Ingrown toenail treatment in Esperance
An ingrown toenail happens when the edge or corner of a nail digs into the skin beside it. It most often affects the big toe, and it can be surprisingly painful for something so small.
Signs of an ingrown toenail
Pain, tenderness or pressure along the side of the nail, especially in shoes
Redness and swelling of the skin beside the nail
Pain when the toe is touched or bumped, even by bedsheets
If it becomes infected: increased redness, warmth, pus or a raw, bleeding bump of tissue beside the nail
What causes it?
The most common causes are:
How the nail is trimmed, especially leaving a sharp or jagged corner
A naturally curved nail. Some nails curve down at the sides (called involuted nails), so the edges press into the skin
Tight or narrow shoes that squeeze the toes together
Injury to the toe or nail, or a bony lump under the nail (see below)
Activities that put repeated pressure on the toes, such as running and sports
For many people it's a combination of a curved nail and how it's been cut.
How a toenail grows, and why some nails curve
Your toenail grows from a group of cells called the nail matrix, often referred to as the nail root. The nail matrix sits under the skin, just back from where the visible nail begins.
These cells don't sit just under the skin's surface. They sit quite deep, close to the bone of the toe. How far the nail matrix wraps around the bone decides how curved the nail grows:
A flatter nail matrix grows a flatter nail.
A nail matrix that wraps further around the bone grows a more curved (involuted) nail.
The more curved the nail, the more its edges press down into the skin at the sides, and the more likely it is to become ingrown. This is why some people get ingrown toenails no matter how carefully they cut them.
Injury can change how a nail grows
The position of the nail matrix cells can change after a significant injury to the toe, such as stubbing it hard or dropping something heavy on it. Because toenails grow slowly, the effect often doesn't show straight away. A nail can start to become ingrown around 6 months after the injury, and may stay a problem from then on.
A bony lump under the nail
Sometimes the top of the last bone in the toe develops a small bony lump, called a subungual exostosis. As the nail grows over it, the lump pushes the centre of the nail upwards, which makes the sides dig into the skin even more. This can also be fixed surgically.
Why "cut straight across" isn't the answer
You've probably heard that you should always cut your toenails straight across. It sounds sensible, but in practice it often isn't possible, and it can even cause the problem it's meant to prevent.
Many nails simply aren't flat and straight. Toenails curve, and the edges sit down in close contact with the soft tissue of the toe. For some people, trimming the nail properly means gently working down the sides of the nail a little.
You don't cut your fingernails straight across either. You follow the curve of your fingertip. Toenails are no different.
Square corners are sharp corners. Toes sit so close together that they touch, and even more so in some shoes and during some activities. A nail cut straight across leaves sharp, square corners that can dig into the skin of the same toe or the toe next to it.
The key: a rounded, smooth corner
What matters most is the corner. Whatever shape your nail is, make sure the corner is left nicely rounded and smooth. A sharp or jagged corner is exactly the bit that will dig into the skin and cause an ingrown toenail.
Tips for trimming safely
Trim after a shower or bath, when nails are softer.
Use good-quality nail clippers rather than scissors.
Follow the natural curve of the nail and toe.
Don't cut too short or too deep into the corners.
File the corner afterwards so it's rounded and smooth, with no sharp edges or spikes.
If you can't see or reach your feet well, or you have diabetes or poor circulation, let us do it for you.
How we can help
Regular trimming of curved nails
Rebecca has more than 30 years' experience trimming curved (involuted) toenails that are prone to becoming ingrown. She carefully trims and shapes the nail edges and leaves the corners rounded and smooth, so they don't dig into the skin.
This treatment doesn't change the way the nail grows, and therefore it doesn’t permanently change the shape of the nail. But done at the right intervals, it can keep problem toes comfortable and out of trouble. Rebecca will suggest how often you need to come in, based on how quickly your nails grow and how prone they are to digging in.
Tools to use at home
We sell nail care tools at the clinic that work well for managing nails prone to becoming ingrown:
Nail clippers that make it easier to trim curved nails neatly and safely
Black's files, used to make sure the corner of the nail is left rounded and smooth
Ask us at your next visit, and we can show you how to use them.
Nail surgery for a permanent fix
If regular trimming isn't enough to keep your toe comfortable, or you'd simply rather fix the problem once and for all, nail surgery is the answer.
Nail surgery is a minor procedure done under local anaesthetic. The edge of the nail that digs in is removed, and the nail root along that edge is treated so it doesn't grow back. The result is a slightly narrower nail that no longer digs into the skin.
Rebecca doesn't perform nail surgery herself, but:
most GPs perform this procedure, or
Rebecca can refer you to a specialist in Perth for toenail surgery.
She can talk you through whether surgery is the right option for you. Your surgeon will explain the procedure, including the small chance of the nail edge regrowing, so you can make an informed decision.
When to get help quickly
See us or your GP promptly if your toe shows signs of infection, such as increasing redness, swelling, warmth, pus, or red streaks spreading up the foot. If you have diabetes, poor circulation or reduced feeling in your feet, don't try to treat an ingrown toenail yourself. Get it checked straight away.
Book an appointment
If you have a painful toenail, or nails that keep digging in, book in with Rebecca at Esperance Podiatry. No referral is needed.
Call (08) 9072 1514 or visit us at Suite B, 116 Dempster Street, Esperance.