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Ingrown toenails

Author: Vanessa Ngan, Staff Writer, 2005.

What are ingrown toenails?

An ingrown toenail is a painful condition of the toe that occurs when the sides or corner of the toenail digs into the skin at the end or side of the toe. The condition mostly affects the outer edge of the big toe, although the nail on both sides of the toe, or nail on any toe can become ingrown.

An ingrown toenail is also known as onychocryptosis.

What causes ingrown toenails?

The causes for ingrown toenails are listed below, but the two most common causes are ill-fitting shoes and improperly trimmed nails.

What are the signs and symptoms of ingrown toenails?

Ingrown toenails can be classified into 3 stages according to severity.

  • End of the toe becomes reddened with mild swelling
  • May feel warm and be painful to touch
  • No pus or drainage
  • Toe becomes increasingly red, swollen and painful
  • May be white or yellow coloured pus or drainage from the area
  • Infection may have developed
  • Symptoms of redness, swelling and pain are increased
  • Granulation tissue forms and adds to the swelling and discharge of pus
  • Lateral nail-fold hypertrophy (overgrowth of skin tissue around the affected toe)
  • More severe infection with fever may follow

Pseudo-ingrown toenails of the newborn

About 2% of newborn babies are noted at birth to have ingrown toenails. This is because the growing nail plate is very short. It is rarely painful. The appearance rights itself within a year or so.

What is the treatment for ingrown toenails?

Treatment is dependent on the stage of the condition. However, at any stage of the condition, the patient should avoid tight-fitting or high-heeled shoes. If possible, wear sandals until the condition is cleared up.

Stage 1 ingrown toenails should be managed conservatively using the following methods.

Stage 2 may require the administration of topical or oral antibiotics. Topical antibiotic ointments combined with local anaesthetic agents help to heal the toe faster and also provide pain relief by numbing the affected area. Surgical removal of the ingrown toenail may be required if the condition worsens.

Stage 3 ingrown toenails are often treated surgically. The surgical technique of lateral nail avulsion plus matricectomy is highly successful. A brief description of this procedure is given below.

The following post-surgery procedures should be followed:

Other treatment for ingrown toenails

Ingrown toenails may also be treated by a gutter splinter using slit plastic tubing to keep the nail and the lateral nail folds apart. These are kept in place by using tape or acrylic adhesive. An artificial nail may be sculputured using formable acrylic solution.

Chemical or medical nail avulsion is a painless, slow way to remove damaged nails. As the whole nail is destroyed by the process, it is rarely used for ingrown toenails.

Can ingrown toenails be prevented?

Adhering to the following simple rules can easily prevent ingrown toenails:

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