Diagnosis

Ingrown toenails are one the more common foot problems treated by the Podiatrist. They can be very painful, with people limiting their activity to keep off their sore feet. Ingrown toenails are caused by impingement of the skin along the margins of the nail by the nail plate. Some ingrown toenail are chronic, with repeated episodes of pain and infection. Pain can be present without infection, and occasionally infection is present without pain. The usual signs of infection include; redness (erythema), swelling (edema), increased warmth (calor), and pain (dolor). Diagnosis is usually made on examination only. (Hint: If your toe looks anything like these pictures, congratulations, you've got an ingrown toenail.)  X-rays may be taken if it is suspected that any infection has spread to the bone.

Symptoms may include:

• Sensitivity to any pressure such as shoes, socks and even the weight of bedding
• Pain along the edge(s) of the toenail
• Inflammation, swelling, proud flesh
• Redness and discoloration
• Infection with the drainage of pus, or a watery discharge tinged with blood
• Bleeding

• Improper trimming of toenails
• Tight fitting shoes
• Socks or hose that are too tight, typically made from artificial fibers
• Abnormally shaped nail plate
• Other toenail deformities (ie. excessively thick nail plate)
• Trauma to the nail plate or toe
• A change in weight
• A change in gait, often occurring after an injury to the back, leg or foot

• Trim toenails straight across, and leave slightly longer then the end of the toe
• discontinue wearing  tight fitting shoes and/or socks
• Wear shoes and socks made of natural materials (ie. leather, cotton)
• Soak foot in warm water two or three times a day
• Keep foot and toe clean to prevent infection

• Trim a small spicule of nail to relieve the pressure. Callus (dead skin) may have accumulated in the nail groove, which needs to be removed. Routine ingrown toenail care may need to be done periodically.
• Elevate the end of the nail plate to prevent impingement on the soft tissues
• Surgically drain an infection
• Prescribe special soaks and/or antibiotics
• Surgically correct a chronic ingrown toenail
• Completely remove a deformed toenail so it will not grow back.

• Any infection may spread to foot and leg, or into blood stream.
• Loss of nail plate from infection or inflammation of the nail bed
• Chronic in-growing nails can cause deformity of the nail plate and/or surrounding soft tissues
• A small benign tumor called a granuloma can form along the nail margin
• Diabetics and those with poor circulation to the feet may develop open ulcers and possibly loss of toes, foot, or leg. 

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