Ingrowing Toe Nail

What is an ingrowing toe nail?

This is a condition where the nail grows rolling inwards and digs into the skin particularly the sides of the nail. This causes irritation of the skin and if the skin breaks down it may cause localised infection. This may manifest itself as redness, pain and discharge of pus from around the nail edges. It commonly occurs in the big toe, although any toe nail can be affected.

What causes an ingrown toe nail?

An ingrown toe nail may occur due to ill fitting tight shoes, tight socks, family history or an injury to the nail. One of the commonest causes of an ingrown toe nail is trimming the nails incorrectly. This may be either cutting the side of the nail too short or not cutting it at all.

What are the symptoms caused by this condition?

Most commonly one might experience pain, difficulty with wearing shoes and tenderness. If the skin breaks down due to irritation from the toe nail, it may result in an infection with redness and discharge of pus.

How is this condition diagnosed?

Your consultant will examine your foot clinically and this usually makes the diagnosis clear.

Can the condition worsen?

This condition can be quite persistent. It may cause minimal symptoms such as pain and difficulty with shoe wear, or if it progresses may cause repeated infections.

What treatment options are there?

If symptoms are minimal, you will be advised regarding shoe wear. Usually shoes with a wide toe box will help ease your symptoms. If there is an infection, regular dressings and a course of oral antibiotics will be required to tide over it.

If symptoms are irritating, surgery may be necessary. This involves either removing the entire nail or a wedge of the nail and treating the nail bed with a chemical to ablate (destroy the cells) responsible for nail growth.

Is surgery necessary?

The decision to proceed with surgery should be taken after non surgical options described above have been exhausted. The majority of patients will benefit from shoe wear modifications. If symptoms continue to affect lifestyle and function in spite of this then surgery may be discussed with your consultant.