What are ingrown toe nails?
An ingrown nail is caused by a piece of nail protruding into the side of the nail sulcus skin, or into the nail bed itself. This allows for the entry of bacteria into the flesh which causes an infection in the toe. Ingrown nails are painful and can limit your ability to exercise, work and wear enclosed shoes. Chronic nail infections are also dangerous as the infection can become systemic (travel into the blood stream) or seed into surrounding structures like bone or joints.
At Footwell Podiatry, our experienced podiatrists have managed thousands of infected ingrown nails. If you are looking for a permanent solution, book an appointment today.
Who gets ingrown toe nails?
Ingrown nails affect all ages but are most common in teenagers. In this age group we generally see a thinner (sharper) nail which has a better ability to penetrate the adjacent soft tissue and cause an infection. Combine this with poor nail cutting technique (cutting down the sides of the nail rather than straight across), long periods in sweaty footwear, poor hygiene habits (lack of foot washing), high activity levels, and we have a recipe for infected ingrown nails. In older folk, years of intermittent nail trauma from footwear, injury, poor circulation, and infections (like Fungal Nail Disease), causes nails to thicken and in-grow and generally put pressure on the nail bed and surrounding soft tissue.
What causes ingrown toe nails?
An ingrown nail (onychocryptosis) can be caused by some of the following:
- Nail Trauma – blunt force, fungal infection etc
- Involuted (Curved) Nails – genetics, tight footwear
- Ill-Fitting Footwear – common with growing adolescents and women’s fashion footwear
- Poor Nail Care – picking, long nails, cutting down the sides
- Poor Hygiene – sweat, dirt, bacteria
How are infected ingrown toe nails treated?
Treatment for infected ingrown nails involves a minor surgical procedure to remove the offending nail particle and to drain/clear the infection. Before surgery, antibiotics may be required to clear an infection as this will improve the effectiveness of the local anaesthetic and prevent an infection seeding the bone (note the start of the nail attaches to the outer coating of the bone). The procedure begins with a local anaesthetic injection to numb the area and a thin section of the nail is removed taking care to remove it in one piece – leaving a small spicule of nail deep down in the nail sulci will result in recurrent infection. With the thin piece of offending nail now removed, the nail bed is cauterised with a chemical so the ingrown nail will not grow back again. This procedure provides a permanent solution in greater than 95% of patients. Importantly, podiatrists only remove a thin section of nail without the need to resect (cut) the surrounding skin and curette nail bed. This results in much less trauma and a fast recovery – usually back to exercise/work in 1-3 days. After 10-12 weeks, the free edge of the nail and skin will join and no visible signs of surgery will be present, apart from a slightly narrower nail plate.