The painful truth of ingrown toenails

Ingrown toenails are a common and painful problem which occurs when the corner or edge of the toenail digs in to the soft tissue of the nail grooves. This is more likely to occur in the larger toenails but the smaller nails can also be affected.

What causes an ingrown toenail?

Incorrect nail cutting technique/picking nails – When you cut down the sides of a nail or pick at them, there is a high risk of getting an ingrown toenail. This is most often because a small nail spike can be missed in the corner of the nail. Over time this spike will push into the skin causing an ingrown toenail. Nails should be cut straight across and only filed on the corners.

Trauma – An acute injury, such as stubbing your toe or even having your toe stepped on during a sporting match can cause an ingrown toenail.

Involuted nails – Nail edges can curve into the skin so that rather than being flat along the surface, the nail is more like an arc. This can be due to trauma, genetics or improper nail cutting technique.

Genetics – The shape of your toenails and the amount of soft tissue around the nail is usually inherited. You may find yourself talking to a parent or family member who has also had issues with their toenails in the past. An example of this is a wide nail plate. If you have a wide nail plate, the nail is more likely to push into the soft tissue at the sides of the skin, regardless of how you cut the nail.

Excess pronation/flat feet – If you have ‘flat feet’ or your feet ‘roll in’ you are more likely to put a compression force on the side of the big toe. This can lead to the nail pushing in to the soft tissue and causing an ingrown toenail.

Tight fitting shoes – Pointed or tightly fitted shoes can put pressure on the skin around the nails, causing the nail to push in to the skin.

How are ingrown toenails treated?

Conservative podiatry treatment

Seeing a podiatrist regularly to cut the nail correctly and clear any nail spike that may be present is the best conservative option to take. Your podiatrist can also assist you to identify and eliminate the cause of your ingrown toenail. In some cases however, further treatment is required.

Nail surgery

Ingrown toenail surgery is a minor procedure performed by podiatrists to permanently remove an ingrown toenail. It is performed under a local anaesthetic. This is a great long term option as the offending nail is taken out and does not grow back in this section, creating a nice straight nail edge after healing.

Ingrown toenails can be easily infected and you should watch for signs of infection around the nails eg pain, pus, hot top touch and a shiny appearance. Antibiotics may be required in these cases, but the ingrown toenail still needs to be removed for it to settle.

If you have trouble with ingrown toenails, early intervention is paramount. If you are experiencing pain or notice any discomfort around the nails please make an appointment with one of our Melbourne podiatrists.