Ingrowing toenail

Some questions answered

What is an ingrowing toenail?

When the edge of the toenail digs into the skin fold beside the nail, the skin becomes red, hot, tender and swollen. This is an ingrowing toenail. Sometimes bacteria from the skin get into the inflamed skin and an infection begins. This results in much more inflammation which may spreead throughout the toe or into the foot. Pus may also discharge from the edge of the nail.
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Why does it happen?

The nail edge may dig in because of its shape, because it becomes ragged and sharp or because of an injury. Often it seems to happen for no particular reason. It has been suggested that people with ingrowing toenails have abnormally shaped nail beds, but this has not been proven.
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Can an ingrowing toenail be prevented?

If you look after your toenails well and prevent them from getting ragged or developing painfil spikes, you will reduce the chance of getting an ingrowing toenail.
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Is there a right way to cut my nails?

If you cut your nails straight across they will not have spikes on the end and the end will be clear of the edge of the nail fold where it usually digs in. However, even this will not guarantee that you cannot get an ingrowing toenail. It may still happen in well-kept nails, especially if you have had one before or are diabetic.

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Can I treat an ingrowing toenail myself?

If the nail is only mildly inflamed, trimming it straight across and easing it out of the irritated area in the nail fold can help. Salt baths can help reduce the inflammation.

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When should I take professional advice?

If redness and tenderness go beyond the toe, it may be infected and you should see your doctor as soon as possible.

If you have an ingrowing toenail that is not getting better with simple treatment and is interfering with your life it is worth contacting your GP or a chiropodist.
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How will my doctor or chiropodist know what's wrong?

The doctor or chiropodist will listen to your complaints about your nail. Then he or she will examine you, to see how bad your nail is and to see if there is any reason why it has failed to heal. Tests for medical conditions which may interfere with healing of your toenail, such as diabetes, may be advised.
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What can be done about it?

First the chiropodist will want to check that you have tried all the simple measures outlined above. If so, and if the nail is not getting better, it is usually best to partially or completely remove the nail to allow the nail to heal. This is usually done under local anaesthtic, not asleep. Afterwards, dressings will be put on the nail bed until it heals.

Many ingrowing toenails will heal after this treatment, but many others will not. If the ingrowing toenail recurs it is often best to remove the corner of the nail bed to stop the edge of the nail growing again. This may be done either by burning the nail bed out with a chemical or by cutting it out surgically, This operation is successful in 95% of people. Again, it is usually done under local anaesthetic.
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I had my nail taken off for an ingrowing toenail. Now it's grown back and digging in again. Should something else be done?

Probably. It would be worth consulting your GP or chiropodist, as it may be worth destroying the edge of the nail bed to stop it growing again.
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