Ingrowing Toenails are a common issue for the General Practitioner.
The reason for this post is simply to highlight some self-help measures.
The following information is adapted from a superb review article in American Family Physician.
Why do I have ingrowing toenails?
Ingrown Toenails (IT) occur when the skin adjacent to the nail is punctured by the actual nail (the nail plate). This causes inflammation and infection. They are thought to occur because a small sharp bit of nail (a barb – a bit like a fish hook) anchors itself into the skin, and this gets worse with walking. There seems to be a genetic component to this. Sweaty feet makes the skin and nail softer and so become more easily split.
What is the treatment of ingrowing toenails?
Antibiotics would be required for infections. Sometimes, the nail will need removing because of long term problems or recurrent infections. This may be done by some doctors, and by some podiatrists.
What can I do myself to help?
There are things you can do yourself to help the ingrowing toenails longer term.
The following self-help method is appropriate when the nail is not very painful, very red or discharging (ie. Infected).
This method can reduce the chance of needing the toenail removed – so is well worth trying!
Soak the affected foot for 15 minutes in warm, soapy water. After each soak, there is the option to apply an ointment for a week. These ointments are prescription only and I recommend kenacomb ointment (this is normally used for the ear canals, but it contains everything that would help the problem – the American family physician journal (AAFP) recommend either a topical antibiotic ointment or a steroid ointment – and kenacomb contains all of these). But there are plenty of other options. Unfortunately, they are not available over the counter although you can buy Hydrocortisone ointment which is the closest to the recommended treatments in AAFP.
A visit to a podiatrist can also help; they may Place wisps of cotton wool under the ingrown edge of the nail. Doing this yourself would be tricky but I include these instructions for those who want to give it a try to themselves. The cotton wool is put in place using a small instrument (podiatrists may use a curette, or “nail elevator”). The edge of the ingrown nail plate is lifted away from the nail bed using the instrument, and non absorbent cotton is passed underneath the corner of the nail. A few days of intermittent soaks will make this easier to do. Podiatrists may also use gutter splints or other methods.
There is a new taping method published in 2014 – it looks very promising. The edge of the nail bed is pulled away from the ingrowing part of the nail using eg. micropore. It’s taped at least once per day for up to 2 months. This method was researched on 541 people and around half had a resolution of symptoms within 2 months.
Who should I see about my ingrowing toenails?
You’ll need to see your GP for advice about infection and self-help.
Removal of toenails is these days often performed by podiatrists.