
o Hereditary -- the nail is just too large for the toe and has curved edges.
o Wearing tight shoes that cause pressure and crowding around the toes.
o Repeated trauma to the feet from normal and sporting activities, stubbing the toe or having the toe stepped.
o Footwear and socks that push your toe flesh onto the nail so that it pierces the skin. o If you sweat excessively or don't rotate your footwear, this makes the skin moist and weak, which means the skin can be pierced by the toenail.
Who gets ingrown toenails?
o Ingrown toenails are more common in teenagers, especially those who are active in sports.
o People who pick at or bite their nails or cut them too low.
o People who wear socks, support hose or narrow shoes with tight toe boxes that squeeze the toes.
Preventing ingrown toenails
o Cut the nails straight across, but don't cut too low; nails should be no shorter than the edge of the toe or longer than the tip of the toe. Use a sharp toenail clipper to cut nails without tapering or rounding the corners. The corner of the nail should be visible above the skin. It's better to cut the nails after a bath or shower when they are softer and easier to cut.
o Avoid moist feet by rotating your footwear so they can dry out thoroughly. Choose cotton socks and leather shoes or other materials that are breathable and fit well.
o Protect feet from trauma and wear shoes and hosiery (socks) with adequate room for the toes.
o Keep feet clean and dry at all times. See the diagram on how to properly cut/trim toenails.
o If left untreated, ingrown toenails can become infected. The infection can spread to the rest of the toe and foot. The quicker you treat the problem, the less painful the toe and the treatment.
Treatment
The treatment of an ingrown toenail depends on how bad it is. For the most basic ingrown toenail, a podiatrist will carefully remove the offending spike of nail causing the problem.
If the ingrown toenail progresses and becomes too painful to touch, the podiatrist may have to use a local anesthetic to numb the toe before removing the offending portion of nail. The podiatrist will cut the ingrown portion of the nail out and may prescribe a topical or oral medication to treat the infection. Very seldom are antibiotics needed to treat this condition as long as the ingrown portion of the nail is removed.
If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently fix the problem through removal of the corner of the nail that ingrows, along with the matrix or root of that piece of nail. The nail is removed and a chemical, laser or other method is used to prevent regrowth of the toenail. This procedure, developed by podiatrists, is over 97 percent successful. After the procedure, the nail will be a little narrower but appear the same as before. You will have to return for post-op visits so the podiatrist can make sure the area heals correctly.
If you have an ingrown toenail, you should see a podiatrist as soon as possible. While you are waiting to see the podiatrist, if you have pain or redness due to the ingrown toenail, put the foot in a cool water and vinegar soak or a basin of soapy water for a few minutes two times a day, then apply an antiseptic and a bandage to the area. Rest your foot as much as possible and wear sandals or shoes with plenty of room. People with diabetes, peripheral arterial diseases (PAD) or other circulation problems must never soak their feet or try to treat the ingrown toenail themselves. They should see a podiatrist as soon as possible.
o For more information email us at foothealth242@gmail.com or visit us at www.apma.org, foothealth.org or feetforlife.org. To see a podiatrist visit Bahamas Foot Centre, Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates, Albury Lane, telephone 394-5820.

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