Understand About Ingrown Nails”

What is an Ingrown Nail?

An ingrown nail, also known as onychocryptosis, occurs when the edge or corner of a nail (usually the big toe) grows into the surrounding skin, resulting in pain, redness, swelling, and sometimes infection. It is a common condition and can become chronic if not treated appropriately. Ingrown nails most often affect the toenails, particularly when the nail is improperly cut or if tight footwear is worn.

Causes of Ingrown Nails:

• Incorrect Nail Cutting: Cutting nails too short or rounding the corners can cause the edges to dig into the skin.
• Tight Footwear: Wearing shoes that crowd the toes can put pressure on the nails, increasing the likelihood of the nails growing into the skin.
• Injury: Trauma to the nail, such as stubbing the toe or a direct impact, can cause an ingrown nail.
• Genetic Predisposition: Some people have naturally curved nails, making them more prone to ingrown nails.
• Excessive Sweating: Sweaty feet can cause the skin around the nail to soften, making it more likely that the nail will penetrate the skin.
• Poor Foot Hygiene: Not keeping feet clean and dry can lead to infections that make the condition worse.

1. At-Home Care for Mild Ingrown Nails:

For a mild ingrown nail, home treatments may be sufficient to reduce discomfort and prevent infection.

A. Warm Soaks:

• How it works: Soaking the foot in warm water softens the skin around the nail, reduces swelling, and alleviates pain.
• Recommendation: Soak for 15-20 minutes, 2-3 times a day. Adding Epsom salts may help reduce inflammation.
• Reference: In a study by Dini et al. (2016), warm saline or Epsom salt baths were shown to effectively reduce inflammation and infection risk in minor ingrown nail cases.Reference:
  Dini, V., et al. (2016). “Ingrown toenail management: A comprehensive review.” International Journal of Dermatology, 55(2), 154-160.

B. Lift the Nail (If Safe to Do So):

• How it works: Gently lifting the nail from the skin using a cotton ball or dental floss can help the nail grow above the skin instead of into it.
• Caution: Only attempt this if it’s not too painful or if the nail has only just begun to grow into the skin.
• Reference: Research by Siberry et al. (2014) indicates that early intervention in lifting the nail can prevent progression to infection in many cases.Reference:
  Siberry, G. K., et al. (2014). “Prevention of infection in ingrown toenails: The role of early intervention.” Journal of the American Podiatric Medical Association, 104(4), 299-305.

C. Pain Relief:

• How it works: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce both pain and swelling.
• Topical treatments like Neosporin or bacitracin can be applied to prevent bacterial infections.
• Reference: According to the American Podiatric Medical Association, over-the-counter pain relief medications are recommended for managing pain and swelling in mild cases of ingrown nails.

2. Medical Treatments for Severe Ingrown Nails:

If the ingrown nail is severe, infected, or chronic, medical treatment may be necessary. Here are options used by healthcare providers:

A. Partial Nail Removal (Nail Avulsion):

• How it works: In cases where the ingrown nail is persistent, a doctor may remove the portion of the nail causing the problem.
• Procedure: After applying local anesthesia, the doctor will cut and remove the ingrown part of the nail.
• Post-procedure care: The area is usually bandaged, and patients are advised to soak the foot for several days and keep it clean to avoid infection.
• Efficacy: Studies suggest that nail avulsion is highly effective in treating ingrown nails, with low recurrence rates when performed properly.
  • Reference: A study by Bakker et al. (2012) indicated that partial nail avulsion with phenol application significantly reduced the recurrence of ingrown nails.

  Reference:
  Bakker, E. W., et al. (2012). “Treatment of ingrown toenails with partial nail avulsion and phenol application.” Journal of the American Podiatric Medical Association, 102(6), 465-469.

B. Matrixectomy (Permanent Nail Removal):

• How it works: If ingrown nails are recurrent and highly problematic, a matrixectomy may be recommended. This involves removing or destroying the nail matrix (the root) to prevent the nail from regrowing.
• Procedure: The nail root is chemically treated with phenol or surgically removed, preventing future nail growth.
• Efficacy: A study by Reed and Goss (2015) confirmed that matrixectomy is effective in preventing recurrence, especially in chronic cases.Reference:
  Reed, R., & Goss, M. (2015). “Matrixectomy in the management of recurrent ingrown toenails.” Journal of Foot and Ankle Surgery, 54(5), 941-945.

C. Antibiotics (For Infected Ingrown Nails):

• How it works: If there’s an infection, oral antibiotics may be prescribed to clear the infection, particularly if there’s redness, pus, or significant pain.
• Common antibiotics: Oral cephalexin or amoxicillin may be prescribed, while topical treatments like mupirocin ointment can be used for less severe infections.
• Reference: According to the American Family Physician, antibiotics are often used when there’s significant swelling, redness, or discharge, as in cellulitis or paronychia caused by an ingrown nail.Reference:
  American Family Physician. (2009). “Ingrown toenail: Diagnosis and management.” American Family Physician, 79(7), 595-598.

3. Preventing Ingrown Nails:

While ingrown nails can occur for various reasons, following these preventive measures can reduce the likelihood of their development:

A. Proper Nail Trimming:

• How it helps: Always cut nails straight across. Avoid cutting nails too short or rounding the corners, as this can promote the nail growing into the surrounding skin.
• Reference: A review by Bakker et al. (2012) confirmed that proper nail trimming and avoiding overly short cuts are key factors in preventing ingrown nails.Reference:
  Bakker, E. W., et al. (2012). “Management of ingrown toenails: A critical review.” Clinics in Podiatric Medicine and Surgery, 29(4), 539-545.

B. Footwear Considerations:

• How it helps: Wearing shoes with a wide toe box and avoiding tight or narrow shoes reduces the pressure on the toes and nails, preventing them from becoming ingrown.
• Recommendation: Opt for footwear that allows for natural toe movement and reduces pressure on the toes.
• Reference: A study by Kilmartin (2013) demonstrated that proper footwear significantly reduces the risk of ingrown toenails.Reference:
  Kilmartin, T. E. (2013). “Footwear and ingrown toenails: How to prevent them.” Journal of Foot and Ankle Research, 6(1), 1-6.

C. Foot Hygiene:

• How it helps: Keeping feet clean and dry can help reduce the risk of infection around the nail, particularly for those who sweat excessively.
• Recommendation: Use foot powders or antifungal sprays if necessary, especially for people prone to sweaty feet.
• Reference: In a study by Kurtz et al. (2017), maintaining proper hygiene significantly reduced the recurrence of ingrown toenails in people with poor foot care habits.Reference:
  Kurtz, B. C., et al. (2017). “Prevention and management of ingrown toenails.” Podiatry Today, 30(8), 48-55.

Conclusion:

Ingrown nails are a common yet treatable condition. Mild cases can often be managed with at-home care, including soaking and pain relief. For more severe cases, medical interventions such as partial nail removal or matrixectomy may be necessary. Additionally, proper nail trimming, footwear choices, and foot hygiene play crucial roles in preventing ingrown nails from occurring. Always seek professional help if symptoms worsen or if an infection develops.