I think I’ve got an ingrowing toenail

Graphic showing an ingrowing toenail

I speak from personal experience when I say in-growing toenails are extremely painful and unpleasant.

They hurt when you walk, when you have shoes on, even in bed. They can bleed and weep and get infected. They are definitely not something you want to show off to people.

What is an in-growing toenail?

Technically an in-growing toenail is when the edge of the nail has created a wound in the skin. This can lead to this excessive, weepy and extremely sensitive tissue developing called hypergranulation tissue. Because there is a wound the toe can often get infected and require antibiotics. While antibiotics will help clear any bacterial infection, they will not cure an in-growing toenail.


Graphic showing the anatomy of an ingrowing toenail


What causes an in-growing toenail?

In my experience there are a few main culprits for developing an in-growing toenail:

●     Poor or inappropriate nail cutting technique (cutting down into the corners)

●     Tight shoes

●     Trauma to the nail

●     Picking the toenails (most commonly seen in teenagers!)

You can have certain nail types that can make you a bit more prone to getting an in-growing nail if you have/do any of the above. These are an involuted nail (where the nail curves down the sides into the skin) or a wide or ‘fan’ shaped nail.

When is an in-growing nail not an in-growing nail?

If you are getting pain down the side of a nail it might not be an in-growing nail. You could potentially have a corn or hard skin down in the side of the nail in the part of the skin called the sulcus, these usually develop from pressure of the nail against the skin (predominantly from tight footwear).

Sometimes if you have a very involuted nail that in itself can be uncomfortable, and these can be trickier to cut and leave a spike so be careful.

What can I do if I have an in-growing toenail?

This very much depends on what has caused the in-growing in the first place.

If you just have a small nail spike for not quite cutting the nail properly, these can often be managed quite easily and quickly.

If you have a very swollen, painful, weeping/bleeding in-growing nail it may be that you need a minor surgical procedure to remove part of the nail, especially if thi is a recurring issue. This procedure is called nail surgery, or a partial or total nail avulsion. It’s done under local anaesthetic and will permanently change the width and shape of the nail.

It’s also important to evaluate your footwear to see if it's causing the issue.

Sometimes even quite bad in-growing nails can be managed more conservatively, but would need to be evaluated on a case by case basis.

So what do I do now?

If you think you may have an in-growing, or a painful nail I highly recommend seeing a Podiatrist and getting it checked. Podiatrists can tell you what’s happening and formulate a long term treatment plan to get you out of pain.

If you are suffering or have suffered in the past it's important to remember these points:

●     Don’t wear shoes that are too tight

●     If you struggle cutting your nails well, get someone else (like a Podiatrist) to do it for you or teach you the best way of doing it yourself

●     DO NOT PICK YOUR TOENAILS! (It’s just a very unpleasant habit for starters)

●     Don't leave any problems to fester, they will usually get worse