MANY people at one point or another have experienced an ingrown nail. Whether it be on your finger or your toe, it isn't something to pick at for weeks or months at a time! An ingrown nail is typically due to the combination of your nail shape and the way in which the nail is trimmed. In some unfortunate situations, ingrown nails may become an issue no matter how you cut your toenails. In yet other cases, people who never had issues with ingrown nails may develop problems following an injury to the toe.
The general recommendation when it comes to nail trimming is to cut your nails straight across. While in a few cases, cutting the corners out may not initially cause any issues, the practice of routinely cutting the corners out yourself can lead to further issues. Especially in the case of toenails, it is difficult to see the extent or depth of a curved nail and therefore we often see people who thought they had removed the ingrowing portion of nail only to find out that there was a large piece of nail now hidden under the border growing into the skin.
When a toenail initially feels 'ingrown' it can present as pressure, sharp pain or even hypersensitivity of the border of the nail or the whole toe. As the nail presses into the adjacent skin, the superficial nerves become inflammed and in some cases the toe can be excrutiatingly painful - not only in shoes from pressure, but even with the bedsheet passing over the toe. Initially ingrown nails are painful simply because of the mechanical pressure on the nerves in the skin. As they go untreated, the pain can worsen due to callus build-up in the nail corners.
Ingrown nails can become so inflammed that your body creates a granuloma. A granuloma translates as being "proud flesh." This appears as beefy-red, blubous tissue on the nail border. This tissue is very very sensitive and if trimmed can really bleed! The tissue is made up of inflammed vessels in that area which is why they tend to bleed - a lot! These may occur simply because a nail has been ingrown for a long time, but they are much worse if one continually tries to pick at or remove the ingrown nail. These granulomas look pretty intimidating, but they are not always associated with infection of the ingrown nail.
Ingrown nails become infected if the nail begins to cut into the skin as it grows out, but infection can also develop when the ingrown nail is picked at or if the skin next to the nail is inadvertantly cut when one tries to trim out the border. The bacteria that is natural to have on your skin can creep under the nail and now grows up to a point that a small abscess (or pus pocket) can develop. You may or may not see the pus drain from the toe, but you will definitely notice redness of the toe especially around the border, and throbbing pain as your body mounts an immune response to the infection. You may not think that an ingrown nail could be THAT big of a deal, but it is not unheard of for someone to have a portion of their toe removed (an amputation) in instances where infection reaches the underyling bone. This can happen sooner than you may think, because the growth cells for the nail lie on the bone itself.
Treatment for a simple ingrown nail without infection or granuloma involves a visit with your podiatrist. After a thorough assessment, we are able to determine the extent of nail ingrowth and carefully file and trim the nail to remove the painful portion of nail. This usually does not require any anesthetic. If your ingrown nail is infected and/or has a granuloma, the toe will likely be numbed up with anesthetic to allow your podiatrist to remove all of the inflammed and infected tissue as well as the offending nail border.
Some ingrown nails are a one-time occurence, but in other cases, these nails can be pretty pesky. If a few months of routine visits to file and trim the borders are not successful to relieve symptoms, an in-office procedure can be performed to remove only the portion of nail which is causing pain and this is made permanent with the application of a certain medication.
If you or someone you know is struggling with an ingrown nail, get in touch with us today! Especially in cases of infected ingrown nails, we strive to see our patients within 24 hours to ensure a quick recovery. Don't wait until it's 'more than an ingrown' to call! Our doctors treat this condition every day and are compassionate and gentle to ensure you have a good experience.