Ingrown toenail or onychocryptosis is when the toenail grows into the nail fold. These can be extremely painful and can develop redness and an infection. It can stop people playing sport and can mean a visit to the podiatrist. To prevent the problem there are several measures that can be taken:
Footwear should be the correct size and not too tight or loose. Footwear should suit the foot type and different makes of trainers, boots, and shoes should be fitted appropriately as this can change according to the brand. Footwear should also be altered when worn away or had its time of use and dried if wet after use. The footwear should also be appropriate for use and the situation or surface. Read more on choosing running shoes.
Appropriate nail trimming
Prepare by washing both hands and feet and make sure both are dry. Have the correct tool for use; nail clippers or manicure scissors can be used. Make sure the nails are cut regularly and cut straight prevents ingrowing toenails apart from a little rounded at the edges. You should cut the opaque area (off-white) only and not take to much of the nail away.
No nail picking ( poor foot hygiene)
An infected ingrown toenail can be caused by picking if you have not washed your hands properly. When you pick the nail will not be straight and this may cause an issue. Also if the nail is picked the skin bed and nail become tethered and more of the nail is taken away than necessary causing the skin to fold over. Keeping the feet clean and free from fungal infections and dry prevents nail issues.
Reduce repetitive trauma and stress
Stress to the nail bed or toes can cause ingrowing toenails. If there is repeated trauma such as bruises through stamps or excessive stopping in activity the nail or surrounding tissue can become inflamed. Repetitive small stresses should be avoided. It may also be the case that the trauma is a landing issue and improving the biomechanics may be helpful.
Improve gait patterning
A poor gait patterning on walking or running can cause more stress to the nail, skin or nail bed. Appropriate strengthening, altered biomechanics, or a kinetic chain review may be necessary to improve gait patterning, which reduces an excessive load to the toe or toes causing ingrown toenails.
Swelling through acute or chronic trauma can be a causing effect of an ingrowing toenail. Appropriate measures to prevent or reduce swelling either through injury, infection or a reduction in obesity through exercise and diet should be undertaken to reduce the percentage of getting an ingrowing toenail.
If an injury has occurred which affects the load, changes foot biomechanics produces swelling or puts an altered strain on the toe or toes it should be treated effectively and appropriately as soon as possible. This will reduce a possible ingrowing toenail.
Foot deformity measures
If a foot deformity has occurred, is worsening or is congenital it is important to have appropriate reviews of footwear and to make sure the deformity is being treated appropriately if able to do so. Deformities should also be checked if new but regularly checked if worsening in any way as loading of the foot and toes may have changed which can cause ingrowing toenails.
Signs and symptoms
Symptoms of ingrown toenails can be redness, swelling, and pain. It can be swollen or look infected and a discharge usually yellow can also be present. A podiatrist can usually fix the problem but in some cases, further medical care must be sought and surgery can sometimes happen. In most cases, the area improves without intervention although medication may be required in the case of infection especially if pus is apparent or the pain persists with swelling.
Some conditions such as a fracture from trauma, infection, cysts or tumors and foreign bodies can also be similar to symptoms and signs of an ingrowing toenail and should be ruled out with a diagnosis.
How to treat an ingrowing toenail
- Lukewarm footbath for 20 min and use of Epsom salts
- Anti-inflammatory medication may help if swollen or red but follow guidelines and seek a doctor as it may require antibiotics. If red or pain seek help.
- Elevate the foot and leg above the heart to reduce swelling and help drainage
- Trim the toenail as above
- Clean the skin area if able to with gauze and warm clean water.
- Seek Medical help or a podiatrist should symptoms worsen or persist. Help in this way is better than surgery.
Be preventable rather than having to combat an infected toenail. Foot health is important in general but also to prevent ingrowing toenails. Look after your feet and trim regularly – once a week or once every 2 weeks. Use appropriate footwear that is applicable to the activity and not to tight or excessively loose.