Hurst Podiatry Blog

What you need to know about Ingrown Toenails (Onychocryptosis)

If you’ve ever had an ingrown toenail before, you can attest to the excruciating pain and continual discomfort that is associated.

In fact, it can be so painful, that we’ve had a patient describe it as “someone sticking a knife in the corner of my toe and leaving it there!”.

Consequently, many home remedies have developed over the years ranging from soaking the sore toe in warm water, all the way to ripping the nail out with a knife – which, as you can imagine, often causes more harm than good.

Thankfully, safe and effective treatment options do exist, provided by medical professionals known as podiatrists. Continue reading to learn more about what causes ingrown nails and what can be done about them!

What are ingrown toenails?

Ingrown toenails, medically known as onychocryptosis, is a condition whereby a nail edge, spike or shoulder can begin to irritate and eventually pierce the adjacent nailfold, which is the skin on either side of the nail.

This generally begins at a tolerable level, however as the nail grows, it punctures the skin, which often results in inflammation and infection.

This condition. predominantly affects the big toes, and less commonly the smaller toes. One or both sides of the nailfold could be prone to becoming ingrown.

What are the signs and symptoms of an ingrown toenail?

The most common signs and symptoms of ingrown nails can include some or all of the following at once:

redness;
skin appears shiny;
swelling;
pain with pressure;
increased sweating on and around the toe;
pus;
granulation; and
hypergranulation tissue.

The severity of ingrown nails is generally categorised into three different stages:

Stage 1: Little trauma to the skin, gradual onset of mildly painful symptoms, slight swelling, redness and sweating.

Stage 2: All the symptoms of stage 1, formation of granulation tissue, moderate levels of pain, odour and pus indicating an infection.

Stage 3: All the symptoms of stage 2, and formation of hypergranulation tissue, high levels of pain.

Who is likely to get ingrown toenails?

Ingrown toenails can affect people of all ages – young and old.

A survey conducted found the condition to primarily affect females advanced in age (causes for this will be discussed later in the article).

Among the paediatric population it has been noted that 17% of children suffer with ingrown toenails.

What caused my ingrown toenail?

There are many potential causes of ingrown toenails, each of which can alter the treatment provided by your podiatrist. Below are some of the most common ingrown toenail causes:

1. Cutting nails too short

Cutting your toenails too short can allow the nail folds to grow over the corner of the nail, resulting in irritation when the nail grows out. (see image to right)

2. Rounding the corners of the nail

Cutting your toenails and rounding the corners may be cosmetically ideal, however this often can result in a ‘barb’ shaped nail being created, due to the instrumentation used or poor visibility.

3. Constrictive footwear

Ill-fitting footwear can be the genesis of many foot pathologies.

A narrow fitting shoe at the toe region can cause pressure on the side of the toenail resulting in inflammation and an ingrown toenail edge.

This particular cause is easily recognised with a sudden onset of pain after wearing a new pair of shoes.

4. Curve shaped nails

Certain people develop curved shaped nails as a result of injury to the nail, while others are born with them.

Curved nails (also known as involuted nails) increase pressure on the skin directly under the edge of the nail.

Pressure applied to the toe from walking and footwear further drive the nail into the skin, causing an ingrown toenail.

5. Injury to the nail

Localised trauma to the nail often causes a tear within a section of the nail.
This can result in a sharp nail edge or spike forming which results in an ingrown nail forming.

What can I do to treat the ingrown nail?

When it comes to treating ingrown nails, there are both home remedies and professional treatment options. Here are some of the best treatment options.

Home treatments:

Taping

This treatment involves pulling the skin along the side of the nail edge that’s growing in, away with tape. This treatment option provides temporary relief, however will not fix the ingrown toenail.

Nail soaking

This treatment involves soaking the ingrown nail in warm soapy water for 20minutes 3 times a day. This softens the nail making it easier to cut the ingrown nail portion with greater ease.

Cotton wool

Packing the nail along the edge during the early stages of an ingrown toenail forming can help create separation between the nail and the skin. Leaving the cotton wool under the nail for an extended period of time can encourage the ingrown nail spike/edge to grow over the skin.

Professional treatments:

Cutting out the nail

Podiatrists are uniquely trained to cut out ingrown toenails with the use of specialised nail clippers or a scalpel blade.

Partial nail avulsion

A partial nail avulsion is a nail surgery performed to permanently remove the offending portion of nail and prevent it from growing back.

This procedure is performed under local anaesthetic. A section of nail is removed and a cauterising agent is applied to the nail matrix (the area where the nail forms) to prevent regrowth.

Total nail avulsion

A total nail avulsion is a surgical procedure performed to remove the entire nail and prevent it from growing back.

This procedure is performed under local anaesthetic and the entire nail is surgically removed. A cauterising agent is applied to the nail matrix to prevent regrowth.

This procedure is performed when in addition to an ingrown toenail the nail has become thick or infected by fungal organisms.

If you have an ingrown toenail

Don’t suffer in silence with painful ingrown toenails, here at Hurst Podiatry we are experienced at treating ingrown toenails no matter how mild or severe your condition may be.

Whether you have an ingrown toenail or you’re experiencing any issues with your feet, book in to see us by calling 03 5901 2216 or online here.