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Did you grow up with your parents telling you to make sure you cut your nails or you'll get an ingrown toenail. If so, you're not alone. Just trimming your nails correctly doesn't always prevent an ingrown toenail from forming. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, Texas. In my practice, ingrown toenails are one of the most common conditions that I treat and they know no boundaries. I've seen ingrown toenails in infants all the way to my more elderly patients.
Ingrown toenails are one of the most common conditions seen in any podiatrist's office. It can be caused by a number of reasons. Most people think that they're caused by improperly trimming the nails, or by tight shoes, and they are, but they're not the only reasons. Most ingrown toenails that I see are hereditary. The toenail grows too wide for the nail bed. And this causes the edges of the nail to be beneath the skin. Usually a parent or grandparent will have the same situation. That's how ingrown toenails can be inherited. If you have an ingrown toenail like this, you may never have a day of pain from it. It may never become inflamed and may never become infected. But in many cases, something happens that causes it to turn the corner. Maybe it's a tight shoe, or maybe someone stepped on the toe, or you hit the toe on something.
It can cause the skin around the toenail to become red, swollen, inflamed, and even infected. It's a very painful situation. There are other causes of ingrown toenails. Sometimes they happen after a pedicure, if the technician is too aggressive in clearing the nail borders of dead skin. That can cause the border to become inflamed and painful. Sometimes you can trim your own toenails too aggressively. It's a knee-jerk reaction when you start feeling discomfort in your toe. You just know you can get that border out and make it feel better. So you angle the borders, you try to get them cleared and relieve the pain. I call this "bathroom surgery." It's very rarely effective.
Your toenails also may naturally curve, especially as you age, this can drive the edges of the toenail into the skin as you wear shoes. This type of ingrown toenail usually doesn't end up infected, but it is uncomfortable. If you have an ingrown toenail that is inflamed or infected, you need to be seen by a podiatrist. Antibiotics alone is not enough to treat this infection. They may relieve the symptoms for a short time, but the infection and inflammation will come back soon after. That's because the toenail is still embedded in the skin. The only way to relieve the infection and pain is a short procedure that's done in the office. I start off by numbing your toe. I do that with injections around the toe. That's the only time you'll feel discomfort during this procedure. After waiting a few minutes to make sure you're nice and numb,
I remove the ingrowing border. The rest of the nail is untouched. The whole procedure takes less than five minutes. After the procedure, you'll need to soak your foot and apply antibiotic cream for the next week as your toe heals. In some cases, the ingrown toenail is recurrent. The good news is you don't have to keep undergoing the procedure each time. There's a procedure that will permanently prevent the ingrown toenail from returning. This procedure can only be done when the toe isn't infected, so it's not always an option the first time around. The main part of this procedure is exactly the same. After I remove the ingrowing boarder, I then apply a medication to the base of the nail. This chemically cauterizes the corner of the nail matrix, which are the cells that grow the nail. Again, only the border of the nail is treated. The rest of the nail will continue to grow as usual. After this procedure, there's no need to soak the foot since there's no infection to clear. I do supply a dressing kit that has everything you need in it to care for your toe. You'll be dressing your toe for two weeks after this procedure.