Ingrowing Toenails

What is an ingrowing toenail?

The nail becomes 'ingrowing' when the side of the nail cuts into the skin next to the nail. This can become painful. The skin next to the nail may also become infected or inflamed. Any toe can be affected, but the big toes are affected most commonly. It is a common problem, especially in teenagers and young adults.

Usually there is no apparent reason why it occurs. Tight fitting shoes may be a cause in some cases. It is also more common in people who cut their toenails very short and 'round'. The correct way of cutting nails is 'straight across'. This helps the nail to grow normally and may prevent ingrowing toenails from developing.

If caught early
If the 'ingrowing' part of the nail is small, it may be prevented from becoming worse, and sometimes cured, by the following.

• Soak the toe in water for 10 minutes to soften the folds of skin around the affected nail.
• Then, using a cotton wool bud, push the skin fold over the ingrown nail down and away from the nail. Do this starting at the root of the nail and move the cotton wool bud towards the end of the nail.
• Repeat each day for a few weeks, allowing the nail to grow.
• As the end of the nail grows forward, push a tiny piece of cotton wool under it to help the nail grow over the skin and not grow into it. Change the cotton wool daily.
• Do not cut the nail but allow it to grow forward until it is clear of the end of the toe. Then cut it straight across and not rounded off at the end.

If the nailfold becomes infected
Sometimes antibiotic creams or tablets are prescribed.

For persistent ingrown toenails
It may be necessary to remove part of the nail. The usual procedure is as follows.

• The toe is made numb and painless by injecting local anaesthetic into the base of the toe.
• The toe nail is then cut with scissors longways a few millimetres in from the offending edge.
• It is cut right up to the base of the toenail and the offending edge can then be pulled out.
• A small amount of acid is often put on the exposed part of the nail bed to stop the edge of nail regrowing and causing another ingrown nail.
• The nail is then dressed.

© EMIS and PIP 2004   Updated: November 2002   CHIQ Accredited