Ingrown toenails

Diagnosis

Your doctor can identify an ingrown toenail by assessing your symptoms and conducting a physical examination of the affected nail and the surrounding skin.

Treatment

If home remedies prove ineffective for your ingrown toenail, your doctor might suggest the following interventions:

• Lifting the nail: In cases of a slightly ingrown nail, your doctor may delicately lift the ingrowing nail edge and insert cotton, dental floss, or a splint beneath it. This helps separate the nail from the overlying skin, encouraging its growth above the skin edge within 2 to 12 weeks. Daily soaking of the toe and replacing the material at home is necessary. Additionally, a prescribed corticosteroid cream may be recommended for application after soaking. Another alternative involves using cotton coated with a solution to fix it in place and render it waterproof (collodion), minimizing the need for daily replacement.
• Placing a gutter splint under the nail: Here, your doctor numbs the toe and inserts a tiny slit tube beneath the embedded nail. This splint remains in place until the nail grows above the skin edge, providing relief from the pain of an ingrown nail.
• Taping the nail: This method involves your doctor using tape to pull the skin away from the ingrown nail.
• Partially removing the nail: For more severe ingrown toenails with inflamed skin, pain, and pus, your doctor may numb the toe and trim or remove the ingrown portion of the nail. It may take 2 to 4 months for the toenail to regrow.
• Removing the nail and tissue: If the problem persists on the same toe, your healthcare provider may suggest removing a portion of the nail along with the underlying tissue (nail bed). This procedure aims to prevent that part of the nail from growing back. The toe is numbed, and various methods, including chemicals, laser treatment, or others, may be used.

After a nail-removal procedure, pain relievers can be taken as needed. Applying a wet compress for a few minutes each day until swelling subsides is recommended. Rest and elevate the toe for 12 to 24 hours, avoiding activities that cause discomfort. Swimming or using a hot tub should be avoided until approved by the doctor, but showering is typically permissible the day after surgery. If the toe fails to heal, contacting your doctor is essential.

Recurrence of the problem, even after successful surgery, can occur. Surgical approaches generally prove more effective in preventing a recurrence compared to nonsurgical methods.