Ingrown Nails

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.

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.

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).

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.

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.

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.