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Ingrown Toenails

What Is an Ingrown Toenail?

A toenail is ingrown when one or both sides of the nail begin to grow into the soft skin of the toe. This can lead to irritation and infection because of all the bacteria that are present on and around feet.

Causes of Ingrown Toenail

  • Cutting Nails too Short – when nails are cut too short, the skin on the sides can cover the corners of the nail. This causes the nail to grow back into the skin.
  • Poorly fitting shoes – Ingrown toenails are often caused by improperly fitting footwear. Shoes that are too tight can push the skin on the sides of the nail up over the nail, forcing the nail to grow in. Shoes that are too short can also cause nails to grow into the soft skin.
  • Toe Injuries – Injury to the toe that causes the nail to fall off can lead to ingrown nails because a new nail has a higher chance of becoming ingrown than an existing one.
  • Repeated Activity – Sometimes, simply repeating the same activity, such as kicking a soccer ball over and over again, can lead to ingrown toenails.
NB: In INFANTS ingrown toenails occur due to rubbing by a shoe or a tight sock. Your baby may cry and pull on his toe or foot. If he is old enough to toddle around, he may limp or grimace when he walks.

How Can You Tell If a Nail Is Ingrown

How can you tell for sure if an ingrown nail is the cause of your toe pain? In addition to pain, signs of an infected ingrown toe include:
  • Swelling around the ingrown edge
  • Pink or red color
  • Liquid or pus discharge
  • Warm feeling
  • Unpleasant odour

Non-Surgical Treatments For Infants:

Soak your infant’s foot in warm (not hot) soapy water for about ten minutes, two or three times a day. (Most infants love to splash around in water, so it shouldn’t be too hard to convince them to do this.) Afterward, dry the foot and apply a dab of over-the-counter antibiotic ointment or cream to the problem area.


Non-­Surgical  Treatments:

Left untreated, an ingrown toenail can become infected, so it’s important that you:
  • Keep your feet clean by washing them regularly with soap and water
  • Change your socks regularly
  • Cut your toenails straight across to stop them digging into the surrounding skin
  • Gently push the skin away from the nail using a cotton bud or hand (this may be easier after using a small amount of olive oil to soften the skin)
  • Wear comfortable shoes that fit properly
Surgery may be recommended if your toenail doesn’t improve. Depending on the severity of your symptoms, this may involve removing part or total toenail; this generally does not occur in young children.


Partial Nail Avulsion (PNA)

Partial nail avulsion removes part of your toenail and is the most commonly used operation for treating ingrown toenails, with an extremely high rate of success. A local anaesthetic is used to numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future. A course of antibiotics may be prescribed if your nail is infected, and any pus will be drained away.


Total Nail Avulsion (TNA)

Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, you’ll have an indentation where your nail used to be. However, it’s perfectly safe for you not to have a toenail.


After PNA or TNA

After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any bleeding and prevent infection. Rest your foot and keep it raised for one to two days after the operation. To help reduce the pain, you may need to take a painkiller, such as paracetamol, and wear soft or open-toed shoes for the first few days after surgery.
Further information on dressings will be provided and discussed by the podiatrist on the return appointment after surgery.