What is an ingrown toenail?

An ingrown nail is when the toenail grows into the skin next to it, typically at the tip of the nail plate. This causes redness, pain, and swelling. Sometimes the toe can become infected.

Why do they form?

Ingrown nails can occur for many reasons. Sometimes a sharp spike is left on the part of the nail that is buried most deeply after trimming it. This spike then digs into the skin as it grows out. An ingrown nail can also be caused by pressure from shoes or another toe against the skin next to the nail. The pressure pushes the skin around the nail into the nail edge, leading to irritation and swelling. Once the swelling gets bad enough, the nail can no longer grow past the skin and it becomes ingrown. Nails can also be unnaturally shaped due to infection or injury.

How are ingrown nails treated?

Ingrown nails are typically treated by removing the entire side of the nail plate that is ingrowing. When performed properly, the area heals so well that it is difficult to see that a procedure was done. Occasionally the entire nail is involved, and it must be fully removed. In this case, the skin of the nail bed becomes calloused and protects the toe as a normal toenail would.

Nails can also be removed permanently by using a chemical to destroy the nail cells in the location where they grow from. This is called a matrixectomy. The procedure is the same as previously described, except prior to applying a bandage, the chemical is applied. This procedure usually requires an additional two weeks of healing time. It can be performed on the sides of the nail or on the entire nail matrix.

How long do they take to heal?

A routine nail avulsion usually heals within one week. Occasionally epsom salt soaks are required every day if there is an infection. The typical bandage is neosporin and a band aid after the first day. Patients may shower 24 hours after the procedure. Antibiotics are rarely necessary. The pain of removing a nail is typically very mild and often feels better than it did prior to the procedure because the painful nail has been removed.

A matrixectomy usually requires 3 weeks of healing. The toe must be soaked in epsom salts once or twice daily to help facilitate drainage. Neosporin and a band aid are also used to keep the area clean after this procedure.