Ingrown Toenails are considered an urgent condition that can cause severe pain and discomfort. Those who have suffered from an ingrown toenail know how uncomfortable and painful it can be. We know it too! Hence, we do our best to book your appointment as soon as possible to treat those “angry toes”.
In this post, you can find useful information about the reasons for ingrown toenails, what you should or should not do to prevent or treat ingrown toenails, and what treatments we can offer at Orangeville Foot Clinic.
Ingrown toenails (IGTN) cause inflammation but rarely can lead to infection. They rarely clear up on their own. Unfortunately, many doctors only prescribe antibiotics for IGTNs which is not required in most cases and it can lead to antibiotics resistance. If you take an antibiotic now for an ingrown toenail, you may be resistant to it later when you need it for a more serious problem. If, however, your infection does not clear right away or if you have a compromised immune system, then we will likely prescribe antibiotics.
There are several underlying causes for IGTN including genetics (usually someone in the family has/had IGTNs), poor trimming technique, the shape and side curvature of the nails, poor-fitting shoes, and trauma to the nail.
An ingrown nail is much like having a thorn growing into the skin of your toe. Since there are many nerve endings around the toes, this condition can be extremely painful. Often, we hear from our patients that it hurts even just by touching the bedsheet. To eliminate the pain the thorn MUST be removed.
Myths about ingrown toenails
1- Cutting straight! You probably have heard that we should cut our nails straight to prevent IGTNs. However, this is not always the case. Also, there is no evidence and proper research done on which it proves that cutting the nails straight will prevent ingrown toenails. In fact, in some cases trimming the nail in a straight cut can leave a sharp edge or spike behind which eventually grows into the skin.
The first research paper suggesting a straight cut of toenails to prevent IGTN goes back to decades ago, but it was just the opinion of the authors which was later repeated/referred by other researchers without solid evidence.
In the podiatry world, it has been recommended to cut the toenails following the shape of the toe. But in general, no matter how you cut your nails, the most important thing to remember is that you should not leave a sharp edge/spike behind! Filing the corners of the nail after cutting them is a useful technique to reduce the risk of IGTN.
The image below shows how even cutting the nail in a straight way can end up with an ingrown toenail. This is particularly important if the nail is curved on the sides and part of the nail is not visible/accessible.
2- Soaking the toe in the water! Soaking the toe in just water does not help the IGTN. However, soaking in Epsom salt + water can reduce the swelling and inflammation which can reduce the pain. Having said that, soaking alone is usually not enough to treat a painful ingrown toenail.
3- Cutting a V in the middle of the nail! This is an old-school home remedy that does not work at all! The idea behind it is that cutting a V in the centre of the nail bed leaves some room for the sides of the nail to move towards the centre and come out of the skin. This is not how nails grow!
4- Packing gauze or cotton underneath the edge! Although this method can work in some cases, we do not recommend it as the gauze/cotton under the nail can accumulate dirt, germs, and debris and can be a nasty source of infection.
5- Polysporin or topical antibiotics around the nail! As mentioned earlier, most cases of IGTN are not infected. Although using a topical antibiotic does not cause any harm, it may not do any good as well.
6- Ingrown toenail only happens in weird nails! This is not true! Anyone can end up with a painful ingrown toenail. However, it is more common in certain types of nails with a genetic predisposition.
7- Ingrown toenails only happen in teenagers and adults! Although IGTN is most common in teenage boys, it can happen at any age including infants! The youngest patient I have seen for IGTN was 3 months old.
What You Should Not Do With An Ingrown Toenail!
We strongly discourage our patients from self-treatment or as we call it “bathroom surgery”. It is very common to have patients with IGTN that have tried to treat it by themselves and not only caused more damage but also made our job more difficult.
Although patients do not pay if they go to hospitals/ER for their ingrown toenails, this will not always be a pleasant and successful experience. As someone with a medical background and experience working in the ER and as a GP, I know that most doctors do not have enough expertise to treat ingrown toenails. Chiropodists/Podiatrists are the most reliable professionals that can properly help you with ingrown toenails with minimum pain and maximum success rate.
We take great pride in our ability to take care of an ingrown toenail as nearly painless as possible. If your toe is tender, we will ensure that your toe is completely numb before taking care of the nail problem. We even numb up your skin with a cold spray before local anesthetic (if needed).
One of the most common statements we hear after taking care of an ingrown toenail is “That wasn’t painful– I wish I hadn’t waited so long!”.
In addition, we usually only have to remove a very small portion of the nail. Your nail will therefore usually look normal after you have healed.
What ingrown toenail treatment options do we have at Orangeville Foot Clinic:
Option 1: Quick Release!
This procedure does not prevent the regrowth of the ingrown nail and we do it if this is the first and only time you have had an ingrown toenail. We also will do this procedure if the patient is not ready for doing nail surgery or is at high risk to do surgery (severe diabetes, poor circulation, etc).
For the quick-release treatment, we simply cut a small portion of the corner of the nail and remove the spike. In most cases, it will not be painful or the pain is tolerable. If the toe is very sensitive, we may need to numb the toe.
Antibiotics are not usually necessary as long as the portion of the nail that is ingrown is removed. But if there is evidence of infection, we also prescribe topical or oral antibiotics.
Option 2: Permanent Relief!
This treatment is called Partial Nail Avulsion (PNA) with phenolization (or Matrixectomy), which basically means that we surgically remove a small portion of the nail, we then place a chemical (an acid which is called phenol) on the root of the nail that prevents that portion of the nail from growing back again. Obviously, we do this procedure after your toe is 100% numb and you will not feel any pain during the procedure. Numbing the toe requires two injections but the pain of the needle is usually way less than the actual ingrown toenail.
We will advise this procedure if you have had frequent incidents of ingrown on the same toenail. After this procedure, your toenail will still look normal after it has healed.
Option 3: Conservative treatment!
The conservative treatment that we use is called Onyfix. In this technique, we use a resin base material to prevent the nail from becoming ingrown.
The Onyfix nail correction system enables completely painless treatment of many forms of involuted and ingrown toenails. This method is not a cure and has to be repeated every 10-12 months.
If you are suffering from an ingrown toenail, do not wait! We do our best to see you as soon as possible! We acknowledge the pain and discomfort of IGTN. Give us a call at (519) 942-4705 to book an appointment.
If you have any questions, you can use our CONTACT FORM and we get back to you as soon as possible.
If you are not in Orangeville or Dufferin County, try to find a chiropodist/podiatrist in your area. If you are in Ontario, you can go to the Ontario Society of Chiropodists to find a chiropodist in your area.