Ingrowing toenails
toenails; ingrowing; ingrown; infections; shoes; toes; nails;
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Ingrown toenails can cause a lot of toe pain and soreness, so it’s worth finding out what causes them and what you can do to prevent them. Whether someone gets problems with ingrown toenails depends a lot on the shape of the toenail, but tight shoes and damp, hot feet can make the problem worse.
Normal toenails
- The toenail forms at the bottom edge of the nail, 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 that is used for many tasks such as fighting and tearing food apart.
Ingrown toenails
- Ingrown toenails occur when a spike of the nail grows into the skin at the outer corners of the nail.
- At the outer edges of the tip of the toenail, usually of the big toe, the toe can become reddened, swollen, painful and tender, as a spike of the toenail grows into the skin.
Causes of ingrown toenails
- Ingrowing toenails happen when the toenail has become cracked or frayed, forming sharp spikes that push into the skin and start an infection.
- They can also happen when the nail is cut too short and a sharp corner of the nail digs into the skin.
- 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', with synthetic socks), the hot sweaty environment softens the toenail, making it more likely to break and form spikes. This provides an ideal environment for infection to get going.
- Tight shoes, which press the skin at the side of the nail onto the sharp edges of a toenail, 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 after use).
- 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. And the shoes need to be long enough
- Wear sandals, other open shoes or no shoes at all as much as possible.
- Avoid wearing synthetic socks that keep feet hot and moist. (Note: there is some disagreement about this, 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 that 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. Cleaning carefully with a disinfectant may help. 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.
- Continue with all the preventative treatments, as they are an essential part of treatment. You will need to persist for life, 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, leaving a narrow and odd looking nail. This can be a good solution for some people.
Josh says:
“You need to look after your feet, as they are going to carry you throughout your life. Make a date once a week to soak your feet, dry them well, check for any problems, and cut your nails when needed. If you’re not good at cutting your nails yourself, get mum or dad to do it, or get one of them to supervise while you do it yourself.
Don’t mess around if you have problems with your feet – go and see your doctor or a podiatrist”.
A. Ford, ‘Fact Sheet on Ingrowing Toenails’, Women's and Children's Hospital, South Australia.
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).