Ingrown Toenail

Ingrown toenails are very common and can occur in people of all ages. The big toe is most frequently affected, but any toe may be involved (Fig. 1). The most common causes of ingrown toenails are:

  1. Cutting the nails improperly
  2. Congenitally deformed nails and/or extra skin around the nails
  3. Trauma
  4. Fungus infection of the nail
  5. Poorly fitting shoes

Ingrown nails can be mildly uncomfortable or very painful. Infection occurs when a piece of the nail penetrates the skin (Fig. 2). In these cases, swelling, redness, and drainage will be present. Surprisingly, infected ingrown toenails are not always painful.

Over-the-counter preparations cannot relieve ingrown nails because they do nothing about the piece of nail that is penetrating the flesh.

An infected ingrown nail is a medical emergency, because a chronically infected nail can lead to bone infection, especially in diabetic patients. For that reason, patients with infected nails are seen immediately at North Shore Foot & Ankle. Under local anesthesia, the portion of nail that is penetrating the flesh is removed, and the abscess is drained. Oral and topical antibiotics are prescribed. Relief is usually immediate.

Self Care of Ingrown Toenails:

  1. Cut nails straight across, and file the edges with an emery board to prevent the edges from irritating the skin.
  2. Wear gym shoes or other shoes with roomy toe boxes.
  3. Talk to your podiatrist about the Phenol procedure to permanently relieve the ingrowing.

In reality, ingrown toenails are very difficult to cut properly. For that reason, North Shore Foot & Ankle offers the Phenol Procedure to permanently remove the ingrown portion of nail. The Phenol Procedure is an office procedure performed under local anesthesia. The ingrowing portion of nail is removed and the nail root is cauterized with Phenol. This "chemical surgery" prevents the ingrowing portion of nail from growing back. There is very little postoperative discomfort and patients can return to work the next day.

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