TOENAIL, INGROWN

General Information

DEFINITION--A condition in which the sharp edge of a nail grows into the flesh of a toe, usually the great (big) toe.

BODY PARTS INVOLVED--Toes.

SEX OR AGE MOST AFFECTED--All ages, but most common in adolescents and adults.

SIGNS & SYMPTOMS--Pain, tenderness, redness, swelling and heat in the toe where the sharp nail edge pierces the surrounding fold of tissue. Once tissue surrounding the nail becomes inflamed, infection usually develops in the injured area.

CAUSES--

An ingrown toenail is likely to accompany one of the following conditions:

• The nail formation is more curved than normal.
• The toenail is clipped back too far, allowing tissue to grow up over it.
• Shoes fit poorly, forcing the toe of the shoe against the nail and surrounding tissue.
• The person participates in activities that require sudden stops ("toe jamming").

RISK INCREASES WITH--Any of the circumstances listed as causes.

HOW TO PREVENT

• Wear roomy, well-fitting shoes.
• Cut toenails carefully. Persons with diabetes mellitus or peripheral vascular disease should be especially careful in trimming toenails. Foot injury is dangerous with these disorders because of impaired blood circulation to the feet.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.
• Surgery to remove the nail.

POSSIBLE COMPLICATIONS--Chronic infection that cannot be cured without surgery.

PROBABLE OUTCOME--Curable with treatment. Oral antibiotics usually relieve symptoms of infection within 1 week. Then part or all of the toenail is removed surgically and the nail bed is scraped so the problem will not recur. The nail should grow back, but it probably won't look the same.

How To Treat

GENERAL MEASURES----The following home treatment is appropriate either before or after surgery:

• Use immersion soaks (see Soaks in Appendix).
• Lift the nail corners free of surrounding inflamed tissue by wedging a small piece of cotton under the nail around the edges. Protect the inflamed tissue from further injury.

MEDICATION--Your doctor may prescribe antibiotics to fight infection.

ACTIVITY--Resume your normal activities as soon as symptoms improve. You may need to wear a shoe with the toe cut out until the toe heals.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of an ingrown toenail.
• The following occurs during treatment or after surgery: Fever. Increased pain. Signs of infection (pain, redness, tenderness, swelling or heat) in the toe.