Patient information: See related handout on ingrown toenails, written by the authors of this article. Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser. Randomized clinical trial of surgical technique and local antibiotics for ingrowing toenail. If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail. You may need to gently lift the edge of the ingrown toenail from its embedded position and insert some cotton or waxed dental floss between the nail and your skin. If excessive inflammation, swelling, pain and discharge are present, the toenail is probably infected and should be treated by a physician (see left image below).
Surgery is effective in eliminating the nail edge from growing inward and cutting into the fleshy folds as the toenail grows forward.
Unless the problem is congenital, the best way to prevent ingrown toenails is to protect the feet from trauma and to wear shoes and hosiery (socks) with adequate room for the toes. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. The condition of ingrown toenails is known by various terms like toe infection, nail infection, ingrown nail or onychocryptosis.
Symptoms of ingrown toenail include sore and painful nail folds with redness and swelling of the surrounding skin. An ingrown toenail can develop due to various reasons like poorly fitting shoes and toenails that are not trimmed the right way.
Injuries to the toenail or a broken toe or deformities of the foot or toes like unusually thick toenails and curved toenails are also the factors for an ingrown toenail. The risk factors for ingrown toenails include poor fitted footwear, poor foot hygiene, athletic adolescents and children, toenail infections, diabetes, obesity, naturally short nails, congenital foot deformity and congenital toenail malformation. Persons with very long toes and also those born with curved nails that tend to grow downward are also prone to ingrown toenails. This condition can be resolved without medical treatment unless it’s a complicated case where a physician is required for treatment. These home remedies for ingrown toenail, however, work only as long as an infection doesn’t develop. When an ingrown toenail infection is found, immediate treatment is necessary otherwise it may lead to other infections.
In an early stage, as part of ingrown toenail home treatment, the pain and swelling can be relieved by soaking the foot in warm water and adding some Epsom salt to it.
Tight socks, hose or shoes should be avoided as these tend to put pressure on the toenails.
Placing a small cotton ball under the ingrown nail will work to keep the affected area safe.
For treating ingrown toenail, the cotton method or waxed dental floss method should always be applied along with antibiotics.
If the ingrown toenail condition is not cured by home remedies or treatments and it keeps recurring, surgery becomes mandatory as the final ingrown toenail treatment. The cost of ingrown toenail surgery is usually affordable and it varies according to the time required for treatment and severity of the wound.
Ingrown toenail’s often re-occur, it is best to seek professional treatment from your GP or a podiatrist. Ingrown toenail is a foot disease that creates toe injury and results in a serious painful condition if not cured in time. The ingrown toenail is a relatively common condition that affects the big toe preferably young adults. The ingrown toenail is a relatively common condition often affecting the big toe a young population. This entry was posted in Ingrown toenail, Ingrown toenail removal, Ingrown toenail surgery, Ingrown toenail treatment, ingrown toenails, toenail removal and tagged Ingrown toenail, Ingrown toenail removal, Ingrown toenail surgery, Ingrown toenail treatment, ingrown toenails, toenail removal by admin. Anyone who's ever had an ingrown toenail likely knows how painful, annoying, and persistent this condition can be.
You'll also want to make sure to clean any tools you use to touch the areas around and underneath your toenail.
This home remedy is very similar to a common form of treatment that doctors often use to treat ingrown nails.
When you're done with your home treatment, clean the nail again, making sure to gently apply soap to any sore spots or areas that showed signs of bleeding. Though rare, infected ingrown toenails can eventually require surgery or cause dangerous illnesses like osteomyelitis (a type of bone infection) if they're not dealt with.[3] While these conditions are treatable, preventing them by handling infections early with antibiotics is much easier (and cheaper) than the more drastic approaches needed to fix more serious complications.
For long-term use, be sure to remove the bandage, clean the wound, and re-apply a new bandage daily. If you have a habit of picking or biting your toenails, this can make it hard to let your toenails grow to the edge of your toes.


Visit a podiatrist or your family doctor, especially for extremely painful or infected conditions. If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. Conservative therapy provides a cost-effective approach that obviates the need for a minor surgical procedure and its attendant short-term minor disability and pain.
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Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe.
Permanent removal of the nail may be advised for children with chronic, recurrent infected ingrown toenails. Your toe is injected with an anesthetic and your doctor uses scissors to cut away the ingrown part of the toenail, taking care not to disturb the nail bed. Nails should be cut straight across with a clean, sharp nail trimmer without tapering or rounding the corners.
It is caused by abnormal growth of the toenails, usually the big toes, and the surrounding tissues. Infected ingrown toenail is a very common problem affecting primarily the big toenails.  Most people develop an ingrown toenail big toe during their 20s and 30s.
The abnormally growing nail acts like a foreign body and causes a break in the skin due to the constant poking. Cutting the toenails incorrectly, too short or not straight across causes them to re-grow into the skin.
Repeated injuries to foot, prior nail surgery, poor posture and gait, fungal nail disease, abnormal nail growths, arthritis and excessive foot sweating are also some of the other risk factors. Therefore you need to do whatever you can to prevent it.  Toenails are very susceptible to infections when they are ingrown, so do your best  to keep it covered and clean for ingrown toenail relie and prevention.
There are various methods for ingrown toenail removal where one of them is Ingrown toenail surgery, which is a perfect method to get rid of ingrown toenail permanently and is used majorly nowadays.
The surgery is often necessary, but the recurrence rate is high risk with functional and aesthetic sequelae irreversible.
The nail unit includes fabric paronychium, the tablet bed and the matrix (Figure 2) .The fabric is formed by the paronychium nail proximal and bead seat side. 4.5 The use of a laser to destroy the matrix enables better control of the degree and the depth of treatment. As with any surgery, dermatology, must be the curative procedure but also aesthetically acceptable.
While the very best way to treat an ingrown toenail is to see your general practitioner or a specialist like a podiatrist, there are steps you can take by yourself at home to ease the pain or even eliminate the ingrown nail entirely — just make sure to keep an eye on your toe after your home treatment and contact a medical profession at the first sign of trouble. With any sort of procedure or treatment where there's a risk of irritating or cutting the skin, infection is a concern. Using a clean, sterile pair of tweezers, lift the edge of your toenail away from the flesh it has grown into.
Sometimes, a nail is so ingrown that it's very painful or outright impossible to insert cotton under it. While the home remedies described above may work well for non-serious ingrown toenails, they may not necessarily work for all ingrown toenails or cases that have progressed beyond a certain point. Even if your ingrown toe treatment is successful, your toe may remain sore for a few days as the inflammation and swelling subside. Since preventing infection is a major concern with ingrown toenails, it's a good idea to apply antiseptic creams and ointments to the affected nail semi-frequently to halt the growth of any bacteria. One great way to prevent infection in an ingrown toe is simply to keep any sort of infectious material out of the wound entirely.
If your ingrown toenail is giving you pain or discomfort after treating it with a home remedy, you don't simply have to grin and bear it. Another common cause of ingrown toenails is injury — usually, either from something falling onto the foot or smashing into it from the front.
If you wear tight shoes that constantly squeeze your toes, this may be the cause of your ingrown toenail.[10] Try switching to a looser-fitting pair of shoes or wearing less-constrictive shoes like slippers around the house to lessen your chance of ingrown nails in the future. These shoes put no pressure at all on the toes, so there's no risk of them causing an ingrown nail. One conservative treatment option is to soak the affected toe and foot for 10 to 20 minutes in warm, soapy water. Although the use of oral antibiotics before or after phenolization is widespread, their use is based solely upon historic practice without evidence from clinical trials. Trauma, such as stubbing the toe or having the toe stepped on, may also cause an ingrown nail.
The ingrown nail can also apply pressure in the nail fold area without any skin penetration causing pain though it isn’t considered as ingrown toenail.


It would be 10 to 30% for the modified Emmert plasty and only 5 to 10% for the phenol procedure.
However, it's especially important to protect against infection when dealing with an ingrown toenail for several reasons. You may need to pull back the skin on the side of your toe with one hand to be able to reach the ingrown part of the nail.
If this happens, end your home treatment by soaking up blood with a cotton ball, gauze, or a clean rag.
If your ingrown toenail doesn't seem to go away or becomes worse, make an appointment with your doctor or a foot specialist as soon as you can.
Toenails that are too short can be pressed into the skin of the toe by the pressure that comes from wearing shoes, leading to ingrown situations.[8] To prevent this, after you've had an ingrown toenail, try letting it grow unhindered for a few months.
Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization. Removing your whole ingrown toenail (complete nail plate avulsion) increases the likelihood your toenail will come back deformed. If the ingrown toenail is removed, it will take about 3-4 months for the nail to grow again. As with any dermatologic surgery, the procedure must not only curative but also aesthetically acceptable. Subungual dermis lies directly on the periosteum without subcutaneous tissue which makes it very adherent to the bone. The back foot should be maintained so that the forefoot is relieved and is not only to keep the shoe in place, which may cause trauma to the toes.
If you have an ingrown toenail, there's a good chance that the skin around it is already likely tight, irritated and inflamed already, making it vulnerable to infection from the get-go.
Toenails should be cut straight across, and the corners should not be rounded off.Risk factors predisposing to development of ingrown toenails include anatomic and behavioral mechanisms. An ingrown nail occurs when the skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. Patients with ingrown toenails are among the most common visitors to chiropodists or podiatrists. This infection may cause complications for diabetics or other patients due to poor circulation of blood on their feet. In addition, the skin around toenails is often kept in dark, semi-moist environments all day — the perfect breeding ground for bacteria.
Some experts suggest that wider nail folds and thinner, flatter nails increase the risk of ingrown toenails,3 but this remains unproven. A sculptured acrylic artificial nail can also be used in patients with an ingrown nail and no granulation tissue. Ensure that the entire nail fragment and flat edge of the nail bed is retrieved to prevent formation of a nail spicule and the potential for recurrence of an ingrown nail.Release the tourniquet after adequate hemostasis is achieved.
If left untreated, the nail can go under the skin causing more severe ingrown toenail infections. Try to make a smooth cut — you don't want to leave a sharp corner, which can catch on your skin as the nail re-grows and lead to another ingrown situation. This makes it less likely for the nail to grow into the skin and develop into an ingrown nail.
Partial nail avulsion followed by either phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toe-nails. Options for destruction of the nail-forming matrix beneath where the nail plate was removed include phenolization or mechanical destruction of the nail matrix.
The functional and aesthetic results are good because the nail keeps its integrity without risk dystrophy.
Compared with surgical excision of the nail without phenolization, partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence of ingrowing toenails, but has a slightly increased risk of postoperative infection. Formable acrylic is then placed on the nail and platform and molded into a nail shape to cover either a portion or the entire nail area surface.
For phenolization, apply an 80 to 88% phenol solution directly to the nail matrix three times for 30 seconds each round (Figure 8). The effectiveness of the surgery may still be higher than that of phenol if it is performed by experienced surgeons. In older persons, spicule formation can become a chronic problem caused by their reduced ability to care for their nails secondary to reduced mobility or impaired vision.



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