Sometimes, a small problem becomes severe. When a toe is involved, even a little pain can be extremely distracting, frustrating, and uncomfortable. A toenail problem can sideline you indefinitely, making it difficult to wear shoes or even stand and walk. At Abbott Foot & Ankle Clinic, we know putting your life on hold because of foot pain isn't easy.
Whether you're spending long days on your feet at work or enjoying an active retirement, we're here to help you get back to doing what you love. Collingwood chiropodist Tony Abbott brings over three decades of experience treating ingrown toenails with conservative care and surgical options when needed.
What Is an Ingrown Toenail?
An ingrown toenail occurs when the side of your toenail curves and grows into the surrounding skin and tissue. While this condition often starts as a minor irritation, it can become extremely painful and infected without proper treatment. Most ingrown toenails affect the big toe, though any toe can develop this problem.
Common Causes of Ingrown Toenails
Understanding what causes ingrown toenails can help you prevent them from developing. Here are some common triggers:
- Improper trimming, like toenails too short or rounding the edges instead of cutting straight across
- Tight footwear, such as steel-toed boots and work shoes that squeeze the toes together
- Trauma or injury
- Genetics
- Poor foot hygiene
- Repeated pressure caused by standing for long periods or participating in sports that put pressure on the toes
Who Is Most at Risk of Ingrown Toenails?
Certain groups face a higher risk of developing ingrown toenails. Construction workers, factory employees, and others who wear protective footwear daily often experience this problem due to tight shoes and prolonged standing. Active seniors who enjoy golf, hiking, or other outdoor activities may also develop ingrown toenails from repetitive pressure on their feet.
What Are the Symptoms of an Ingrown Toenail?
Early detection of an ingrown toenail can help prevent the need for surgery. Watch for these warning signs:
- Pain and tenderness along the nail edge
- Redness around the toenail
- Swelling of the toe
- Warmth in the affected area
- Drainage or pus if infection develops
- Difficulty wearing shoes or walking normally
Types of Surgery for Ingrown Toenails
We typically discuss toenail surgery when patients experience significant pain, infection, or difficulty walking or carrying out their daily activities. It can also be beneficial if you suffer from recurring ingrown toenails. We may opt to remove just part of the toenail, some of the underlying tissues as well, or permanently remove the entire toenail. Permanent removal is usually for those with a chronic, recurring problem.
More often than not, we recommend one of the following options:
- Nail avulsion. This basic procedure involves removing part or all of the affected toenail. We use local anesthetic to ensure your comfort, and most patients return to regular activities within a few days.
- Wedge excision. For recurring problems, we remove a wedge-shaped portion of the nail and the underlying nail bed. This helps prevent the problematic section from growing back incorrectly.
- Nail bed ablation. This technique permanently removes a portion of the nail bed using a chemical solution. It's particularly effective for patients who experience frequent ingrown toenails on the same toe.
Our procedures are done at our office, and we strive to make this procedure as minimally invasive as possible. Generally, the procedure lasts about an hour. The initial anesthesia may cause some discomfort, but you will not feel anything during the surgery except for slight pressure or a tugging sensation.
About Zadek's Procedure
Reserved for the most severe cases, this procedure removes the nail matrix to prevent nail regrowth. While it's the most invasive option, it offers a permanent solution for chronic problems.
Risks of Leaving an Ingrown Toenail Untreated
Ignoring an ingrown toenail can lead to severe complications:
Infection
An open wound can allow bacteria and viruses to enter the bloodstream, causing an infection. In some cases, a spreading infection can trigger a potentially deadly immune response called sepsis. In other cases, bacteria can penetrate deep into the tissue and reach the bone. This serious condition, called osteomyelitis, typically requires intensive medical intervention.
Tissue Damage
Chronic inflammation from an ongoing ingrown toenail can permanently damage the surrounding tissue. This damage may affect nail growth and toe function even after the initial problem is resolved.
Limited Mobility
You may find yourself unable to wear particular shoes or participate in regular activities. This can affect your ability to work, exercise, or walk comfortably.
Diabetic Complications
For people with diabetes, even a minor ingrown toenail can lead to severe complications. Poor circulation and reduced healing ability make infections more likely and more difficult to treat.
Chronic Pain
Without treatment, the pain from an ingrown toenail can become chronic, affecting your quality of life. It can potentially change how you walk, which can cause additional foot problems.
Granulation Tissue Formation
The body may respond to chronic irritation by forming excess tissue around the ingrown nail. This red, wet-looking tissue bleeds easily and can make treatment more complicated.
Work-Related Issues
For those in physically demanding jobs, an untreated ingrown toenail can lead to missed work days, reduced productivity, and potential safety risks if it affects your ability to wear protective footwear properly.
Recovering After Ingrown Toenail Surgery
Recovery from ingrown toenail surgery typically takes 2-3 weeks with proper care. Most patients return to work within a few days, though those with physically demanding jobs may need additional time off.
After surgery, we will set you up for success with a comprehensive list of post-operative instructions. It is generally best to keep weight off the foot for the first day and elevate it when possible. Many return to work and school within a few days, but you may need to avoid vigorous activities for a few weeks. Wearing open-toed shoes or a style with a wide toe box is helpful to keep pressure off the affected toe. Complete healing usually takes two to three weeks with proper post-operative care.
Preventing Future Ingrown Toenails
Prevention is always better than treatment. We recommend:
- Trimming toenails straight across
- Wearing properly fitted shoes with adequate toe room
- Keeping feet clean and dry
- Inspecting feet regularly for early signs of problems
- Choosing protective footwear that doesn't compress the toes