Ingrown Nails

An ingrown toe nail, also know as onychocrpytosis, is a painful condition.  It occurs when a sharp corner of the toe nail painfully cuts into the skin at the border of the nail. Pain and sometimes inflammation occur at the area where the nail curls into the skin. If allowed to continue, the inflamed area may begin to grow extra tissue or drain yellowish fluid. If untreated, the ingrown toe nail can progress to an infection that may require surgical treatment. Any toe nail can become ingrown, but the condition is mostly commonly found to be in the great toe. Most of the pain is along the margin of the nail and worsens when wearing tight footwear. The toe can become so sensitive that the weight of a simple bed sheet can be excruciating. Ingrown nails can easily become infected if not treated quickly. Early signs of an infection are redness, swelling, drainage, and pain around the nail area. As an infection progresses, you will see pockets of pus and blood.

Ingrown toe nails are caused by improper cutting of nails, cutting the skin along the border of the nail, peeling off the nails, trauma to the nails plate, and improper shoe wear.

Ingrown nails can be prevented  by cutting the nails straight across and using an Emory board to smooth the edges of the nail. This is a good technique to use when the nail is flat. When the nail is curved or incurvated the nail should be cut straight across at first but then slightly beveled at both edges and made smooth with an Emory board to prevent the edges of the nails from forming painful edges.

Treatment Options

Treatment for the ingrown nails consist of soaking the affected toe in Epson salt and room temperature water and Antibiotic ointment with a bandage. As the toe nail worsens, the toes should be treated with oral antibiotic medications and surgically removed. The surgical procedure of choice is a partial or total nail avulsion of the affected nail plate. If the nail becomes ingrown after this surgical procedure is done, then permanent destruction of the affected nail border may be necessary. This surgical procedure is called P&A. Similar to the nail avulsion, P&A is also performed after under local anesthesia. The difference is that once the nail border or plate is removed an phenol acid is applied to the exposed nail plate. After a certain amount of time the acid is neutralized with the application of alcohol. The toes that are treated should be soaked and covered with antibiotic ointment with a bandage.