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Your Ingrown Nail FAQs, Answered
Posted 15 Mar '22

Your Ingrown Nail FAQs, Answered

When it comes to ingrown toenails, there are a lot of questions that we get asked every day. From the common questions like why on earth they’ve affected you and how you can prevent the pain from ever coming back, to whether epsom salts can fix ingrown toenails, we’ve taken a handful of your FAQs and answered them today in our blog. If you’ve still got a question, check out our general FAQs here, give us a call, or send us a message!

Does trimming a V in the nail help prevent an ingrown toenail?

It used to be thought that cutting a V in the centre of the nail could discourage an ingrown toenail from growing. Now, this has largely been disproven by considering the nail anatomy and the physiological process by which a nail grows and lengthens – which starts from the base out, as opposed to growing out from the end of the nail and being influenced by the ‘V’ shape. This shape can also leave your nail vulnerable to ‘catching’ on your socks and shoes and being pulled, which can then irritate the area of the nail that has ingrown.

Can medication fix an ingrown nail?

It’s natural to want to take painkillers to help ease the pain, or to get a script for antibiotics if your ingrown toenail has become infected – and there’s nothing wrong with either. But no, neither of them – or any other medication – are solutions or treatments for ingrown toenails. Instead, painkillers temporarily mask pain (until they wear off and it comes back), and antibiotics help kill the bacteria causing the infection – but neither removes the ingrown nail from the skin it has pierced – which is the cause of your pain.

I keep treating my ingrown toenail but it keeps coming back. Why?

In this case, it looks like you’re treating the symptoms, which is the nail growing into the skin, as opposed to treating the cause behind why it keeps doing this. Without treating the cause, it’s likely to keep coming back periodically. Causes of ingrown nails can include:
  • Wearing tight, narrow, pointed or generally ill-fitting footwear – wearing shoes that are too tight or poorly fitting can cramp your toes together, pushing your nail into the surrounding skin. This encourages the nail to pierce and penetrate the skin, and unfortunately, will continue to do so in the future if you continue to wear the same shoes regularly
  • Picking or pulling the toenails – we’ve all known someone who ‘picks’ their toenail and rips it off instead of cutting the nail using nail scissors or clippers. As the ripping tends to go down the side of the nail, it often leaves behind nail spicules that, due to their location, can’t be seen – but can definitely be felt when they continue to grow and pierce the nail
  • Rounding the nails when trimming – even when you do use nail tools to trim your nails, curving the nails down into the sides may encourage them to become ingrown. The better way to trim the nail is to cut them straight across in a straight line, and then gently round off the very edges using a nail file if needed
  • It’s hereditary – your genetics may simply make you predisposed to developing recurring ingrown toenails. This is particularly true for those that have naturally curved or pinched (‘involuted’) toenails, larger toenails, or more skin surrounding the nail

If I’ve trimmed the nail and removed the ingrown portion myself, why is my nail not healing?

The most common answer is that you still have a piece of nail piercing the skin. Even if you saw a large piece of nail come out when trimming back the ingrown nail, there definitely can be more – even as podiatrists we’re often surprised when we remove a big piece of ingrown nail, have a quick check to ensure we’ve gotten it all, and find yet another piece of nail lodged in deep. Unfortunately, without the right tools, it can be very difficult to know if you really have removed all of the ingrown nail or not, especially when the surrounding skin is swollen or the ingrown nail is deep. If you’re still getting toe pain and ingrown nail symptoms after you believe it has been treated, this is usually a sign the problem hasn’t been fully fixed.

What are the early signs of an ingrown toenail?

When an ingrown nail first starts, it means that a sharp edge or spicule from the nail has recently pierced and penetrated the skin next to the spicule – even just slightly. This means that when any pressure is put on the nail, whether from being squeezed, from footwear, or even the natural vibrations through the feet when we walk, we can feel pain or discomfort. As the nail spicule has only recently pierced the skin, the skin surrounding the nail may not be red or inflamed, like is typically pictured in images of ingrown nails. The location of the nail spicule may be deep down in the nail, or toward the top of the nail in the corner  – this really depends on where the spicule or sharp edge developed. Often, the spicule is deep down the side of the nail, deeper than the eye can see, meaning at the early stages it’s barely noticeable. What may give an ingrown toenail away in the early stages in a build-up of callus down the side of the nail – this can indicate that the nail edge has been rubbing against the skin for some time, and has finally penetrated. All in all, an ingrown nail in the early stages may not look so different from an unaffected nail. You can still have an ingrown toenail without any bleeding, swelling, redness or any discharge from the toe. The key is the pain when pinching the toe – if you get sharp, localised pain when pinching the toe, it could be the start of an ingrown toenail.

I have toe pain but I’m not convinced that it’s an ingrown toenail. What else could it be?

While ingrown nails are usually distinctive and common, similar toe pain can also be caused by:
  • Callus build up on the toe, by the nail, but without the nail piercing the skin
  • A foreign body like a splinter piercing the skin at the toe
  • Damage to the nail and nail bed from trauma – like from stubbing your toe
  • Toe fracture, which affects the toe bone beneath
  • A cyst or a clogged sweat gland may be present in the area

What happens if I leave my ingrown toenail untreated? Will it eventually go away on its own?

Given that the hard nail sits on top of our toe, it’s easy to think that the painful ingrown area is along the surface of the nail too, and so will easily grow out in time, taking the pain away with it. In most of the cases we see, the reality is quite different. The ingrown portion of the nail, which we call the nail spicule, is usually located quite deep down the side of the nail – often much deeper beneath the swollen skin than you can visibly see. Waiting for your nail to grow out then means driving this nail spicule deeper into an already tender toe.  Given that toenails grow much slower than fingernails at an average rate of 1.62mm per month, and you may have multiple centimetres of skin to go through, this can mean months of severe pain, difficulty wearing shoes – and the risk of infection.

Can babies get ingrown toenails?

Absolutely, we’ve treated ingrown nails in babies as young as six months old. We’ve shared one of these case reports here.

Do ingrown toenails only affect the big toes?

No, while they most commonly affect the big toes, they can affect any of the toes. Here is a patient story and photo example of ingrown nail pain in the second toe.

My toe is starting to feel a little numb, and it’s a bit red. Could this be an ingrown toenail?

Numbness is not on the ‘typical’ or ‘expected’ list for common symptoms associated with ingrown toenails, but it is possible. More often, we would expect feelings of pain, swelling, redness, bleeding, and even clear/yellow discharge if an infection is present, a piece of nail is currently piercing into your skin and these are all fairly normal responses from your body.

Have more questions? Let us know!

If you have more questions about ingrown toenails, let us know, and we’ll include them in part two of our ingrown nail FAQs in our next blog! If you’re concerned about an ingrown nail or have toe pain that has recently started, book an appointment with our team by giving us a call on 09 523 2333 or booking online. We’re located within the One Health Clinic in Remuera, inside Perform Podiatry.  

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