Noticing some slight redness, irritation or swelling on the side of your toenail, especially if it’s still mild and in its early stages, may seem like no big deal. Some people presume that when the nail grows in by itself, it can grow right out.  Unfortunately, ingrown toenails rarely get better on their own – and in fact, in some cases, they can cause complications. While ingrown toenails usually have a simple fix and don’t need to be serious or severe, today we thought we’d share what can go wrong with ingrown toenails and what you should look out for. 

Ingrown Toenails: The Basics

An ingrown toenail is a nail that has pierced the surrounding skin. Often, it’s a small piece of the nail, like a little spicule that has been left behind after part of the nail was trimmed, that is the culprit. Once it has pierced the skin, it can cause great pain because it continues to move around with every step – much like walking with a splinter in the side of your toe. Ingrown toenails can affect one or both sides of any toenail, though usually affect the big toe. In most cases, the nail edge will curve down into the skin, however, the presence of extra or swollen skin surrounding the nails may obstruct regular nail growth and result in the nail growing into it. Initially, the nail may push tightly against the skin which can cause tenderness and redness, but it is the moment the nail cuts through the skin that it is deemed ‘ingrown’ and the risk of complications such as infection begin.

Causes Of Ingrown Toenails

The most common cause of ingrown nails we see is poor nail cutting technique (where nails are left frayed or curved down the sides) as well as picking or pulling the nails off. Tight footwear can also create pressure on the sides of the toes that can push the nail into the surrounding skin. The shape of the nail can also play a role, especially where the nail is particularly involuted or curved. This is often linked to uncontrollable genetic factors that dictate the features and shape of the nail.

Complications Of Untreated Ingrown Toenails

When ingrown nails are left untreated, they can get infected and you may notice yellow discharge and bleeding from the toe. If this infection is unmanaged, it can form an open sore, and ultimately an ulcer. If a secondary infection is then picked up and reaches the bone, you may develop a bone infection. While these latter complications are much less common and very avoidable if the right care is taken, we simply wanted to illustrate that ingrown toenails do carry very real risks to your health, and that you should treat them carefully and promptly. You may have a higher risk of these complications if you have conditions like diabetes or problems with blood flow and circulation. This is as good blood flow is necessary to support healing, close wounds and fight off infections. Without this, your wound stays open for longer and you are more vulnerable to a persistent infection.

Treating Ingrown Toenails

Here at the Auckland Ingrown Toenail Clinic, our experienced podiatrists make treating ingrown toenails easy, simple and painless. We remove the offending nail edge from where it is lodged in the skin, trimming that part of the nail that often lies deep beyond where you can see without the right instruments and experience. If you’re concerned about pain, we can use local anaesthetic to numb your toe. We can either do this as a one-off treatment, best suited for first-time ingrown toenails that are unlikely to come back, or as a permanent solution, taking extra steps to stop the problematic nail edge from growing back again – and eliminating the risk of another ingrown toenail in the future. Our treatment options include:

• Conservative nail care – for first-time ingrown toenails, we remove the offending nail spicule if it doesn’t look like the nail will re-grow back and keep causing you pain.
• Partial nail avulsion – for recurring ingrown toenails, we remove the nail spicule permanently, using a chemical to prevent the problematic edge of the nail from growing back in the future.
• Total nail avulsion – for recurring ingrown toenails that have a secondary problem, like a thickened, damaged or distorted nail – or one with a fungal infection too – we can perform a total nail avulsion. This involves removing the entire nail and allowing it to grow back naturally hopefully without the previous issues.

To get help from our trusted podiatrists, our clinic is located in the One Health building in Remuera. Book your appointment by calling 09 523 2333 or book online here.