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An Introduction to Ingrown Nails

I have a special place in my heart for patients who come to the office with ingrown toenails. Having had two ingrown toenails myself, I know how painful they can be, and how much relief a podiatrist can offer.

When I was fifteen, I worked a summer job on a vegetable farm, and after developing an ingrown toenail, I tried to convince my mom that I couldn't go to work because my feet hurt too much. Although my plea for sympathy didn't get me out of work that day, it did get me my first appointment with a podiatrist. Little did I know that my pesky ingrown toenail would also be the launching point of my future career path, as it sparked my interest in the podiatric field.

Who gets ingrown toenails and why?

The way we cut our toenails, and the shoes we wear contribute to ingrown toenails. Many times, patients with an “incurvated” or upside down smiley face nails are more likely to develop ingrown toenails. Shoes that don’t fit properly or trauma (like a stubbed toe, or breaking the end of your toenail, dropping a bowling ball…) are other causes. In my case, my feet were growing faster than my parents could buy shoes, and the pressure of my shoes caused pressure on my toes, and led to the ingrown toenail.

Whatever the cause, as the nail digs into the soft tissue at the edge of the nail, the body responds with swelling, and redness, and pain. Tempting as it may be to self-remedy the situation, trying to fix an ingrown toenail yourself can just lead to further complications. So-called bathroom surgery can introduce infection, delay the healing process, and make the toenail worse.

Those with peripheral vascular disease, neuropathy, and infection can face even greater complications.

How should I treat an ingrown toenail?

Treatment depends on when in the process a patient decides to make an appointment. Coming earlier could mean simply cutting away the part of the nail that is causing a problem. Often, patients postpone treatment which leads to the need for a more aggressive but still relatively basic procedure called a “partial nail avulsion”. After anesthesia, The entire edge of the nail is painlessy removed to allow the nail to either grow back better, or it is removed and the nail root is chemically cauterized (damaged) to prevent regrowth. Without regrowth, you shouldn’t have ingrown toenails. I had this chemical treatment, a “chemical matrixectomy” with my first ingrown nail. I was able to go home that night, even play basketball. Then, I soaked it in warm soapy water. Pain was minimal over the first few days; a definite improvement from the pain before the treatment.

Though on a rare occasion, even with the chemical treatment, the nail may occasionally grow back. This is the exception, not the rule. But you can do your best to prevent this problem by wearing appropriate footwear and properly trimming your nails. If not, I can recommend a good podiatrist, (or four!)