Do you suffer with:

• Pain and tenderness in your toe along one or both sides of the nail?
• Redness around your toenail?
• Swelling of your toe around the nail?
• Infection of the tissue around your toenail?
• Bleeding from the tissue around your toe nail?
• A sharp pain around your toe nail?
• A stabbing pain around your toe nail?
• Pain even when the bed clothes touch your toe nail?
• Pain in shoes?
• Pain when walking?
• Do you feel miserable?

• Do your nails look like any of these?

We have 40 years of joint experience in the treatment of ingrown toenails.

Call to make an appointment. We can help you.

An ingrowing toenail is one that pierces the flesh of the toe. It can often be a splinter of nail digging into the flesh, and can be extremely painful. In more severe cases, it can become infected, producing pus and bleeding. Ingrowing toenails most commonly affect the large toenail, but can affect the other toes too. A nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn’t a true ingrowing toenail, but can also be very painful and inflamed.

Who gets ingrowing toenails?

• Active, sporty people are particularly prone as they usually get hot sweaty feet
• Younger people are often quite likely to get them where they pick their nails
• Those wearing of support hose that squeezes the toes
• People wearing shoes with tight toe boxes
• People cutting their toenails too low

Are ingrowing toenails serious?

If left untreated, and they become infected, the infection can spread to the rest of the toe and foot. The quicker you treat them, the less painful the treatment.

What causes the problem?

There are many genetic factors that can make you prone to ingrowing toenails, such as your posture (the way you stand), your gait (the way you walk), a foot deformity such as a bunion, hammer toes or excessive pronation (inrolling) of the feet, and inherited problems causing your nails to naturally be wide and fan shaped, or curl in instead of growing straight, encouraging your nail to grow into the flesh.

Tight footwear and socks can alsopush your toe flesh onto the nail so that it pierces the skin and, if you sweat excessively, or don’t rotate your footwear, this makes the skin moist and weak, so that it is pierced by the nail. If you have brittle nails with sharp edges or are in the habit of breaking off bits of nails that are sticking out, you’re more likely to get an ingrowing toenail.

However, one of the most common causes is cutting your nails incorrectly.

What can I do to prevent ingrowing toenails?

Firstly, learn to cut your nails properly. Small nail cutters aren’t a good idea because the curved cutting edge can cut the flesh and nail scissors can slip. It’s best to use larger nail cutting tools (available from chemists or podiatrists) because they have a smaller  utting blade but a longer handle. Cut your nails straight across and don’t cut too low at the edge or down the side. The corner of the nail should be visible above the skin. Also, cut them after a bath or shower when they are soft.

Good hygiene can go a long way to preventing ingrowing toenails. Avoid moist, soggy feet by rotating your footwear so each pair has a chance to dry out thoroughly. Choose socks and shoes made of materials that breath.

What is the treatment for an ingrowing toenail?

It depends on the severity of your condition. For the most basic ingrowing toenail, your local podiatrist (also known as a chiropodist) will carefully remove the offending spike of nail. Podiatrists are specialists in treating nail conditions. To locate a podiatrist in your area please see the back page of this leaflet.

If your toe is too painful to touch, your podiatrist may use a local anaesthetic to numb the toe, before removing the offending portion of nail. If you have involuted nails, your podiatrist may remove the bit that’s curling into the flesh and file the edges of the nail to relieve discomfort and advise on preventing this happening again. If you have bleeding or discharge from the toe, or even excessive healing flesh (hypergranulation tissue) around the nail, you may need antibiotics to beat the infection, after having the offending spike removed.

If you are particularly prone to ingrowing toenails from underlying problems such as poor gait, your podiatrist may recommend correction of the underlying cause as well as a more permanent solution to treating the nail problem. Partial nail avulsion’s (PNA) are done under a local anaesthetic where a small section of the offending nail edge is removed including the growing area at the base of the nail, so the nail becomes slightly narrower. A chemical is used to prevent the nail regrowing along the offending edge. This procedure was developed by podiatrists and is shown to be over 97% successful. You will, however, have to go back to your podiatrist for re-dressings post operatively.

After surgery, the overall appearance of the nail looks normal – to the extent that some people even forget which nail they’ve had done!

High risk patients

If you have diabetes, are taking steroids or are on anti-coagulants, don’t attempt any form of selftreatment by trying to remove the ingrowing spike of nail yourself; refer to your podiatrist as soon as you can.

What to do before seeing a podiatrist

Once you’ve booked an appointment with a podiatrist, help relieve the discomfort in the meantime by bathing your foot in a warm salty footbath. This will help prevent infection and reduce inflammation. After the foot bath put a clean, dry dressing over the area to keep it clean. Rest your foot as much as possible and wear shoes with plenty of room, or open toes.