Ingrowing toenails
toe; ingrowing; ingrown; toenail; shoe; nails; foot; ingrown toenail; ingrown toe nail;
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Ingrowing toenails can cause a lot of toe pain and soreness so it is worth finding out what causes them and what you can do to prevent them. Getting problems with ingrowing toenails depends partly on the shape of the toenail, but tight shoes and damp, hot feet can make the problem worse.
A normal toenail
- The toenail forms at the edge of the nail nearest the body, under the skin, and is pushed (as more toenail forms) along the upper surface of the toe to the end of the toe.
- In humans the toenail protects the upper surface of the toe from injuries, while in some animals the 'toenail' forms a claw which is used for many tasks such as fighting and tearing food apart.
Causes of ingrowing toenails
Ingrowing toenails happen when the end of the toenail has become cracked or frayed, forming sharp spikes which push into the skin and set up an infection.
The toe becomes reddened, swollen, tender and painful.
When your feet are hot they produce a lot of sweat. When feet spend a lot of time inside shoes (especially inside joggers and 'sneakers'), the hot sweaty environment softens the toenail (making it more likely to break and form spikes) and provides an ideal environment for infection to get going.
Tight shoes, which press the skin at the side of the nail onto the sharp spike, also make the situation worse.
Until the nail grows long enough so that the end is beyond the skin at the end of the toe, infections can come back even when they are treated.
Preventing ingrowing toenails
The main aim of prevention is for the sides of the toenail to grow out beyond the end of the toe itself so that the corners cannot dig into skin. This can be difficult with nails that are soft and break easily, especially when nails are softened by being kept moist and hot.
- Do not wear closed shoes, especially joggers or sneakers, unless really needed, then take them off as soon as possible afterwards.
- When closed shoes need to be worn, such as for school, make sure the soles are firm, giving protection to the toe, so that the nail is not flexed (bent) during running or walking. Flexing can cause the nail to break. Make sure that they are long enough too.
- Wear sandals, other open shoes or no shoes at all as much as possible.
- There is some disagreement about what type of sock is best, with some people stating that some synthetic socks keep feet drier than cotton or wool socks. The aim is to keep feet, toes and toenails cool and dry. Do what works!!
- Don't cut the corners of the toenails back. This may 'solve' the initial problem, easing the pain, but the problem comes back as the nail grows longer again. Let the nails grow until the corners have grown past the skin of the toe. This may mean lots of holes in socks, but it is better than painful feet!
- Some people do not have troubles with ingrowing toenails, because of the shape of their nails. They may be able to 'get away' with breaking these 'rules', but if you have troubles with ingrowing toenails it is really worth trying the things listed above.
Treatment for ingrowing toenails
If the toe is tender and painful, it is likely that there is an infection present.
Antibiotics or antifungal treatments may be needed. See your doctor or a podiatrist.
Do not dig into the corner of the nail. This injures the tissues, can cause bleeding and keeps infections going.
With the preventative ideas above, the toenail may grow normally and not cause problems. But you will need to persist with prevention, as ingrowing toenails tend to come back.
If simple treatment is not successful, some people need to have the sides of the nail removed surgically by a doctor or podiatrist, which can be helpfull for some people.
A. Ford, Fact Sheet on Ingrowing Toenails, SA: Women's and Children's Hospital, 1999.
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).