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Ingrown Toenails Fundamentals

Ingrown toenails most commonly involve the big toe, but can involve any of the toenails. The nail becomes ingrown when one or both sides grow into the skin of the toe. The skin then becomes red, swollen and painful. Sometimes the nail actually breaks the skin and causes a localized infection which may become more acutely painful and cause drainage from the side of the toe. If ignored, an ingrown toenail can cause inflammation of the bone (osteomyelitis), resulting in systemic infection.

Ingrown toenails can be prevented by cutting the toenails after bathing, when they are soft and making sure to cut the nails straight across, only slightly rounding the edges of the nails. You should not cut down into the borders of the nails. After properly trimming the nails, the edge of the nails should be lightly smoothed with a file or emery board. Additionally, you should wear well fitted shoes that are not restrictive in the toe area.

What causes Ingrown Toenails?

Ingrown toenails may be caused by the following factors:

  • The nail grows into the skin rather than gliding above the skin
  • Shoes that compress the nail against the toe skin
  • Thickened nail
  • Toe injury or repeated toe trauma
  • Fungal infections

Ingrown toenails are most commonly caused by shoe pressure, although some people may be born with a tendency to develop ingrown toenails. Thee individuals inherit this directly from one or both parents who may suffer from the same problem. Proper footwear and nail care are the best defenses against ingrown nails.

How is this treated?

Treatment options include:

  • Soaking the foot in a solution of lukewarm water and mild soap (Dreft, Ivory), then applying an antiseptic or topical antibiotic and covering with a bandage when wearing shoes.
  • Allowing it to "air out" in bed at night.
  • Reducing pressure on the toe by wearing open-toed shoes.
  • Taking oral antibiotics to treat infection.
  • Surgery.