Ingrown Toenails

An ingrown nail is the result of a nail growing into the skin that surrounds it. This often occurs at either edge of the big toe. Ingrown nails may be caused by improper trimming, inherited nail deformities, injuries, fungal infections, or pressure.


Symptoms

Ingrown nails may cause pain at the tip of the toe or all the way to the base of the toe. The pain is often worse while walking. An ingrown nail may also lead to infection, inflammation, or a more serious condition. If it's infected, you might see pus or redness.


Evaluation

To determine the extent of your problem, your podiatrist examines and possibly palpates (presses) the painful area. If other problems are suspected, blood tests, cultures, or x-rays may be done as well.


Treatment

If the nail isn't infected, your podiatrist may trim the corner of it to help relieve your symptoms. He or she may need to remove one side of your nail back to the cuticle. The base of the nail is then treated with a chemical to keep the ingrown part from growing back. Severe infections or ingrown nails may require antibiotics and temporary or permanent removal of a portion of the nail. To prevent pain, a local anesthetic may be used in these procedures. This treatment is usually done at your podiatrist's office.


What are thickened nails?

Abnormally thick or crumbling nails may be caused by injuries, pressure from shoes, fungal infections, or conditions such as diabetes, psoriasis, or vascular disease. Eventually, the nail may loosen and fall off.


Symptoms

Along with thickening, the nail may appear ridged, brittle, or yellowish. The nail may also feel painful when pressure is put on it.


Evaluation

Since thickened nails may be a symptom of an underlying medical condition, it's important for your podiatrist to look at your medical history for possible related problems. To check for a fungal infection, a culture may be done. The thickness and color of the nail are also examined carefully to determine possible infections or other conditions.


Treatment

If the nail isn't infected, your podiatrist may be able to thin it by trimming, filing, or grinding. If a fungal infection is present, oral or topical anti fungal medications may be needed. This can help prevent ulcerations under the nail while keeping the fungus from spreading to other nails. If pain is still present, the entire nail or part of it can be surgically removed. Do not remove the nail by yourself.


How can I prevent nail problems?

Many nail problems can be prevented by wearing the right shoes and trimming your nails properly. To help avoid infection, keep your feet clean and dry. If you have diabetes, talk with your podiatrist before doing any foot self-care.


The Right Shoes

Get your feet measured (your size may change as you age). Wear shoes that are supportive and roomy enough for your toes to wiggle. Look for shoes made of natural materials such as leather, which allow your feet to breathe.


Proper Trimming

To avoid problems, trim your toenails straight across without cutting down into the corners. If you can't trim your own nails, ask your podiatrist to do so for you.