What is an ingrown toenail?

An ingrown toenail is when the shape of nail growth causes pain and pressure on the borders of the nails.  This can be mildly irritating to very painful and (depending on the severity) can cause breaks in the skin and even infection.

What causes ingrown toenails?

Some people have a predisposition to ingrown nails, depending on the shape of their nail.  Other people can have a traumatic accident which places pressure on the nail border.  While 2 people may have the same shape of nail, one may never have any irritation or pain, as sometimes the types of shoes worn can cause pain.  Even some foot deformities can aggravate nail borders.

How are ingrown toenails treated?

If a person is experiencing a first-time incident of an ingrown nail, it is possible that a simple trimming of the nail can reduce pain indefinitely.  In many other cases, the condition can become chronic and require further treatment.

  • If it is not infected: Treatment is focused on decreasing the pressure on the nail border.
    • The offending nail border can be trimmed back and smoothed out to decrease the chance of future irritation. 
    • If tight shoes are complicating the matter, shoes with a wider toebox may be recommended. 
    • In some people, a buildup of thick skin (callus) at the nail border can also cause more pain as the nail grows out and it may be recommended that you begin using a special cream (with urea) to keep the skin at the nail borders soft and supple.  Your podiatrist offers a great cream called urea cream and there are various strengths of this available.
  • If it is infected: Treatment is focused on relieving the pressure from the nail border and eliminating the infection.
    • Depending on the level of pain you are experiencing, it may be recommended that you have a shot to numb the toe and allow the doctor to remove the painful nail.
    • Antibiotics will likely be prescribed to treat the infection of the skin near the nail border.
    • Daily soaking of the nail is recommended after removal of the nail border to allow infectious material to drain from the nail corner.
    • An Amerigel post-op kit is recommended to expedite your healing.
  • If the problem becomes a continuous issue: There are options available to nearly eliminate future episodes of ingrown nails.
    • A permanent nail border avulsion involves a numbing injection to the toe, followed by removal of the offending nail border, and finally a high grade acid is used to stop the growth at the base of the nail.  This is done using sterile instruments and gloves to reduce the risk of infection.
    • An Amerigel post-op kit is also recommended following this procedure to speed healing and prevent infection.
    • Your doctor will have follow-up visits scheduled to ensure that the procedure site is healed well. 

Ingrown nails do not have to be a continuous source of aggravation.  Discuss your treatment options with your doctor and free yourself from the pain of ingrown nails!