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Ingrown Toenail Removal
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is an Ingrown Toenail?
An ingrown toenail is a condition where the nail, most commonly of the big toe, curls downwards and grows into the surrounding skin. This leads to discomfort, inflammation, and potentially infection. While it primarily affects the big toe, other toes can also experience this condition.
While ingrown toenails are relatively common, those with the condition should seek timely medical attention to relieve any pain, prevent infections and address any underlying issues effectively.
Causes of Ingrown Toenails
Ingrown toenails develop due to a variety of factors including:
- Improper Nail Trimming
Cutting the toenails incorrectly, such as making them too short or rounding the corners, can encourage the nail to grow into the skin. - Ill-Fitting Footwear
Shoes that are either too tight or do not have enough space for the toes can exert pressure on the nails, leading to their inward growth. - Naturally Curved Nails or Disproportionately Large Nail Size
Individuals with naturally curved nails or nails disproportionately large for the size of their toes are more susceptible to ingrown toenails. In certain cases, the condition might be congenital, with the nail naturally too large for the toe. - Toe Injuries
Physical trauma such as stubbing the toe can initiate the development of an ingrown toenail.
Symptoms and Signs
The symptoms and signs of an ingrown toenail include:
- Hardening of Surrounding Skin: Initially, the skin around the ingrown toenail becomes hard, swollen, and tender.
- Redness and Infection: As the condition progresses, the area may exhibit redness. Infection can develop, indicated by pus drainage or increased warmth in the affected area.
- Pain and Discomfort: The affected toe often experiences pain, especially when pressure is applied.
- Dark or Red Skin Around the Toenail: The skin around the ingrown toenail may darken or exhibit distinct redness compared to other areas.
Diagnosis
Diagnosing an ingrown toenail typically involves the following steps:
- Physical Examination: The primary method is a visual and physical examination of the affected toe. The foot specialist looks for indicators that include swelling, redness, pain upon light touch, and any skin growing over the nail.
- Comparative Assessment of Symptoms: Comparing the affected toe with unaffected toes to identify differences in appearance and symptoms aids in confirming the diagnosis.
- Infection Evaluation: In cases where an infection is suspected, especially in individuals with diabetes or circulation issues, further investigation may be needed. This could include an X-ray to examine if the infection has spread to the bone.
Non-Surgical Treatment Options
Non-surgical methods are often effective in treating ingrown toenails, especially when addressed early.
Warm Water Soaks |
Initially, the foot specialist may suggest regularly soaking the foot in warm, soapy water or water with Epsom salt. This softens the skin and reduces swelling, thus providing relief and aiding in healing. |
Nail Lifting |
Gently lifting the edge of the ingrown toenail and placing a small piece of cotton or waxed dental floss underneath can help redirect the nail’s growth away from the skin. |
Use of Antibiotic Creams |
Applying antibiotic cream and a bandage can help manage minor infections and protect the area from further irritation. |
Pain Management |
Over-the-counter pain relievers like ibuprofen or acetaminophen can be used to alleviate discomfort. |
Surgical Treatment Options
In more severe cases or when non-surgical treatments are ineffective, surgical interventions may be necessary.
Partial Nail Removal (Partial Nail Avulsion)
This procedure involves numbing the toe and then surgically removing the ingrown portion of the toenail. It is typically done for persistent or severe cases.
Complete Nail Removal (Total Nail Avulsion)
In cases where the entire nail is problematic or recurrent ingrown toenails occur, the complete removal of the toenail might be required.
Prevention Strategies
Certain strategies can help reduce the risk of developing ingrown toenails.
- Proper Nail Trimming - Trim toenails straight across, avoiding rounding the corners. Ensure nails are not cut too short, ideally aligning with the tip of the toe.
- Soaking Before Trimming - Soaking the nails in warm water before trimming can soften them, making them easier to cut and less likely to result in an ingrown toenail.
- Wearing Comfortable Footwear - Choose shoes with a proper fit, offering sufficient room in the toe box. Avoid shoes that are too tight or place excessive pressure on the toes.
- Maintain Good Foot Hygiene - Maintain good foot hygiene by keeping feet clean and dry, and regularly cleaning nail trimming tools.
- Protect the Feet from Injury - Protect the feet from trauma, especially during activities prone to toe injuries. Those engaging in sports or activities that could lead to toe injuries may consider wearing protective footwear.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What Happens If You Don't Treat an Ingrown Toenail?
Untreated ingrown toenails can lead to complications, including persistent pain and the risk of infection. Infections, if not managed, can worsen and potentially spread. Early intervention by a foot specialist can help prevent the condition from escalating.
What Is the Least Painful Way to Get Rid of an Ingrown Toenail?
A professional medical approach is often more effective and may be less painful than home remedies. The foot specialist employs various pain-minimising techniques, ensuring comfort during treatment.
Will Your Toe Still Hurt After Removing an Ingrown Nail?
After the removal of an ingrown toenail, some discomfort is normal during the healing process. This is usually temporary and less severe than the pain caused by the ingrown nail. If pain persists, consult a foot specialist to ensure proper healing and to rule out any complications.
When Should I Seek Medical Attention for an Ingrown Toenail?
Medical attention should be sought for an ingrown toenail if there is severe pain, signs of infection (such as redness, swelling, or pus), or if the condition does not improve with basic home care. Individuals with diabetes or circulation problems should seek immediate medical attention for any foot issues, including ingrown toenails, to prevent serious complications.