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Common Complications of Ingrown Toenails and Why It's Important to Treat Them

What Are Ingrown Toenails?

An ingrown toenail occurs when the side or corner of a toenail grows at the wrong angle and moves inward into the skin instead of along the surface of the skin. This happens most frequently with the first or “big” toe, but it is possible on any toe. There are a few common causes, such as wearing tight-fitting shoes or trimming the nails too short. However, genetic predisposition, or trauma to the foot or toe can also result in ingrown toenails.

What Happens With A Severe Ingrown Toenail?

As an ingrown toenail progresses untreated and becomes more severe, it can grow deeper into the skin, or even curl into itself and grow in the opposite direction. This growth will proceed and worsen as the nail continues to grow. For this reason, it’s very important to be attentive to the care and treatment of your toenail before it may become serious.

Complications and Risks

Ingrown toenails are not a major concern if treated promptly. All of the below complications result from improper or late treatment of an ingrown toenail. Early treatment and prevention are key to preventing any of the unnecessary pain and complications before they become a problem.

Pain

While an ingrown toenail can initially be just unsightly or a nuisance, it can get very painful if left untreated as the nail grows deeper into the skin. This pain may be worse when you wear shoes or put weight on the foot.

Swelling and Inflammation

In addition to pain, severe ingrown toenails can cause swelling and inflammation at the site. This is caused by the nail pressing into the skin. Combined with pain, this can make it difficult to wear shoes, walk normally, or go about your daily activities.

Diabetes Complications

People with diabetes should be particularly vigilant about ingrown toenails because diabetes can cause poor blood flow to the feet. This can exacerbate any symptoms or complications from ingrown toenails by preventing proper healing and possibly leading to infection.

Infection

The most serious complication is infection. The primary signs of an infection include pus at the site of the ingrown toenail, and experiencing a fever (and body aches or chills). You may also notice the redness or inflammation spreading out from the toe into your foot.

Treatment Options

At Home

If your ingrown toenail is mild, you can try treating it at home. Most ingrown toenails can be treated this way, particularly if caught and cared for early. One effective at-home treatment is soaking in warm water to soften the skin. This treatment, combined with ibuprofen or another over-the-counter painkiller for mild pain, may be able to alleviate an early or minor ingrown toenail.

Do not attempt to cut out the nail yourself, as you can worsen the situation, or injure your skin by doing it incorrectly. If the progression of your ingrown toenail is at a point where you feel the need to cut it, it’s time to visit your doctor.

With Your Doctor

Most doctors may be able to do something for your ingrown toenail, but podiatrists (foot and ankle doctors), offer more advanced treatment to help you treat the ingrown toenail. The treatments at your podiatrist’s office are simple and effective. Quick treatment is vastly preferable to suffering through prolonged pain or risking infection with an ingrown toenail.

Medicine

Your podiatrist may prescribe antibiotics to stave off or fight an existing infection. He or she may also prescribe stronger painkillers if over-the-counter medicine is not sufficient for your pain.

Surgical Interventions

For mild to moderate ingrown toenails, it may only be necessary to remove the part of the nail that has become ingrown to resolve the issue. This may be combined with antibiotics or painkillers to resolve an infection.

If it is a severe ingrown toenail, your podiatrist may need to perform a simple procedure that removes the edge of the nail all the way to the nail bed and apply a specialized chemical called phenol to that area. This chemical will permanently stop the edge of the nail from returning.

This will drastically help your ingrown toenail and prevent them from happening in the future. Doing this will also keep your nail looking natural; it will simply look narrower than it did before.

In extreme cases, the entire nail may need to be removed. To avoid this outcome, see your doctor long before the ingrown toenail has become that serious.

After such procedures, you should be able to return to basic activities within a few days, with the pain and inflammation a thing of the past. However, speak to your doctor about the preferred timeline for returning to more vigorous activities such as running or playing sports. And follow any specific care instructions or recommendations your doctor may make for your recovery.

Prevention and Awareness

It is important to know the signs of an ingrown toenail and intervene early to prevent complications and infection. Be ready to call or visit your doctor if medical attention is necessary or the ingrown toenail is worsening with at-home care.

  • You can also prevent future recurrence of ingrown toenails. A small amount of preventative care can stave off pain, complications, and extra doctor’s visits, and is well worth the effort.
  • Keep your feet clean and dry at all times. If you engage in activities that lead to wet or sweaty shoes and socks, be sure to change into clean and dry socks frequently.
  • Avoid tight-fitting shoes or high heels, which compress the toes and make ingrowth more likely.
  • Maintain proper toenail shape by cutting your toenails straight across, instead of on a curve.
  • Don’t cut them too short; keep them at least as long as the edge of your toe.

If you are predisposed to ingrown toenails due to genetics or other factors, remain vigilant by checking your toes regularly to catch an ingrown toenail as early as possible.

Be prepared to provide at-home care for any ingrown toenail or seek medical treatment before complications arise.

Published online: Jul 13, 2022

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