Ingrowing toe nails are when the nail plate becomes very misshapen so the nail can look flat when looking from above but the shoulders of the nail (the side bits) can be very rounded and sharp travelling quite a long way down into the surrounding flesh.
Why does this happen?
Inherited- where there is a likelihood that either parents may have a similar shaped nail too.
Damaged – nails can be damaged by a single large trauma -eg; trapping the toe in the door or repeated smaller traumas for example walking downhill, where the foot slips to the front of the shoe and the nail gets repetitive tapping from the shoe and over a long walk that will cause as much damage to the nail as one single trauma. The nail bed gets damaged and a thicker more involuted nail will grow in its place.
Footwear that is too tight around the toe area creates an increase of pressure on the nail, this applies to male footwear as well as female.
Hosiery- socks, tights or Babygro’s that are too small or tight around the toes, causing the nails to push into the skin.
Poor nail cutting or nail picking - When the nail is cut down the sides into the flesh, this creates a sharp nail edge, which when the nail grows forward again the rough sharp edge will irritate the surrounding skin, which can lead onto an infection. Picking of the nails creates the same problem. Teenage boys tend to fall in this category!
Swollen toes- this is where the toes themselves are bigger than usual due to fluid retention, the nail doesn’t change shape but the skin grows around the nail creating the look of an ingrowing toe nail and creating the same problem.
Diabetes- for long term uncontrolled diabetes, the poor blood supply affects nail growth and causes the nail to grow in an involuted fashion referred to as “pincer shaped nails” which can eventually affect all the nails on both feet.
Are they painful?
Absolutely! especially when a bacterial infection is present. They can make for a miserable life if they go on for a while.
What can I do if I have an ingrowing toe nail?
If you have got to the point where it is bothering you, then a visit to us in clinic is the best option. As Podiatrists we are able to work out why you have the problem in the first place and if conservative podiatry treatments will help you resolve the problem? Getting treatment quickly is key to resolution here.
If the nail is repetitively getting infections and failing to resolve conservatively then there is the option of having a partial nail removal (the edges of the nail) or total removal of a nail is necessary through nail surgery.
It does sound a bit frightening but the procedure itself is painless as it is carried out under local anaesthetic by ourselves. Sometimes just removing the side of a nail is enough to stop the problem but in severe long-term cases, you are simply just better off without the nail. A chemical is applied to the nail bed and this prevents the nail from re-growing. If the nail is removed without the chemical application to the nail bed then it will grow back again and the shape of the nail is likely to be worse than the one that has been removed! Podiatrists never perform this option.
Not one of our nail surgery patients have ever regretted choosing nail removal.
Stages of an ingrowing toenail
How can I prevent ingrowing toenails?
Trim the toenails across and do not follow the nail down the side of the skin.
Keep the nails at a moderate length and not too long as they can press against the shoe which will increase the pressure on the nail.
Do not pick at the nails as this will leave a rough sharp edge on the nail that will irritate the surrounding skin.
Make sure your footwear has enough room in the toe-box of the shoe allowing adequate room for the toes.
Wear looser socks and tights and cut the feet out of the Babygro’s to prevent the toenails getting aggravated from the pressure of the fabric.
Diabetics need to check their toes visually to make sure the nails are not ingrowing as long term diabetics sometimes cannot always feel there is problem with the feet.