What causes a curved toenail?
A curved toenail, also known as an ingrown toenail, occurs when the sides of the toenail grow into the surrounding skin. This causes pain, redness, swelling, and infection of the toe. There are several potential causes of ingrown toenails:
- Improperly trimmed nails – Cutting the nails too short or rounding off the corners encourages the nail to grow into the skin.
- Heredity – Some people are just prone to developing ingrown toenails due to the shape of their nails and toes.
- Poor foot structure – Abnormalities like bunions, hammertoes, or flat feet put pressure on toes and make ingrown toenails more likely.
- Injury – Trauma to the nail or toe can cause inflammation and nail growth problems.
- Improperly fitted shoes – Narrow, tight, or high-heeled shoes place pressure on the toes and contribute to ingrown toenails.
- Nail or skin conditions – Fungal infections, warts, or hyperhidrosis (excessive sweating) can all lead to toenail issues.
So in summary, the main causes are trimming nails incorrectly, genetic predisposition, structural foot problems, injuries, ill-fitting shoes, and other nail/skin conditions. Taking proper care of feet and nails is important to prevent painful ingrown toenails.
What are the symptoms of an ingrown toenail?
Some common signs and symptoms of an ingrown toenail include:
- Pain, tenderness, or throbbing in the affected toe
- Swelling, redness, and warmth around the toe
- Difficulty wearing shoes due to discomfort
- Skin irritation, bleeding, or infection near the nail
- Visible nail growing into surrounding skin
- Thickening or overgrowth of the corner of the nail
- Drainage of pus from around the nail
The pain is often worse when walking or wearing closed toe shoes. As the condition worsens, increased swelling and infections may occur. Diabetics and those with circulation issues are at higher risk for complications. Seek medical care if infections develop.
How can an ingrown toenail be prevented?
Here are some tips to help prevent ingrown toenails:
- Trim nails straight across – Avoid rounding off the corners.
- Don’t cut nails too short – Allow a couple millimeters to extend past the skin.
- File away sharp edges gently.
- Wear properly fitted shoes – Avoid those that are narrow or tight.
- Don’t pick at the skin around nails.
- Apply moisturizer daily to prevent skin dryness.
- Wear clean, dry socks that wick away moisture.
- See a podiatrist if you have ongoing issues.
Catching nail problems early and taking preventive precautions helps avoid the pain of ingrown toenails. Those with diabetes, neuropathy, or nail fungus may need extra care and monitoring.
How is an ingrown toenail treated?
Here are some common treatments for ingrown toenails:
Home treatments
- Soak the foot in warm water 3-4 times a day – Helps relieve swelling and pain.
- Apply antibiotic ointment – Prevents infection in mild cases.
- Wedge cotton under the nail corner – Lifts up the nail from the skin.
- Wear open, breathable shoes – Allows room around the toe.
- Take over-the-counter pain relievers.
These conservative measures may help early stage ingrown toenails. Seek medical treatment if home care does not resolve the problem within a few days.
Medical treatments
If an ingrown toenail becomes infected or chronic, a doctor may provide these treatments:
- Partial nail removal – Trims off the problematic nail edge.
- Antibiotics – Oral or topical medicines treat infections.
- Chemical cauterization – Application of phenol destroys the nail matrix.
- Silver nitrate application – Chemical cauterizes the nail bed.
- Surgical nail removal – Severe cases may require full or partial removal of the nail.
These in-office procedures are often effective for stubborn, recurring ingrown nails. Follow all post-procedure care instructions carefully.
How can you flatten the curve of an ingrown toenail?
Flattening the curve of an ingrown nail helps relieve pain and allows the nail to grow out normally again. Here are some techniques:
Soak and lift
- Soak the foot in warm water for 15-20 minutes to soften the nail and skin.
- Use a clean tweezer or orange stick to gently lift the curved nail edge away from the skin.
- Slide a tiny bit of cotton, floss, or orthodontic wax under the lifted nail corner to keep it separated from the skin.
- Apply antibiotic ointment and cover with a bandage.
- Repeat daily until the nail grows out and curve flattens.
This helps flatten ingrown nails and prevents re-embedding into the skin. Don’t forcefully dig under the nail. Seek medical care if you cannot lift the nail yourself.
Nail braces
PlasticCorrective nail braces gently lift and flatten ingrown toenails. These devices have a small, curved plate that adheres to the nail. A tiny spring lifts the embedded nail edge away from the skin. Braces are available at pharmacies or online without a prescription. They must be applied properly under the nail to be effective.
Proper trimming technique
Keeping toenails properly trimmed and filed smooth prevents curves from forming. After soaking the foot, hold the nail straight and cut across. File the edges with an emery board. leave nail tips slightly long. Never cut into the corners.
Podiatrist techniques
For severe or recurring ingrown nails, podiatrists can permanently flatten nails. They may trim off the sides of the nail or destroy part of the nail matrix to stop inward growth. Chemical cauterization with phenol or silver nitrate can also permanently stop curved regrowth.
Home care after flattening an ingrown toenail
Proper home care after nail flattening facilitates the healing process:
- Keep the area dry and clean.
- Change bandages daily.
- Apply antibiotic ointment to prevent infection.
- Soak the foot in warm water to promote healing.
- Take over-the-counter pain medicine as needed.
- Wear open-toed shoes or sandals until healed.
- Watch for signs of worsening redness or infection.
- See your doctor promptly if you have concerns.
Avoid activities that put pressure on the toe while it heals. Proper nail trimming technique afterward helps prevent recurrence of the ingrown nail. See a podiatrist or dermatologist if home care does not resolve the issue.
When to see a doctor for an ingrown toenail
See your primary care physician, podiatrist, or dermatologist promptly if:
- Home treatment does not relieve pain and swelling within a couple days
- Signs of infection develop – redness, drainage, foul odor, increased swelling/pain
- Diabetes or poor circulation impedes healing
- The ingrown toenail recurs despite corrective trimming
- You are unable to flatten the nail curve yourself
Left untreated, serious infections can develop, sometimes requiring partial nail removal. People with certain medical conditions like diabetes should not delay medical care. Seek professional treatment for severe or persistent ingrown nails.
How to find an ingrown toenail doctor
Here are some tips for finding a good doctor to treat an ingrown toenail:
- Ask your primary care physician for a referral to a podiatrist or dermatologist.
- Search online physician directories for podiatrists, foot doctors, or dermatologists near you.
- Look for doctors who specifically mention ingrown nail treatment in their profiles.
- Read online reviews to choose doctors with favorable ratings and experiences.
- Confirm the provider accepts your health insurance.
- Schedule a consultation to meet the doctor and determine if you feel comfortable with them.
Opt for board-certified doctors who are experienced in ingrown nail procedures. Many offer conservative treatments as well as surgical options when needed.
When to consider ingrown toenail surgery
Ingrown toenail surgery is generally only needed when:
- The nail remains painfully curved despite repeated trimming and flattening efforts
- Significant infection develops due to the ingrown nail
- The ingrown nail is a chronic problem with multiple recurrences
- Home care and office treatment fails to fully resolve the condition
- The nail extensively damages the skin or impedes walking
Various surgical procedures can partially or completely remove problematic nails. This provides permanent relief when conservative treatments are ineffective.
Ingrown toenail surgery procedures
Common ingrown toenail surgeries include:
Partial nail removal
The side of the nail growing into the skin is permanently removed. This eliminates pain and discomfort.
Wedge resection
A wedge-shaped section of the nail and underlying nail bed is excised. This prevents regrowth of the curved nail edge.
Total nail removal
The entire toenail is extracted. This is done for severely infected or damaged nails. A new nail may regrow normally.
Chemical matrixectomy
Chemicals like phenol or sodium hydroxide are used to destroy the nail matrix. This prevents regrowth of the ingrown portion.
Laser matrixectomy
A laser beam ablates the nail matrix. The ingrown section then cannot regrow.
These are performed under local anesthesia in an office setting or outpatient surgery center. Medications control post-surgical discomfort.
What to expect after ingrown toenail surgery
The postoperative recovery typically involves:
- 1-2 weeks of minimal walking with the foot elevated
- Use of crutches if needed to avoid putting weight on the toe
- Prescription oral antibiotics and pain medication
- placement of a dressing over the toe for 1 week
- Soaking the foot 2-3 times a day in warm water
- Wearing open-toed shoes until fully healed
- A small amount of drainage or bleeding initially
- Moderate swelling and redness around the nail
- Numbness that resolves as nerves regenerate over 4-6 weeks
- Avoidance of strenuous activity for 2-3 weeks
Proper self-care ensures optimal recovery. Most people experience significant relief with a low risk of complications. Full regrowth of the nail takes 3-6 months.
Possible complications from ingrown toenail surgery
As with any procedure, potential ingrown toenail surgery risks include:
- Infection – Prevented by antibiotics and good wound care.
- Delayed healing – Diabetes or poor circulation reduces healing ability.
- Nail regrowth – Small number have recurrence requiring reoperation.
- Toenail deformity – Post-surgical nails may have altered shape or texture.
- Chronic pain – Nerve damage can cause ongoing discomfort.
- Bleeding – Usually minor and controlled with pressure.
- Swelling – Elevation and ice reduces post-surgical swelling.
- Numbness – Mostly temporary as nerves regenerate.
- Skin overgrowth – Excised skin may extend over nail.
Discuss risks and benefits thoroughly with your surgeon prior to the procedure. Strictly follow all pre and post-op instructions to minimize risks.
How much does ingrown toenail surgery cost?
The costs for ingrown toenail procedures include:
| Partial nail removal surgery | $350 – $1500 |
| Laser matrixectomy | $400 – $2000 |
| Wedge resection surgery | $500 – $2500 |
| Phenol matrixectomy | $600 – $3000 |
| Complete nail removal | $800 – $3500 |
Expect additional fees for the surgical facility, anesthesia, medications, dressings, and follow-up care. Insurance often covers a portion, especially if deemed medically necessary.
Frequently asked questions about ingrown toenails
Can an ingrown toenail fall off on its own?
Ingrown toenails will not detach on their own. The swollen, infected tissue adheres to the nail tightly. Removing an ingrown nail requires soaking and lifting it away from the skin.
How do you pull out an ingrown toenail?
Don’t attempt to rip out an ingrown nail yourself. This will likely damage the nail bed and increase risk of infection. After soaking, gently lift just the edge with a sterile tool. Apply padding to keep it lifted. Seek professional medical treatment for proper removal if necessary.
What happens if you leave an ingrown toenail untreated?
Without treatment, ingrown nails often worsen over time. Swelling, pain, and infections in the toe increase. The nail can extensively penetrate and harm surrounding skin. Serious infections may develop, sometimes requiring hospitalization for intravenous antibiotics or surgical debridement.
Can ingrown nails come back after surgery?
Yes, it’s possible to have an ingrown nail recur after surgical removal, but unlikely. Around 3% of cases regrow incorrectly and require reoperation. Proper surgical technique reduces recurrence risk. Destroying part of the nail matrix prevents regrowth of the problematic nail portion.
How long does it take for a toenail to grow back after surgery?
After ingrown toenail surgery, it takes approximately 3-6 months for the nail to fully regrow. Factors like age, medications, and overall health affect regrowth speed. Most people have a normally growing nail free of discomfort after surgical correction.
Conclusion
Ingrown toenails are often painful but treatable conditions. Home care like proper nail trimming, padding, and foot soaks can flatten and relieve mild cases. Medical providers offer additional treatments like partial removal for severe or recurring ingrown nails. Surgery to excise the problematic nail permanently corrects stubborn cases unresponsive to other therapies. With proper care, most people can achieve pain-free, normally growing nails again.