Ingrowing Toenail

An ingrowing toenail is where a piece of nail pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. Ingrowing toenails most commonly affect the big toenail, however it can affect the other toes too.

What causes an ingrowing toenail?

There are many genetic factors that can cause ingrowing toenails, including your posture, the way you walk and any foot condition such as a bunion, hammer toes or excessive pronation of the feet (when your foot rolls inward excessively). Your nails may also have a natural tendency to splay or curl out instead of growing straight, encouraging your nail to grow outwards or inwards into the flesh.

One of the most common causes is not cutting your toenails properly, such as cutting nails too low in order to relieve the pressure and discomfort of an involuted nail.

Tight footwear, hosiery and socks can also push your toe flesh onto the nail so that it pierces the skin. If you have brittle nails with sharp edges or are in the habit of breaking off bits of nail that are sticking out, you are also more likely to get an ingrowing toenail.

How do you know if you have it?

The most common symptom is pain followed by inflammation in the surrounding nail area. However, not everyone identifies an ingrowing toenail correctly.  Sometimes, you could have a curly nail which has a lot of debris underneath it or a corn or callus down the side of the nail, which can be nearly as painful. However, if it’s a corn, the pain tends to be throbbing as opposed to the sharp pain you get with an ingrowing toenail.

What does the treatment entail?

This involves cleaning the area, injecting a small amount of local anaesthetic into the base of the toe, and then either removing a small section of toenail (wedge) or the whole nail. This is dressed afterwards and you can go home thereafter. Ideally, you should bring comfortable footwear as the initial dressing is quite bulky. It would be preferable to have a family member or friend drive you home after the procedure.