By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
Ingrown toenail is a common condition affecting the big toe. The nail grows into the flesh instead of over it. It causes inflammation. It is very painful and tender to touch. Ingrown toenail affects both adults and children.
Causes of ingrown toenail:
- Cutting the nail too short or too rounded
- Wearing tight or pointed shoes
How is ingrown toenail diagnosed?
The diagnosis should be straight forward. The toe looks red and angry especially around the ingrown nail. Sometimes it can get infected and produce pus. This is more painful. When you see your toe fits this kind of description, you can see your doctor to get it checked.
How is ingrown toenail first treated?
- Avoid the cause – don’t cut too short and don’t wear tight shoes
- Soak the toes in warm water twice a day
- Put a small wedge of wet cotton under the ingrown toenail
- Take pain killers
When is ingrown toenail become serious and you need to see your doctor?
- If you have done the above and the ingrown toenail does not get better, you need to see your doctor
- If there is pus coming out from the toe
- If you have fever and feel unwell
- If you have diabetes and blood vessel problem in the leg (peripheral vascular disease)
What is the surgical treatment of ingrown toenail?
Surgery is reserved as the last treatment if other less invasive treatment does not work. The ingrown nail is removed partially (wedge resection) or fully (nail avulsion) to relieve the pressure and let the pus out. Surgery is done under local anesthesia. It can be done as a day-surgery procedure. After the surgery, the pain on the affected toe is significantly relieved. The patient can resume the normal activities almost immediately in most cases.
When does surgery for ingrown toenail need to be done early than later?
In certain cases when the viability of the toe is threatened, surgery need to be done early. Procrastinating about having surgery can increase the chance of loosing the toe. Surgery should not be delayed in patients with poorly controlled diabetes and blood vessel problems or if there is pus coming out from the toe.
How to prevent ingrown toenail?
- Wearing appropriate foot wear – not too tight
- Not cutting the toenail too short or too rounded
- See your doctor early if you suspect any problem
Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.