An ingrown toenail is one of the most common foot problems seen in podiatry practice. It presents as a painful, inflamed fold of skin where the nail has embedded.

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There are three stages of  an ingrown toenail:

1. Where there is no obvious clinical lesion.

2. Inflammation of skin with associated fluid and pus.

3. Hypertrophy where there is overgrowth of skin in the sulci.

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Common causes include:

• Poor fitting or tight shoes.

• Hyperhidrosis of the skin.

• Pincer or involuted shaped nails.

• Trauma.

• Cutting nails too short.

• Not cutting nails straight.

• Use of acne medication Isotretinoin .

• Juvenile diabetes.

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Early ingrown toenails can often be treated easily by a podiatrist with clearance of the nail edge to stop the nail cutting into the skin. We also recommend the use of betadine solution and dressings the wound to protect the area from infection.

 

​We do not recommend self-clearance as the chance of not clearing the nail properly and causing infection.

We recommend antibiotics for badly infected ingrown toenail that involves severe pain, pus, swelling and redness of skin around the nail especially if it extends to the skin at the base of the nail where the nail plate grows. You should see you GP urgently. Then attend a podiatrist for clearance of the nail. ​Clearing the nail from the nail sulci is important as it allows the skin to heal.

 

​​​​For ingrown toenails that will not resolve, we can perform nail surgery to permanently remove the nail edge that is ingrowing. We would apply an acid called phenol to the nail bed, to stop it regrowing.  This is performed under local anaesthetic.

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The benefit of this treatment includes little post operative pain and reduced infection due to the analgesic and antibacterial effect of the phenol, fast recovery time and low chance of regrowth - 4.3%.​​​

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