Toenails are simply an extension of our skin. The nail, or nail plate, is made up of the same type of cells that makes up our skin, which is the largest organ of the human body. Like every other organ in the body, there can be problems. By far, the most common problem with human toenails are when they become embedded in the surrounding skin, or nail fold. This is known as an ingrown toenail.

The surrounding skin and nail plate become red, swollen, and painful. As this process continues there can be drainage, odor, and eventually an infection with pus. As the infection becomes more severe the pain may subside because the bacteria change the environment in which they are breeding, and can cause numbness to the local nerves. In the more advanced cases of ingrown toenail "proud flesh" will develop, and this is known medically as a granuloma. In the most severe neglected cases the insuing infection can lead to cellulitis, and even an infection of the underlying bone.

Causes
The most common cause of ingrown toenail is improper cutting, trimming, or tearing of the toenail. Injury, genetic irregularity, severe curvature of the nail plate, sports, improperly fit shoes, improper pedicures, and occasionally chemotherapy can lead to deformity of the nail plate and result in an ingrown toenail.

Treatment
Since the most common cause of ingrown toenails is the improper cutting of the nail, it leads the patient to attempt self treatment, this becoming what is known as a "bathroom surgeon". This is especially true in the case of adolescents and young adults.

If the cardinal signs of infection - pain, redness, swelling, local head, drainage - persist for more than 2 - 3 days then you should consult with a Podiatric Physician. Simple debridement or trimming of the ingrown toenail may be all that is required to relieve your symptoms. In the more advanced cases, a local anesthetic will need to be administered in order to properly remove the offending portion of the ingrown toenail. If there is a severe infection involved, the oral antibiotics may be prescribed by your Podiatric Physician.

In cases where there are repeated episodes of a recurrent ingrown toenail then surgery may be recommended as a more permanent treatment.

Recommendations

  • Always cut your toenails straight across.
  • Avoid cutting the toenails too short.
  • Cutting a "V" notch in the center of the nail plate will not prevent ingrown toenails.
  • Avoid shoe gear that is too short.
  • Self treatment of a painful ingrown toenail is not recommended.
  • Cut the nails, don't tear them.