How do physicians diagnose an ingrown toenail?

It’s usually quite straightforward to diagnose an ingrown toenail. However, the signs and symptoms of ingrown toenails can vary quite dramatically, particularly if an infection develops. There may simply be some tenderness at the nail border when pressure is applied. Typically the nail or a spike of nail (spicule) curves inward, pressing into the skin of the nail border. The area may become red or swollen. If the area becomes infected, there may be severe redness and swelling, drainage, pus and malodour.

Making the proper diagnosis requires taking into account the medical history and all possible causative factors. Some conditions such as tumours, foreign bodies, trauma and fungal infection may appear to be an ingrown toenail to the untrained eye.

Are there any home remedies for an ingrown toenail?

The following home remedies may provide temporary relief:

  • Soak the foot in lukewarm for 15-20 minutes with any one of the following options: one part white vinegar to four parts water; 2 tablespoons Epsom salts per quart of water; 1/3 teaspoon of bleach in 1 gallon of water
  • Elevate the foot and leg
  • Take oral anti-inflammatory medications
  • Trim the toenail straight across the top without digging into the corners or leaving them too short
  • Carefully roll back the overgrown skin at the affected nail border may and slip in a small piece of cotton or dental floss to lift the painful edge of the nail up from the skin

If symptoms persist, medical treatment from a podiatrist is recommended.

When should someone seek medical treatment for an ingrown toenail?

People with diabetes or those who have a compromised immune system or poor circulation should promptly seek the care of a podiatrist or physician for ingrown toenail treatment. If home remedies are not successful within a week or there is persistent pain* and/or signs of infection, medical treatment is recommended.

What is the treatment for ingrown toenails?

There are various types of treatments, including self-care, soaking, avoidance of shoe pressure on the toenails, proper methods to trim the nails, and various surgical treatments. Sometimes antibiotics may be required.

Is surgery really necessary?

Surgery to remove the nail border is recommended if conservative treatments fail. If the condition is recurrent and/or chronic, a matrixectomy may be required.

What types of nail surgery are used for ingrown toenails?

Surgical treatments include the following: temporary resection and removal of the offending nail border or corner, avulsion (detachment) of the nail or offending nail border, or permanent elimination of the nail (matrixectomy) or offending nail border (partial matrixectomy). A matrixectomy is the destruction or removal of the cells at the base of the toenail under the skin. This procedure can be done surgically by dissection, chemically, or electrically by destroying part or all of the matrix cells. These procedures are commonly reserved for chronic or recurrent situations.

What does the recovery from toenail surgery entail?

Typically the dressings are removed the day following the procedure. The wound should be cleansed twice a day with antimicrobial soap and/or soaked in Epsom salts. Apply antibacterial cream and a small bandage (Band-Aid) twice a day for one to two weeks. Open toe or loose-fitting, wide toe box shoes are recommended to avoid pressure on the toe while it heals.