An ingrown toenail can result from a number of things. Poorly fitting shoes and toenails that are not properly trimmed are the most common causes. The skin along the edge of a toenail may become red and infected. The great toe is affected most often, but any toenail can become ingrown. Ingrown toenails may occur when extra pressure is placed on your toe. This pressure is caused by shoes that are too tight or too loose. If you walk often or participate in athletics, a shoe that is even a little tight can cause this problem. Deformities of the foot or toes can also place extra pressure on the toe.

• Nails that are not trimmed properly can also cause ingrown toenails.

• Toenails that are trimmed too short, or if the edges are rounded rather than cut straight across may cause the nail to curl downward and grow into the skin.

• Poor eyesight, inability to reach the toes easily, or having thick nails can make it hard to properly trim nails.

• Picking or tearing at the corners of the nails can also cause an ingrown toenail.

Some people are born with nails that are curved and grow downward. Others have toenails that are too large for their toes. Stubbing your toe or other injuries can also lead to an ingrown toenail. The diagnosis of an ingrown toenail can be made on the basis of the appearance of the toe. A history is also obtained to determine the cause of the ingrown toenail, and to address any predisposing conditions.

If you have diabetes, nerve damage in the leg or foot, poor blood circulation to your foot, or an infection around the nail, come to see us right away. Do not try to treat an ingrown nail at home. Otherwise, to treat an ingrown nail at home:

• Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry.

• Gently massage over the inflamed skin.

• Place a small piece of cotton or dental floss under the nail.

• Wet the cotton with water or antiseptic.

When trimming your toenails:

• Briefly soak your foot in warm water to soften the nail.

• Use a clean, sharp trimmer.

• Trim toenails straight across the top. Do not taper or round the corners or trim too short. Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse.

• Consider wearing sandals until the problem goes away. Over-the-counter medication that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this does not work and the ingrown nail gets worse, schedule an appointment in one of our offices.

If your ingrown nail does not heal or keeps coming back, we may remove part of the nail:

• Numbing medicine is first injected into the toe.

• We use scissors to cut along the edge of the nail where the skin is growing over. This portion of the nail is removed. This procedure is called a partial nail avulsion.

• It takes 2 to 4 months for the nail to regrow.

• Sometimes we will use a chemical, electrical current, or another small surgical cut to destroy or remove the area from which a new nail may grow. If the toe is infected, we may prescribe antibiotics.