If you’ve ever had an ingrown toenail you’ll know that the pain is not relative to the size of the problem!

Ingrown toenails are very common, particularly during warmer months, and most often occur on the big toes, but smaller toenails can get ingrown also.

What causes them?
The number one cause of ingrown toenails is incorrectly cutting or picking at the edges of the nail, resulting in a spike of nail remaining on one side. This spike then digs in and causes pressure on the nail fold which can lead to an infection if left untreated.

Excessively curled or very wide/flat toenails are more at risk of becoming ingrown.

Other causes include damaging the toenail through an injury (stubbing or dropping something on the toe), fungal infection of the toenails, soft tissue growths such as warts or benign lesions or previous history of failed nail surgery.

Conservative management
Often times the offending portion of nail is able to be removed simply during a standard podiatry appointment. This is generally pain free, however there is a risk that as the nail regrows the edge will become ingrown again.

Antibiotics may also be needed to resolve the infection, which can be obtained from your General Practitioner.

Education around proper toenail cutting technique and preventative measures will be explained by your podiatrist.

Ingrown toenail procedure
If there is a failure for the toenail to resolve after conservative management, a procedure to remove of part or all of the toenail may be required. This procedure is able to be carried out by your podiatrist within the clinic.

Under local anaesthetic, a small section is removed from the side of the nail without cutting the skin. A chemical called phenol is then used to kill the nail bed at its base to prevent this section of nail from re-growing. There are no stitches with this procedure which means a shorter recovery period, however regular re-dressings for approximately 4-6 weeks are still needed for optimum healing. In the initial few days, this dressing needs to be kept dry and only an open toed shoe should be worn. When the skin surrounding the nail heals, it will appear to be a normal looking nail, only slightly narrower.