An ingrown toenail occurs when the edge of the nail, usually on the big toe, grows into the skin adjacent to it. This causes pain, and if left untreated may result in infection. Signs of an infection include redness, swelling, and discharge at the edge of the toenail. Inflammation may increase to the point where the skin at the edge of the toenail swells over the side of the nail.
Risk factors for an ingrown toenail include:
- Abnormal bone anatomy or position of the big toe
- Abnormal bone growth beneath the nail
- Poor-fitting shoes -- too tight at the toes or too loose
- Trauma to the toenail
If you think you are developing an ingrown toenail, keep pressure off the area and apply antibiotic cream or ointment. It is best to treat ingrown toenails early, at the first sign of pain or discomfort. This will minimize the chance or severity of infection. The ingrown part of the toenail is often deep beneath the skin fold, making it difficult to treat at home.
Medical treatment will likely involve removing the ingrown piece of toenail, which may first require the toe to be numbed with a local anesthetic. If infection is present, oral antibiotics may be prescribed and sometimes an X-ray of the toe may also be prescribed.
Some people will experience recurring ingrown toenails even if they cut their toenails straight across. A common toe shape that is prone to ingrown toenails is one that has a distal phalanx that is extended or "cocked-up". With this shape, the tip of the toe is elevated in relation to the rest of the toe. A treatment option for recurring ingrown toenails is the cauterization, or permanent removal of the part of the nail that ingrows, so that it does not grow back.
Infected ingrown toenails rarely resolve on their own. Having the ingrown piece of nail removed usually resolves the pain and infection quickly -- most people who have their ingrown nail treated at their podiatrist's or family doctor's office will relate that the pain subsided a few hours after treatment and that the infection improved in a few days. In some cases, although infrequently, a long-standing infected ingrown toenail can spread to the toe bone beneath the nail -- this is why it's important to not let the infection linger and to seek prompt medical care.