Ingrown Toenail(s) Infection

An ingrown toenail occurs when the nail grows down and into the skin of the toe. It is caused by abnormal growth of the toenails, usually the big toes, and the surrounding tissues. When the lateral edges of the nail grow into the flesh of the toe, the small piece of nail or the whole nail applies pressure on the skin resulting in pain, swelling and redness. If the condition persists, it also results in infection and inflammation. Patients with ingrown toenails are among the most common visitors to chiropodists or podiatrists.

The condition of ingrown toenails is known by various terms like toe infection, nail infection, ingrown nail or onychocryptosis. Infected ingrown toenail is a very common problem affecting primarily the big toenails. Most people develop an ingrown toenail big toe during their 20s and 30s, but it is also seen in teenagers in case of a tearing in the corners of their toenails.

The sideways growth of the nail edges into the skin of the toe causing discomfort. The abnormally growing nail acts like a foreign body and causes a break in the skin due to the constant poking. The ingrown nail can also apply pressure in the nail fold area without any skin penetration causing pain though it isn’t considered as ingrown toenail. In some cases, a corn/callus is also noticed down the side of the nail as a reaction to the pressure instead of the nail actually penetrating the skin.

Ingrown Toenail Symptoms

Symptoms of ingrown toenail include sore and painful nail folds with redness and swelling of the surrounding skin. Infection of tissue and tenderness in toe along the sides of the nail and pain is observed along with increased warmth. In a few cases where the condition is chronic, repeated episodes of pain and infection or one of these occur. An infection may be present if the skin is red, painful or swollen on the sides of the nail. This infection may cause complications for diabetics or other patients due to poor circulation of blood on their feet. If left untreated, the nail can go under the skin causing more severe ingrown toenail infections.

An examination of the infected foot may show skin which is swollen, firm, red, or tender to touch. Presence of pus in ingrown toenails is also reported in some cases. Skin along the edge of the nail appears to be growing over the nail.

Ingrown Toenail Causes

An ingrown toenail can develop due to various reasons like poorly fitting shoes and toenails that are not trimmed the right way. Cutting the toenails incorrectly, too short or not straight across causes them to re-grow into the skin. Tight hosiery or footwear with narrow toe boxes makes it even worse.

Injuries to the toenail and deformities of the foot or toes like unusually thick toenails and curve toenails are also the factors for an ingrown toenail. It can also be hereditary in some cases.

Ingrown Toenail Risk Factors

The risk factors for ingrown toenails include poor fitted footwear, poor foot hygiene, athletic adolescents and children, toenail infections, diabetes, obesity, naturally short nails, congenital foot deformity and congenital toenail malformation. Repeated injuries to foot, prior nail surgery, poor posture and gait, fungal nail disease, abnormal nail growths, arthritis and excessive foot sweating are also some of the other risk factors.

Persons with very long toes and also those born with curved nails that tend to grow downward are also prone to ingrown toenails. Anyone can develop this condition but adults are more prone to suffer as the nails tend to thicken with age.

Ingrown Toenail Pictures

source: kirkintillochfootclinic.co.uk

source: kirkintillochfootclinic.co.uk

Source: http://www.lib.uiowa.edu

Ingrown Toenail Remedies

How to get rid of an ingrown toenail?

This condition can be resolved without medical treatment unless it’s a complicated case where a physician is required for treatment. An ingrown toenail can be unpleasant and painful. Hence, here are a few ingrown toenail home remedies:

Soak your foot for approximately 15 minutes in warm water with a tablespoon of common salt added to it. Warm water in the presence of common salt acts as a natural disinfectant preventing infections by cleansing away dirt particles and destroying breeding germs. It also softens and heals the skin tissue of the infected toe. After soaking for 15 minutes, dry the foot with a soft towel and twist a small cotton wool ball into a thin thread and wedge it under the ingrown nail. If this process is repeated for a few days before bed, the nail will start growing outwards.

Tying up a lemon slice around the affected toe before bed can heal the infection. The acidic lemon juice fights against microbial growth and prevents the spread of the infection.

Cleaning the area with water and a solution of hydrogen peroxide is also a remedy for toenail infection. Peroxide is capable of healing minor infections.

Infusion of iodine also helps in healing an ingrown toenail. It is also potent in inhibiting bacterial growth. However, this method should not be used on a deeper wound.

Gently massage the skin surrounding the ingrown toenail with some tree oil as it softens the tissues of the nail and relieves pain. It also eases out the pressure created by the nail on the surrounding skin.

These home remedies for ingrown toenail, however, work only as long as a  infection doesn’t develop. When a  infection is observed, consulting a podiatrist at the earliest becomes necessary as complications may result if the wound goes deeper. Those who are suffering from diabetes or other conditions affecting blood circulation should never treat the ingrown toenails on their own and should consult a doctor.

Ingrown Toenail Treatment

When an ingrown toenail infection is found, immediate treatment is necessary otherwise it may lead to other infections. Here are a few tips on how to treat ingrown toenail?

In an early stage, as part of ingrown toenail home treatment, the pain and swelling can be relieved by soaking the foot in warm water and adding some Epsom salt to it. Epsom salt, being an antiseptic, will heal any signs of mild infection.

Tight socks, hose or shoes should be avoided as these tend to put pressure on the toenails.

Shoes that are broad at the base should be preferred as they are comfortable to wear. In case of an infection, open-toed sandals are the best. Try to wear socks so as to keep your feet covered to prevent infection.

Avoid painting the toenails while they are in-grown as unnecessary chemicals near the site may cause infection.

For cutting the nails, the toenail clippers should be used. Toenails should not be kept too short.

Always trim the toenails in a perfectly straight line. Do not ever try shaping them because that makes them more likely to become ingrown.

For fast pain relief, ibuprofen or acetaminophen can be used.

Placing a small cotton ball under the ingrown nail will work to keep the affected area safe. This will also help in nail grow and reaching over the skin. The cotton should be changed daily so as to keep a check on infectious growth.

Once affected, there is a great possibility that it will happen again so preventive measure should be taken.

For treating ingrown toenail, the cotton method should always be applied along with antibiotics as antibiotics only reduce the infection and don’t help in growing the nail back out.

Toenail is very susceptible to infections when it is in-grown, so the best should be done to keep it covered and clean for ingrown toenail relief.

Ingrown Toenail Surgery

If the ingrown toenail condition is not cured by home remedies or treatments and it keeps recurring, surgery becomes mandatory as the final ingrown toenail treatment. An ingrown toenail surgery is minor and involves a simple procedure.

A local anesthesia will be administered before the surgery and then the toe will be cleaned with an antiseptic to avoid infection. The nail will be removed after loosening it using a scalpel.

In mild cases, only an edge of the nail may be removed without disturbing the nail bed. However, in  cases, entire nail will be removed and the nail bed cells are killed by liquefied phenol or a laser or else a surgical debriding. But the nail won’t ever grow back in case of killing the nail bed cells.

Dressing will be done using a non-stick paraffin gauze and crepe bandage. The foot should be kept elevated and rest should be taken for 2-3 days. In case of an ingrown toenail removal, 3-4 months are required for the nail to grow again.

Ingrown toenail surgery isn’t much costlier and varies according to the time required and severity.

References:

http://www.foothealthfacts.org/footankleinfo/ingrown-toenail.htm

http://en.wikipedia.org/wiki/Ingrown_nail

http://www.medicinenet.com/ingrown_toenail/article.htm

http://www.epodiatry.com/ingrown_nails.htm

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