INGROWN TOENAIL: Everything You Need to Know

“Ingrown toenails are some of the most painful issues my patients can experience, yet they are often the easiest and quickest to resolve.”

-Dr. Adam Siegel,  Modern Foot & Ankle

An ingrown toenail is one of those pesky, little problems that, if left untreated, can lead to big complications.

What is it?

When a nail’s corners or sides dig painfully into the soft tissue surrounding the nail, it is an ingrown toenail. This typically occurs on the big nail’s inside and outside border; however, any toe can become affected. Sometimes, a small infection may develop.

What causes it?

Ingrown toenails may result from improperly-trimmed nails, pedicures, shoe pressure that produces toe crowding, repeated foot trauma from normal activities, or an infection surrounding the nail. They can also be caused by heredity.

What are the symptoms?

Symptoms include pain and tenderness along the border, redness and swelling, drainage, odor, and prominent skin tissue (a.k.a., proud flesh).

What are the treatment options?

Mild cases can rarely be managed effectively with only simple soaking or other home remedies. Most ingrown toenails require more in-depth treatment  by a podiatrist to remove the affected sliver of nail. If the issue is chronic, Dr. Siegel may apply an acid solution to permanently prevent a recurrence. Only the ingrown portion of the nail is removed, so cosmesis is almost never an issue. Also, because the ingrowing nail is often the cause of the nail infection, removing the affected portion of nail is all that is needed and no postoperative antibiotics are required. 

What happens if I don’t seek treatment?

Unfortunately, the only way to truly treat more advanced ingrown nails is to have the sliver of ingrown nail removed. Not doing so can cause the ingrown nail to become more painful as the toenail grows out. This can lead to infection of the skin, and in rare cases, infection of the bone, which can result in significantly more invasive treatments.

How painful is a partial or total nail removal?

The procedure is only as painful as the injection of the numbing agent, which is administered to the foot following the application of a sensation-diminishing cold spray. Dr. Siegel will ensure the toe is completely numb before proceeding with the removal. Recovery is minimal and relatively painless.

What are the postoperative care instructions?

Though removal of an ingrown toenail is a minor in-office procedure, proper postoperative attention is a crucial component of the recovery process. In the 5-7 days following the procedure, patients will be instructed to adhere to a daily routine in order to prevent an infection from forming:

  • Soak the foot in Epsom salt and warm water for 10-15 minutes
  • Pat dry and apply GRANU-L8 Wound Gel to the surgical site
  • Place gauze on the affected area and wrap gently with a CoFlex Bandage

Despite the daily dressing changes, patients are permitted to wear their regular shoes and return to regular activity immediately following the procedure.

Who can remove an ingrown toenail?

Those experiencing an ingrown toenail should only seek medical care from a foot and ankle specialist (i.e., a podiatrist). ER physicians, urgent care clinics, and primary care doctors are not specifically-trained in routine nail bed removal and may cause unnecessary complications by attempting to do so. Your primary care doctor will most likely refer you to a podiatrist.

What are my next steps?

  • Book your appointment online or call us right away (we offer same-day appointments)
  • Avoid wearing tight-fitting shoes
  • Soak the toe in Epsom salt if especially painful
  • Fill out your paperwork online to avoid any extra wait time
  • Look forward to relief!

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