An in-growing toenail is a toe nail that pierces the flesh of the toe. It can feel as if you have a splinter, or other foreign object embedded in it and can be extremely painful. In more severe cases, it can cause bleeding and pus. In-growing toenails most commonly affect the big toenail, but can affect the other toes too. A nail that is curling (involuted or convoluted) into the flesh, but does not pierce the flesh, is not classified as in-growing, but can also be red, inflamed and very painful.
Active, sporty people are particularly prone to them, because they sweat more. Younger people are also susceptible as they tend to pick their nails more, compared to older people who may not reach their toes. Women often develop them as a result of cutting nails too low in order to relieve the pressure and discomfort of an involuted nail.
Good hygiene can go a long way to preventing in-growing toenails. Avoid wet skin by alternating footwear and hosiery, so that each pair has a chance to thoroughly dry out. Avoid man-made materials and choose socks and shoes of natural fibre. In the summer, wear open-toed sandals where possible.
If you have booked an appointment with a podiatrist, relieve the discomfort in the meantime by bathing your foot in warm salty water for no longer than five minutes. Gently and carefully massage the area. This can prevents infection and reduce inflammation. Apply a clean sterile dressing, particularly if there is any discharge, then rest your foot as much as possible.
If you have diabetes, are taking steroids or are on anti-coagulants, do not attempt to cut your nails or remove the in-growing nail yourself.
It depends on the severity of the condition. Typically, the Podiatrist will remove the in-growing section of nail. If there is bleeding or discharge from an infection, it may require antibiotics as well as having the offending spike removed..
If the toe is too painful to treat, or the patient is particularly prone to reoccurring in-growing toenails, the Podiatrist may recommend a more permanent solution, such as partial nail avulsion (PNA), or total nail avulsion (TNA). Under local anaesthetic, the in-growing section is removed. The chemical phenol cauterises the wound and prevents that part of the nail re-growing. A number of dressing appointments would be necessary.
After surgery, the overall appearance of the nail looks normal.