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Ingrown Nails

Dr. Nadheer K M (AIIMS)MBBS

January 30, 2020

March 06, 2020

Ingrown Nails
Ingrown Nails

An ingrown nail is a painful condition in which the edge of the nail starts to grow into the soft flesh. It is usually seen in the big toes but can also be seen in the nails of the hands.

Symptoms include inflammation, redness and severe pain in the affected toe or finger. An ingrown nail can sometimes be accompanied by pus discharge from the affected site.

Improper hygiene of nails or any trauma can cause ingrown nails. An ingrown toenail can also occur due to ill-fitted shoes. People who have diabetes or any other medical condition that affects their blood circulation are at a higher risk of suffering from complications associated with an ingrown nail.

People who have diabetes or any other medical condition that hampers their blood circulation are at a higher risk of suffering from complications associated with an ingrown nail.

An ingrown nail can be managed at home but needs medical attention if the condition becomes severe. The doctor can surgically remove the affected part of the nail, to prevent the spread of infection to the surrounding tissues and to the bone.

Ingrown nail symptoms

The signs of an ingrown nail are:

  • Pain and tenderness around the nail, either on one or both the sides.
  • Swelling around the nail.
  • Redness around the nail.
  • The skin around the nail feels hot.
  • Sometimes, a small amount of pus can be seen around the nailbed.

Ingrown nail causes and risk factors

While people with poor blood circulation are more prone to ingrown nails, other people can also get them for these reasons:

  • Congenital: The nail can be too large for the toe or thumb. Or the nails could be unusually curved.
  • Trauma: The nail can also get embedded in the underlying skin in case of trauma, like when someone steps on the nail.
  • Poor feet hygiene: If you don’t clip your nails regularly or do not clean the edges of the nails, the nail edges might start growing in deeper tissues.
  • Tight footwear: Tight or ill-fitted shoes can lead to ingrown nails.

Complications of an ingrown nail

Though an ingrown nail is not a fatal condition, it can create a serious complication for diabetics and people who have poor blood circulation. If an ingrown nail is left untreated, it can spread the infection to the underlying bone. 

Other than an open sore, gangrene is a serious complication of an ingrown nail. Gangrene is a condition where the tissues start to decay and die. Once the tissues start to die, there no other options left but to amputate (cutting or severing the affected part).

Ingrown nail treatment and surgery

An ingrown nail can initially be managed at home. These are the steps you can follow in order to treat an ingrown nail:

  • Soak your affected hand or foot in warm water three to four times a day. This will help the nail to soften and stop impinging.
  • If you can, lift the nail a bit and place damp cotton beneath the impinging part of the nail. Try and keep your affected hand or foot dry for the rest of the day.
  • If the nail is on the foot, wear shoes that give adequate space to the foot.
  • You may take pain killers like ibuprofen which are available over-the-counter.

If the infection still doesn’t improve in two to three days, consult a doctor. Your doctor may prescribe some antibiotics for the infection and analgesics for the pain and swelling.

If the nail still impinges on the surrounding tissues, your doctor may surgically remove the nail partially. This procedure is called partial nail avulsion. In this procedure, the infected finger or toe is injected with anaesthesia and scissors are used to cut away the ingrown part of the nail. This prevents the regrowth of a deformed nail.

How to prevent ingrown nails

While some causes and risk factors of an ingrown nail are out of your control (for example, congenital factors), there are some measures you can take in order to prevent an ingrown nail:

  • Maintain proper nail hygiene: Groom, clip and clean your nails on a regular basis.
  • Do not cut your nails too short.
  • Do not wear tight or ill-fitted shoes.

Diagnosis of ingrown nails

The pain and swelling are usually enough to alert the patient about this condition. However, if you have diabetes or any other condition that affects the blood circulation, you may also have reduced sensation in the hands and feet. In this case, a doctor can diagnose an ingrown nail through a regular physical examination.

Separately, if you have diabetes, you must take extra care of your feet to prevent other infections as well. Some of the foot infections that are more likely to affect diabetics than people with normal blood sugar levels are paronychia, myositis, abscesses, necrotizing fasciitis, septic arthritis, tendonitis and osteomyelitis. If you are diabetic and have a foot ulcer, do mention it to your doctor during your next routine visit.

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