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Published on March 10, 2020

closeup of hands clipping toe nail

Ingrown Toenails: A Tiny Nuisance

It’s the middle of the night and the covers of your bed lying gently over your foot are causing a piercing pain, keeping you from falling asleep. The nuisance comes from an ingrown toenail which has been bothering you all day. That’s right: a simple toenail, designed to protect your toe, is now the source of agitation.

Throwing off the covers, you march to the bathroom to find your clippers and spend a half hour gritting your teeth “dealing with it.” However, this isn’t your first “toe rodeo” — wouldn’t it be nice to get to the bottom of the problem once and for all?

“Patients of all populations deal with ingrown toenails, so there isn’t anything embarrassing or shameful about it,” said Jeffrey Domingue, DPM, podiatrist at Avera Orthopedics. “Treating ingrown toenails effectively can reduce the number of occurrences in the future or take care of the problem completely.”

Treating ingrown toenails begins with finding the root cause of why you’re experiencing them. While a hereditary component might exist, the more typical reasons involve simple care and hygiene.

The most common cause is cutting the toenail too short and/or rounding the tops too deeply around the edges. Another common cause is wearing tight-fitting socks or shoes. Both of these practices encourage the nail to grow imperfectly into the nail fold.

Now imagine these unfortunate situations: a poor toe, which served as the landing spot for a heavy object, may grow deformed toenails due to the injury. Or, toenail fungus may also contribute to toenails growing in abnormal ways.

“The most definitive way to deal with the problem is to surgically remove the borders of the nail and killing the root so the nail no longer grows alongside the skin next to the nail,” said Domingue. “In extreme cases, we might even remove the toenail completely, but these situations are rare.”

However, before resorting to surgery, Domingue recommends trying a topical treatment. This involves soaking your foot in warm water with Epsom salt, and then slathering a topical antibiotic such as Neosporin around the affected area. If that doesn’t soothe the discomfort in a few days, he encourages the surgical approach.

“High-risk patients susceptible to ingrown toenails should visit their podiatrist because they might encounter toe or foot complication down the road,” said Domingue. These populations include people with diabetes or poor circulation, neuropathy/numbness, immunocompromised, or paraplegic.

On a final note, to avoid ingrown toenails, follow these tips:

  • Cut the toenail straight across the tip of your toe — no curving!
  • Choose shoes and socks that don’t hug your toes too tightly, such as high heels.
  • Wear a steel-toed boot in dangerous work environments.

To schedule an appointment or learn more about foot-related conditions, find a podiatrist near you.

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