What is an ingrown toenail?
With an ingrown toenail (unguis incarnatus), the edge of the nail grows into the skin of the toe. This can cause inflammation and pain. Cutting the nail “round” can sometimes be the reason for the ingrowing, but shoes that are too tight or an abnormal shape of the toe can also be the cause. Damage or infection of the nail folds can likewise be the start of an ingrown toenail. In many cases, however, it is not clear why an ingrown toenail develops.
Who can get an ingrown nail?
Ingrown toenails can arise at any age, though adults have them more often than children. The big toe is by far the most commonly affected.
What can be done about it?
Treatment depends on the severity of the problem.
Lifting the nail edge (for mild complaints)
A nail edge that presses only a little into the skin and threatens to grow in can be lifted slightly with a small piece of cotton wool, which reduces the pressure and therefore the pain and the beginning inflammation.
Narrowing the nail (for severe complaints)
When the ingrowing is already so advanced that the nail edge cannot easily be lifted with cotton wool, the nail will have to be narrowed to relieve the nail fold. A temporary or a permanent narrowing can be chosen.
With temporary narrowing, the ingrowing nail edge is cut away under local anaesthetic, and the skin of the nail fold is then given the chance to recover. The regrowing nail becomes as wide as the trimmed nail again; if it then looks as though the nail is going to grow in again, the cotton-wool technique can be used to prevent ingrowing.
If this does not succeed, permanent narrowing of the nail can be chosen. Here not only the nail itself is narrowed, but also the nail root from which the nail grows. This is cut away (again under local anaesthetic) and the site is usually after-treated with phenol. This caustic liquid locally destroys the dividing tissue from which the nail is built, so that this strip of nail will no longer grow back.
When to see a doctor
See your GP or a podiatrist if the toe becomes increasingly painful, red, swollen or produces pus, if simple measures do not help, or if the nail keeps growing in. People with diabetes or poor circulation should seek advice early for any inflamed toe, as foot problems need extra care.