Ingrown toenails are a pretty tough speed bump in life. If the sides of a nail start to pierce the skin, the result can be inflammation and infection of the surrounding tissue. It’s a common condition that most often occurs in adolescence, but people of any age can suffer from it. Sometimes a section of nail (termed a ‘spike’) can become embedded in the skin and can cause pain and infection. Removal is the only course.
The causes of ingrown toenails are obvious, but because they are, they’re that much easier to prevent! Typical causes of ingrown toenails include:
- Bad trimming of nails. This causes the adjacent skin to fold over the nail encouraging the nail to grow into the skin.
- Poorly fitting footwear. Shoes that are too tight can force the nail into the skin, while the excessive sweating (hyperhidrosis) that often results from tight shoes makes the skin soft and more easily pierced by the nail.
- Brittle nails: Nails with sharp edges, such as those that occur in fungal nail infections.
- Any kind of trauma to the nail
- Genetics - in many cases ingrown toenails are an inherited condition.
This is usually done by removing the spike with a small scalpel or fine clippers. Next, a small amount of sterile cotton wool is packed firmly under the nail plate to help elevate the nail. An interdigital (between toes) wedge can be used to reduce the pressure from the adjacent toe. Every two weeks the process is repeated (each time removing the old cotton wool and replacing it with more cotton wool) until the nail has returned to its normal shape and length.
In more complicated cases, minor nail surgery may be required. One procedure, called a partial nail avulsion (PNA), removes – under anaesthetic - the side of the nail that is ingrown. After removal, a chemical called phenol is applied to the affected area to prevent the nail from growing back into the skin. Another procedure - total nail avulsion (TNA) removes the entire nail. Surgery is usually followed by a course of antibiotics and – occasionally – painkillers.
To prevent ingrown toenails, proper trimming of nails is important. Nails should be cut straight across, not down the sides, and shouldn’t be cut too short. Once again, poorly fitting footwear or high heels are common causes of the condition, so they should be avoided if possible. Make sure your feet are kept clean and dry.