Ingrown and Fungal (Mycotic) Nails

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When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe is not painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection.

Causes of ingrown toenails include:

  • Heredity. In many people, the tendency for ingrown toenails is inherited.

  • Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe or engaging in activities that involve repeated pressure on the toes, such as kicking or running.

  • Improper trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail. 

  • Improperly sized footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.

  • Nail conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot or poor circulation.

If you do not have an infection or any of the above medical conditions, you can soak your foot in room-temperature water and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it is time to see a foot and ankle surgeon.

After examining the toe, Dr. Levine will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. 

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. 

Many cases of ingrown toenails may be prevented by:

  • Proper trimming. Cut toenails in a fairly straight line, and do not cut them too short. You should be able to get your fingernail under the sides and end of the nail.

  • Well-fitting shoes and socks. Do not wear shoes that are short or tight in the toe area. Avoid shoes that are loose because they too cause pressure on the toes, especially when running or walking briskly.

What you should know about at home treatment:

  • Do not cut a notch in the nail. Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.

  • Do not repeatedly trim nail borders. Repeated trimming does not change the way the nail grows and can make the condition worse.

  • Do not place cotton under the nail. Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.

  • Over-the-counter medications are ineffective. Topical medications may mask the pain, but they do not correct the underlying problem.

A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older. 

Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail. 

Many people have difficulty with their toenails and need assistance in caring for them. Dr. Levine can diagnose the cause of toenail problems and can recommend treatments. If you believe you are having toenail problems, its important that you get it checked out as soon as possible. Click below to book an appointment with Dr. Levine to have it assessed.

 
 

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