Ingrown toenails can be especially painful. A friend of mine dropped a heavy law book on her toe and for the next six months went back and forth to the podiatrist trying to avoid the next step of having her entire toe nail removed.
Ingrown toe nails occur when something, such as a sudden force or pressure from a tight shoe, forcibly pushes the nail edge into the nail fold alongside the nail. The area quickly becomes inflamed, red and swollen and, without treatment, can progress to a more serious problem.
The most common cause of ingrown toenails is improper trimming according to the American College of Foot and Ankle Surgeons. We tend to trim our nails following the contour of our toes but many times we make the nail on our large toe too curved which can force the nail into the lateral skin if the toe is bumped or squeezed by shoes that are too tight.
Ingrown nails can be inherited, however, it is more common that ill fitting shoes that are too small or even too large are the major culprits. Sports such as soccer can also cause or aggravate an ingrown toe nail. Constant running and kicking while wearing snug, slim fitting shoes, does not allow toes to stretch or move freely. Combined with sweat from the exercise, an environment susceptible to infection can quickly occur.
How to prevent ingrown toe nails:
1. Cut nails straight across so the nail rides onto the surface of the skin at the top of the toe. Do not curve down the ends, slightly round them if necessary and do not cut them too short.
2. Air out your feet when you are home. Wear cotton socks and change them frequently if your feet perspire.
3. Wear properly fitted shoes with a wide toe box to keep toes from pushing against each other. Remove soccer or sport shoes immediately after play to reduce pressure and friction on a potentially irritated big toenail.
What to do if you develop an ingrown toenail:
1. Soak the toe for 20 minutes, 2 to 3 times a day adding Epsom salt or vinegar to the water. Resist the urge to perform home surgery by trying to cut out the inflamed nail yourself! You can massage the skin fold lightly if tolerable after soaking.
2. Depending on how painful the nail is there are various methods to try and “lift” the nail up away from the tender tissue to see if relieving the pressure will help the nail grow straighter.
• Insert a small piece of cotton or dental floss under the edge of the nail to lift it away from the skin fold. Change this cotton daily to avoid developing an infection from drainage coming from the inflamed area.
• Gutter splint: Cut a small piece of a new plastic hollow coffee stirrer straw and slit one side using scissors that have been cleaned first with alcohol. Slip the edge under the nail between the nail and the skin fold. Secure with medical tape.
• Apply an artificial nail: Sometimes applying an artificial nail to an ingrown nail will help pull the sharp area upward and force the nail to grow straighter.
3. Apply a topical antibiotic ointment such as Neosporin after each soaking and bandage the toe.
4. If within the next week, between the soaking and the “lifting,” the toe inflammation does not improve, see a podiatrist. An infection may be brewing and you may need oral antibiotics and/or the offending part of the nail may need to be removed. The entire nail will not need to be removed unless healing doesn’t progress with partial removal.
It is estimated that 20 percent of all podiatric visits are due to ingrown toenails. People with certain health conditions are especially at risk due to excess foot swelling such as those with diabetes, cardiac disease, kidney disease or obesity. Healing may also be impaired in those conditions making those ingrown toenails more susceptible to infection. We can’t avoid unexpected occurrences like my friend had with the heavy law book, but practicing some prevention may help avoid the misery of an ingrown toenail.
sources:
www.medscape.com/viewarticle/588545
http://skindisease.suite101.com/article.cfm/ingrown_toenails
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles