Ingrown Toenails – Everything you need to know and how to solve them the right way

Wow! If you’ve ever had an ingrown toenail you know exactly how painful they can be. With all the pain that’s possible with an ingrown toenail, it’s often not the pain that’s the worst thing. It’s all the things you can’t seem to do easily or enjoy like you used to that makes people reach out for help. Whether it’s not being able to wear certain shoes, not being able to work, move or participate in sports in the same way you know you can, we’ve got you covered!

What are Ingrown Toenails?
As the name suggests, an ingrown toenail is a toenail that has ‘grown in’ to the skin alongside the toenail. As the nail grows into the skin it can cause a painful wound and in some instances this wound can then become infected.

Not all painful toenails are ingrown toenails, and not all ingrown toenails are clinically infected. Sometimes what people can often think is an ingrown toenail is what is referred to as an ‘involuted nail’ (a nail that is pressing into the skin, but has not broken the skin).

What causes Ingrown Toenails?
Like many things, there are often multiple factors that can influence the cause of something. In this case, with ingrown toenails, the most common causes/ influencing factors are:

– Trauma (A knock or bump can break and cause a sharp piece of nail/ broken skin)

– Genetics (The natural shape of the toenail can increase the likelihood of pressure/ break in the skin)

– Activities (People who regularly applying pressure to their toes in kneeling positions, such as tradespeople or people involved in kicking activities such as soccer players can increase the risk of trauma)

– Gait/ Walking patterns (People who walk in such a way where increased pressure applied to the toes may increase the likelihood of an ingrown toenail)

What are the symptoms of Ingrown Toenails?
Ingrown toenails rarely spontaneously resolve, so as the condition progresses they are more likely to become more symptomatic.

In the early stages, people will notice pain only with high pressure activities like running or changing direction and as the condition progresses even the tiniest amount of pressure (such as the pressure from a sock or a bedsheet) can increase the pain.

Ingrown toenails often present with redness, swelling and puss (signs of infection) and in more advanced cases, something called: hypergranulation tissue (an enlargement of the skin with increased sensitivity and blood flow in the affected area).

How is an Ingrown Toenail diagnosed?
An ingrown toenail is something that any podiatrist or general practitioner can diagnose. 

It is helpful to know that referral for diagnostic imaging such as ultrasound is not required to diagnose and begin treatment. Nor is prescription medication required in most cases.

A good Podiatrist who has experience working with ingrown toenails can apply a wide range of physical assessments within a consultation to diagnose, understand more about the causes of the ingrown toenail and begin treatment within the first session, without the need for further tests or prescription medication.

What  are the treatment options for Ingrown Toenails?
It is common for people to receive a course of antibiotics for an ingrown toenail, contrary to clinical evidence for best outcomes.

Although a course of antibiotics can, in most cases, reduce the infection and with it pain temporarily, it does not address the cause of the ingrown toenail. For this reason, sadly people can have course after course of antibiotics without a long term resolution to the problem.

The BEST way to treat an ingrown toenail is to address the CAUSE of the problem and because people are different and because no two cases of an ingrown toenail are the same, it is important that a thorough assessment with a practitioner experienced in helping people with ingrown toenails is conducted.

Treatment options from there may include:
– Minor reduction without need for anaesthetic

– Temporary reduction with anaesthetic

– Permanent reduction with anaesthetic 

In the above reduction treatment options, specialised instruments are used to achieve a fast and effective result. Only a few millimetres of the nail plate is removed and a normal and attractive appearance of the nail is maintained.

In very rare cases, it may be recommended that the entire nail is removed.

Helpful links
Please feel welcome to book an appointment here, or call us on (03) 5298 1147

Written by:
Daniel Monteleone
Podiatrist / Strength & Conditioning Coach

Foot & Ankle Pain, Podiatry

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