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Ingrown Toenails -Treating and Treatment , Causes and Prevention of Ingrown Toe nails

In medical terms ingrown toenail is called as onychocryptosis, by the physicians. An ingrown toenail is a condition that is caused by abnormal growth of both the toenail and the surrounding tissues. When the toenail grows into the surrounding tissue, a painful toe is the result. The irritation from the toenail causes swelling of the tissues, and further inflammation. Ingrown toenails are a common, painful condition that occur when skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. This condition is usually very painful and can be associated with infection of the toe. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Irritation, redness, an uncomfortable sensation of warmth, as well as swelling can result from an ingrown toenail.

Ingrown toenails are common in adults but uncommon in children and infants. Any toenail can become ingrown, but the condition is usually found in the big toe.

If you have diabetes or another condition that causes poor circulation to your feet, you're at greater risk of complications from an ingrown toenail

Symptoms of Ingrown Toenails

Pain is the main symptom of an ingrown toenail

The infection can spread, making the toe red and inflamed (paronychia).

A collection of pus may also develop.

The corner or side of one of toenails grows into the soft flesh of your toe.

Usually affects your big toe

Tenderness in your toe along one or both sides of the nail

Swelling of your toe around the nail

Infection of the tissue around your toenail

Causes of Ingrown Toenails

Ingrown toenails can develop for various reasons. In many people, the tendency to have this common disorder is inherited. In other cases, an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.

Ingrown toenails develop for many reasons. In some cases the condition is congenital, such as toenails that simply are too large. People whose toes curl, either congenitally or from diseases like arthritis, are prone to ingrown toenails. Often trauma, like stubbing a toe or having a toe stepped on, can cause a piece of the nail to be jammed into the skin. Repeated trauma, such as the pounding to which runners typically subject their feet, also can cause ingrown nails.

The most common cause is cutting your toenails incorrectly, causing them to re-grow into the skin. Tight hosiery or shoes with narrow toe boxes only make matters worse. If the skin is red, painful or swollen on the sides of the nail, an infection may be present. This occurs because the ingrown nail is often in a warm, moist and bacteria-rich environment. When the nail penetrates the skin, it provides a convenient entry for germs that can cause infection. Untreated, the nail can go under the skin, causing a more severe infection. In either case, the infection needs to be cured with sterile instruments and antibiotics.

Risk Factors

The major risk factor is the shape of the nail - a nail that is more curved from side to side rather than being flat is more likely to become an ingrown nail (incurvated nails). Some nails go down the side into the nail fold area for a relatively large distance. The shape of the nail is usually inherited, but it can be influenced by trauma and/or shoe pressure.

Poor cutting of these types of nails can leave a sharp corner (or if worse, a small spike) that will initially cause symptoms by putting pressure on the skin and then later penetrate the skin. Trimming too far down the sides is a common cause of an ingrown toenail.

Footwear that is tighter is more likely to increase pressure between the skin in the nail fold and nail, increasing the risk on an ingrown nail.

Previous trauma to the nail may alter the shape of the nail, making it more prone to becoming an ingrown nail.

Diagnosis of Ingrown Toenails

Doctor's examination of the foot is sufficient to diagnose an ingrown toenail.

Incubation Period

Ingrown toenails sometimes correct themselves as they grow out, but in some cases may need surgery.

Treatment of Ingrown Toenails

Treatment of ingrown nails is very similar to what would be done to treat any small foreign body. Antibiotics and soaking can be tried, but the problem will typically continue until an edge, or border of the nail is removed. This in effect removes the foreign object allowing the skin to stop its' foreign body reaction.

The technique used most commonly today to treat infected ingrown nails is called a phenol-alcohol procedure. This procedure is performed in the office under a local anesthetic on an outpatient basis. After the toe is numbed and cleaned with a disinfecting agent, a thin margin of nail is removed. Phenol, which is 77% carboxylic acid, is applied to the nail matrix to kill the cells that produce that small margin of nail only. The phenol is then flushed out with alcohol. Patients can return to a Band-Aid and regular shoes the next day.

The interesting thing about the phenol-alcohol procedure is the lack of pain experienced by patients following their surgery. This is due to the fact that phenol has a topical anesthetic property that last for 2-3 weeks. Although the procedure will drain for several days, the benefit of using phenol is significant.

Other surgical procedures may be used with or without phenol and include the use of a CO2 laser or other chemicals to destroy the matrix cells. The decision to remove one border, both borders or the entire nail should be discussed with your doctor.

The site of infection of an ingrown nail is very close to the underlying bone of the distal phalanx (bone of the tip of the toe). If left untreated, this infection may break through the lining surrounding the bone and cause an infection of the great toe. In this case, the treatment of choice is a partial amputation of the toe. Obviously, infected ingrown nails should be promptly treated to prevent this unnecessary problem.

Prevention of Ingrown Toenails

You can lower your risk of developing an ingrown toenail by trimming your toenails straight across with no rounded corners. The length of your toenail should extend out past your skin. The top of each nail should form a straight line across, level with the top of your toe. Some additional guidelines for preventing ingrown toenails include:

Wear roomy shoes, and keep your feet clean and dry.

Avoid running or strenuous activity for the first 2 weeks.

Avoid high heels and tight-fitting shoes

Trim nails straight across. Don't pick at your nails or tear them at the corners.

Don't pick at your toenails or tear them off.

Make sure your shoes and socks are not too tight.

Keep your feet clean at all times

Complications

Infection, if present, may spread to foot and leg, or into blood stream.

Loss of nail plate from infection or inflammation of the nail bed.

Chronic ingrowing nails can cause deformity of the nail plate and/or surrounding soft tissues.

A small benign tumor called a granuloma can form along the nail margin.

General Care for Ingrown Toenails

Soak your feet. Do this for 15 to 20 minutes twice a day, using warm salt water. Soaking reduces swelling and relieves tenderness.

Give your nail some help. Put fresh bits of cotton under the ingrown edge after each soaking. This will help the nail eventually grow above the skin edge.

Use a topical antibiotic. Apply an antibiotic ointment and bandage the tender area.

If you have diabetes, check your feet daily for signs of ingrown toenails or other foot problems.

Apply antibiotic ointment to the site at least twice a day.

Keep a bandage over the site until it heals.

Take any painkiller to relieve the pain

Keep the wound clean and dry.

Wear loosely fitting shoes or sneakers

Call The Doctor Now

If the signs of infection develop:

•  Increased pain, swelling, redness, or tenderness

•  Heat or red streaks extending from the area.

•  Discharge of pus.

•  Fever

If it has been more than 5 years since your last tetanus booster shot.

If there is no improvement after 3 days of home care.

If you are a diabetic, have poor circulation, AIDS, are on chemotherapy.

If you are a diabetic or at increased risk for infection and your regular physician is unavailable.

If you are a diabetic or at increased risk for infection and have any sign of infection in the toe.