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A Step-by-Step Guide to Treating Ingrown Toenails: A Podiatrist's Perspective

Ingrown toenails are a common and painful condition where the edge of a toenail grows into the surrounding skin, causing discomfort, swelling, and sometimes infection. As a podiatrist, it is one of the most common conditions that I treat. Understanding the procedure for treating ingrown toenails can help alleviate anxiety and ensure proper care. In this blog post, I will outline the step-by-step procedure for addressing an ingrown toenail.

Understanding Ingrown Toenails

An ingrown toenail typically occurs on the big toe on the side closest to the 2nd toe though it can affect any toenail. Common causes include cutting the nails too short, picking at your nails, tight footwear, injury, and genetic predisposition. Symptoms include pain, redness, swelling, and, in severe cases, pus and infection.

Step-by-Step Procedure for Treating Ingrown Toenails

  1. Initial Assessment and Diagnosis

    • Examination: The first step is a thorough examination of the affected toe to assess the severity of the ingrown nail. I will check for signs of infection, such as redness, warmth, and discharge.

    • Medical History: A review of the patient’s medical history, including any underlying conditions such as diabetes or circulatory issues, is essential to determine the appropriate treatment approach. We ask about allergies to medication in case we need to prescribe an antibiotic.

  2. Non-Surgical Treatment Options

    • Warm Soaks: For very mild cases, soaking the affected foot in warm water with Epsom salts for 15-20 minutes several times a day can help reduce swelling and alleviate pain.

    • Proper Nail Trimming: Educating the patient on proper nail trimming techniques is crucial. Nails should be cut straight across and not too short to prevent future ingrown nails.

    • Antibiotics: If there is an infection, topical or oral antibiotics may be prescribed to eliminate the infection and reduce inflammation, but they don’t often fix the problem. 

    • Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation.

  3. Surgical Treatment Options

    • Partial Nail Avulsion: For more severe cases where soaking and antibiotics have failed to alleviate the pain and swelling a partial nail avulsion may be necessary. This procedure involves removing the ingrown portion of the nail.

      • Anesthesia: The toe is numbed with a local anesthetic to ensure the patient does not feel pain during the procedure.  This part of the procedure can be painful but it is short-lived.

      • Removal: I carefully cut the nail and remove the ingrown section. Any inflamed or infected tissue around the nail may also be removed.

      • Chemical Matricectomy: To prevent the ingrown nail from recurring, a chemical such as phenol or sodium hydroxide may be applied to the nail matrix (the root) to destroy a portion of it.

  4. Post-Procedure Care

    • Dressing and Bandaging: The toe is cleaned and dressed with sterile bandages. The patient is instructed on how to keep the area clean and dry.

    • Pain Management: Post-procedure pain is usually mild and can be managed with over-the-counter pain relievers.

    • Follow-up: A follow-up appointment is scheduled to monitor healing and ensure there are no complications such as infection or recurrence. 

  5. Preventive Measures

    • Footwear: Wearing properly fitting shoes with adequate toe room can prevent pressure on the toenails and reduce the risk of ingrown nails.

    • Nail Care: Regularly trimming nails straight across and avoiding cutting them too short can prevent ingrown nails.

    • Hygiene: Excessive sweating needs to be managed to prevent recurrence.  Maintaining good foot hygiene, including keeping feet clean and dry, can help prevent infections and other foot issues. 

Treating ingrown toenails requires a combination of proper care, timely intervention, and preventive measures. Whether managing a mild case at home or undergoing a surgical procedure, understanding the steps involved can help patients make informed decisions about their treatment. As a podiatrist, my priority is to provide effective care and education to ensure my patients can walk comfortably and confidently without the pain of ingrown toenails. If you are experiencing symptoms of an ingrown toenail, don't hesitate to seek professional medical advice to address the issue promptly.

If you have an ingrown toenail, you do not have to wait to make an appointment. We have same-day appointments available. Call us today at 207-774-0028.