An ingrown toenail is a common condition that involves the growth of a toenail into the surrounding skin, thus causing the affected area to become red, swollen, and tender. The sharp edges on the sides of the big toenail are most commonly affected, as they can easily become lodged in the surrounding skin and grow into the area.
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Ingrown toenails are at risk of becoming infected; therefore, it is important that they are detected and treated in a timely manner to prevent complications. This is particularly important for certain population groups that are at risk of complications, such as those with diabetes or other health conditions that affect the peripheral nervous system.
Risk factors
There are various factors that can increase an individual's risk of developing an ingrown toenail, including:
- Incorrect cutting of nails
- Irregular nail shape
- Ill-fitting footwear
- Thickening of nails
- Sweating
People who are at a higher risk of getting ingrown toenails should pay closer attention to any changes in their feet to allow for early intervention and prevent potential complications of this condition.
Symptoms and complications
The initial signs of an ingrown toenail include tender, swollen, and hardened skin surrounding the nail, which is painful under pressure. There can also be a build-up of fluid around the toe.
Ingrown toenails are prone to infection, which may cause additional symptoms such as bleeding or oozing of pus. This can also be very painful, even when the toe is not pressed.
Some population groups are at a higher risk of complications of an ingrown toenail, such as people with diabetes or poor circulation of the extremities. This is often because individuals with these conditions have decreased sensation in the feet and often take longer to notice early signs of the condition. Additionally, the natural ability of their body to fight the infection may be compromised, which can subsequently lead to the development of more severe symptoms.
Treatment
It is best to diagnose and treat an ingrown toenail as soon as possible to prevent the condition from worsening. In most cases, an ingrown toenail can be treated in the home environment; however, professional advice is recommended if the affected individual has diabetes.
The feet should be soaked in warm water 3-4 times each day and the inflamed area massaged to gently push the skin away from the toenail. An antiseptic wash is also useful to reduce the risk of infection.
For immediate pain relief, simple analgesic medications such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective.
For more severe cases, partial or complete removal of the affected toenail may be required. This is usually carried out under local anesthesia to numb the area. Patients can return home shortly after the procedure, although they should avoid putting pressure or weight on the toe for 24-48 hours following the procedure. Prophylactic antibiotics and saltwater baths are also recommended to reduce the risk of infection.
Prevention
There are a number of ways to help prevent ingrown toenails and their related complications. These include:
- Cutting nails correctly (not too short and straight across, rather than rounded
- Keep the feet clean and dry
- Allow toes to get some air when possible
- Avoid wearing tight shoes and socks
It is important for patients to inspect their toenails regularly to monitor for any changes that could be an early sign of an ingrown toenail. This allows them to initiate at-home treatment as soon as possible and helps to prevent the progression of the condition.
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