Ingrown Toenail: Causes, Symptoms & Treatment

An ingrown toenail or ingrown toenail refers to the penetration of the toenail into the surrounding tissue, causing pain especially when wearing shoes. Most often, the big toe is affected by this problem. The technical term for an ingrown toenail is unguis incarnatus.

What is an ingrown toenail?

By an ingrown toenail, medical professionals mean the penetration or ingrowth of the toenail into the nail bed. In this case, the toenail causes an initially superficial injury in which skin and tissue grow over parts of the nail during the healing process. As a result of the foreign body in the nail bed, there is usually swelling associated with more or less severe pain. If left untreated, the tissue can become inflamed by invading bacteria, causing greater discomfort that requires urgent medical treatment. Ingrown toenails are very common. Statistics say that men are affected much more often than women.

Causes

In most cases, ingrown toenails are caused by incorrect nail cutting. In particular, if the nail of the big toe is cut in an oval shape, there is an increased likelihood that its edges will gradually push into the nail bed. This process is supported if the person in question frequently wears tight footwear, which once again additionally presses the nail and nail bed against each other. According to experts, genetic factors also play a role in the development of ingrown toenails. If there are corresponding problems in the family, people with such an increased risk should pay attention to the care of their feet and wearing wide and comfortable shoes.

Symptoms, complaints and signs

The ingrown toenail is very easy to recognize visually and therefore quite simple for the layman to diagnose himself. Most often, the ingrown toenail occurs when the toenails are cut too short or, in turn, too infrequently and the foot is also forced into an awkward position by incorrect footwear. This leads to the fact that the toenail is pressed mostly at its right or left edge too much into the surrounding tissue and cuts there, or grows in under pressure. The ingrowth is usually associated with a purulent inflammation and causes very great pain. With these complaints, the affected person should definitely see a doctor and have the ingrown toenail treated professionally. The first signs can already be seen in a reddening of the tissue. If the ingrown toenail is not treated or is treated incorrectly, the inflammation will progress. In the worst case, this can lead to necrosis or blood poisoning and develop into a life-threatening disease. Normally, however, an ingrown toenail that has been treated by a doctor usually heals very well and does not cause any new symptoms later on if foot care is improved. The first symptoms of a possible ingrown nail are pain at the nail bed and in the immediate area around the nail. At this stage, medical foot care can prevent worse.

Diagnosis and progression

An ingrown toenail can be diagnosed very easily if there is swelling and redness at the nail bed that is associated with pain. Often, it is even possible to see where the nail has grown in and how far it has grown without any tools. If an ingrown toenail is suspected, a specialist should be consulted to initiate appropriate therapy. If the injury remains untreated, it often results in more severe pain, which can significantly limit the ability of the affected person to walk. Wearing shoes in particular causes great problems at this stage. Penetrating bacteria can eventually lead to inflammation, which may be accompanied by pus formation. In the worst case, surgical intervention may be necessary to permanently reduce the discomfort.

Complications

An ingrown toenail is usually a very unpleasant affair that may even need to be treated by a doctor. Of course, various complications can also occur, which usually require medical treatment as well. The most common complication is severe redness and long-lasting pain. Of course, these complications can also worsen considerably if the affected person does not seek medical attention.Under certain circumstances, the toenail can also become inflamed and bleed, which of course also requires appropriate treatment. At the latest, if the inflammation shows pus formation, then the visit to the doctor can no longer be delayed. Anyone who completely forgoes medical treatment at this point runs a very high risk. Otherwise, the pus formation will increase and blood poisoning may even occur. If you want to avoid this complication, you should also see a doctor immediately. Blood poisoning is a very serious matter that can even endanger life. Thus, an infected toenail is usually a very painful matter. If you leave this condition without any treatment, you have to expect the above-mentioned complications. However, these complications can be avoided or treated effectively and quickly with an early visit to the doctor.

When should you go to the doctor?

If the ingrown toenail does not recede on its own or causes discomfort, a doctor should be consulted in any case. It is recommended to have stabbing pain, redness and inflammation in the affected area medically clarified to avoid further complications. If the ability to walk is already limited, the following applies: immediately call in a specialist and have the ingrown toenail medically treated. With early treatment, long-term problems usually do not persist. However, if the ingrown toenail remains untreated, it may lead to severe inflammation and chronic pain as a result. If symptoms of sepsis are noticed, the emergency physician must be called. Depending on how far the inflammation has progressed, a few days of hospitalization may then be indicated. In the case of chronically ingrown toenails, the doctor will also suggest a nail bed reduction to the patient after the initial treatment. Diabetics and people suffering from circulatory problems for other reasons are also best to directly involve the doctor in charge.

Treatment and therapy

If an ingrown toenail is detected and treated at an early stage, no surgical intervention will be necessary in most cases. Basically, in addition to cleaning and disinfecting the affected tissue, the treating physician will ensure that the nail bed is relieved. For this purpose, for example, a wedge or a silicone tube can be inserted between the nail bed and the nail, which significantly reduces the pressure and allows the pain to subside quickly. A so-called nail correction brace can also be used. Here, the toenail is slowly pulled upwards over a period of up to one year, thus preventing it from growing in again. If an ingrown toenail occurs repeatedly despite these measures, a surgical procedure must be performed. The part of the toenail causing the problem is cut out. The injury then recedes and the symptoms no longer occur. In case of chronically ingrown toenails, a nail bed reduction can also be performed. In this procedure, not only the nail itself but also the nail bed is surgically reduced so that ingrowth cannot occur again in the future. If there is already a purulent inflammation of the affected tissue, this may first need to be treated locally before surgery can take place. Nail or nail bed reductions generally achieve quite good results.

Outlook and prognosis

The prognosis of an ingrown toenail is favorable. In the early stages, the affected person can bring about a change himself and trim the toenail himself without much effort. If handled correctly, any subsequent discomfort such as redness or pain will subside. Good wound care and care of the foot is essential. During the healing process, tight shoes should be avoided to prevent further complications or delays in recovery. If the toenail cannot be removed on its own or if the growth process is already advanced, a doctor should perform corrective surgery. With good wound care, complete healing can be expected after a few weeks. The prognosis worsens as soon as blood poisoning occurs.This can happen as soon as bacteria or other pathogens enter the organism via the affected area on the foot. If medical care is not provided during this phase, the affected person may die prematurely. The discomfort increases rapidly and there is a significant deterioration of health within a few days. If the discomfort of the ingrown toenail has led to poor posture of the body or one-sided physical stress, the problems normally regenerate within the healing process. If changes remain, further treatment should take place.

Prevention

An ingrown toenail can be prevented in many cases with wide and comfortable footwear and appropriate foot and nail care. Particular care should be taken when cutting nails to avoid corners pressing into the nail bed. Hereditarily predisposed persons should once again pay special attention to the well-being of their feet and nails. If an ingrown toenail nevertheless occurs, a doctor should be consulted in good time to avoid more serious inflammation.

What you can do yourself

An ingrown toenail is unpleasant, but in most cases it heals on its own without any problems. Nevertheless, there are some things that sufferers can do to speed up the regeneration of the nail and surrounding tissue and avoid any complications. First and foremost, it is important to carefully protect the affected area from additional irritation. This applies to mechanical influences caused by tight shoes as well as to pollution. The use of nail polish, sharp cleaning agents or brushes with hard bristles should also be avoided for a while. Affected persons best give the nail the opportunity to grow out healthy again on its own. Constant manipulation of the affected nail by scissors and nail tweezers often does more harm than good. If a torn toenail is associated with inflammation of the surrounding tissue, a foot bath may be helpful. The water used should be warm and enriched with anti-inflammatory substances such as chamomile or special additives from the pharmacy or health food store. These home remedies can help especially if a small collection of pus has formed in the area of the torn nail. The warm water often loosens the overlying skin. This also loosens the accumulated secretion and possibly existing pressure pain will pass.