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Under the Microscope: Ingrown Toenails
Common but painful, ingrown nails are often the result of poor care — and infection may follow.
by Staff
November 21, 2011
3 min to read
What is it? An ingrown nail is a condition where the nail penetrates the surrounding skin. An ingrown nail usually affects only one side of the finger or toe. Once the nail has penetrated the skin, bacteria can get into the cut and the area is at risk for infection. Clients may complain of warmth, tenderness, swelling, or redness.
How do you get it? Ingrown nails can be caused by incorrect shaping or filing. Often, a part of the nail is filed, but a pointed edge remains on the outside of the nail. That edge acts as an irritant, causing the body to respond to what it perceives as an invader. The body responds first by sending blood to the area, which creates heat and swelling. Left untreated, the nail will grow into the swelled skin that surrounds it. Ingrown nails can also occur when clients are persistent nail biters. Trauma, injury, or constant pressure (such as from running or too-tight shoes) can also cause an ingrown toenail. Finally, some people are predisposed to ingrown nails because of the natural shape of their nails or due to the “fleshy” nature of their toes and fingers.
How is it treated? If an ingrown nail is not yet infected, it may respond to at-home or salon care. However, if a person with poor circulation, a heart condition, or diabetes has an ingrown nail, she should see a doctor immediately. On a person without medical conditions, doctors recommend a foot soak to relieve some of the pain and an application of a topical antibacterial cream. While the foot is soaking, it can be beneficial to push the skin away from the nail. This can ease the pain of swelling and the pain caused from the nail cutting into the skin. If the area is infected, a doctor’s visit is required. The doctor may prescribe a topical or oral antibiotic, or in severe cases, she may need to perform surgery.
What can I tech do? If the client has diabetes, is on heart medication, or is prone to ingrown nails, send her to the doctor for treatment. If the area is infected, again refer her to a doctor. If it’s a clean, uninfected area, soak the nail in warm water mixed with antibacterial soap and gently push the skin away from the nail. Try to find the end of the nail to make sure no small point remains at the edge. If you see a small point, clip or file it away. Shape the nails to reflect the nail bed’s natural shape. If the nail has penetrated and broken the skin, apply a topical antibiotic like Neosporin and a Band-Aid. Instruct clients to avoid wearing tight or narrow shoes until the irritation resolves. Clients can soak the ingrown nails at home a couple of times a day.
What else? Don’t believe the home-remedy myths that circulate about ingrown nail treatment. Rumors include cutting a “V” into the center of the nail and stuffing cotton under the ingrown nail. This could create larger problems if the “V” is cut incorrectly or if the cotton harbors germs that could cause infection. Instead, leave these treatments to doctors and stick with proper filing methods and warm foot baths.
Dr. Colleen Schwartz, D.P.M., contributed to this article.
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