Ingrown Toenail Treatment

When the hard toenail presses excessively against the soft skin on the edges of the nail there is usually pain. Typically, the nail presses for extended periods of time and an infection, or paronychia develops. This toenail infection is usually very painful, develops pus, and causes the end of the toe to become red and swollen.

This photograph shows three degrees of severity of ingrown toenails. The big toe (hallux) has a severe ingrown toenail, where the nail is curved in almost a complete circle. The second toe has moderate severity. The third toe demonstrates a mild level of incurvation. Although it is very common for the skin around the nail to become infected (called a paronychia), here there is no infection present.

At least half of the ingrown toenails that we treat are caused by improper cutting of nails. Many people try to cut the corners of their toenails and either cut the skin or leave a small point of nail which eventually grows into the flesh. This makes a simple problem more complicated. Nails should be cut flat across the top, and the corners should not be cut out. If you feel the need to cut the corners, it should be done only by a podiatrist.

Most drug store topical "cures" for ingrown toenails are ineffective. They may soften the nail edge or decrease the soreness for a short period of time, but they do not cure the problem. The source of the problem is present under the cuticle at the nail root.

The cure for an ingrown toenail usually involves numbing the toe with a local anesthetic such as lidocaine or novocaine. The toe will become completely numb and there will absolutely no pain during the procedure. Approximately a 1/8 inch section of the nail plate will be removed from the painful corner. If an infection is present, it will be treated at the same time. The most important part of the procedure involves the removal of that 1/8 inch section of nail root, so the problem will not return. If the root is not treated, then the abnormally growing nail plate will grow back in the same place and cause a similar problem within a few months.

After treatment a small dressing is placed on the toe and a regular shoe can be worn. Some people prefer to wear a wider shoe, tennis shoe, or an open sandal. The foot is soaked in warm water and the dressing is changed at home the following day.

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