Ingrown toenails form when the edge of a nail - usually the nail on the big toe - grows into the soft flesh along the edge of the nail bed instead of growing above it. Often, ingrown toenails form when shoes are too tight in the toe area and the toes become overcrowded. But they can also form when the toenails are trimmed into a curved shape instead of straight across, which increases the likelihood the nail will push into the skin as it grows out. Ingrown toenails are also more common among people with thick or curved nails, and people with diabetes or circulatory or nerve-related problems are also more susceptible. Sometimes, an injury or deformity can make ingrown toenails more likely. Ingrown toenails can become infected fairly quickly, and prompt treatment is necessary to prevent infection and more serious complications including amputation.
The primary and initial symptom of an ingrown toenail is pain along the edge of the nail, followed by redness and swelling. People with nerve or circulatory problems can have difficulty feeling pain, which means the nail is more likely to become infected. When infection occurs, the skin along the nail will become extremely painful and red, and pus may begin to form around the nail bed.
Ingrown toenails need to be professionally trimmed away from the skin to prevent infection. In mild cases, the edge of the nail can be lifted and a small piece of gauze can be inserted to promote straight growth of the nail. Sometimes, a large portion of the nail or the entire nail must be removed, especially if an infection is serious. Nail removal can be completed using a local anesthetic to numb the toe and avoid pain or discomfort. Once the nail is removed, a special solution can be applied to prevent the edge of the nail from growing into the skin. If an infection is present, antibiotics may also be prescribed. In nearly all cases, patients are able to wear “normal” shoes following their treatment.
In most cases, ingrown toenails can be prevented by wearing shoes that fit properly and have ample room in the toe area. Avoiding high heels is also important for people with chronic ingrown toenails. When caring for nails, always trim straight across, and avoid creating curved or squared-off edges.