So you – or your family member – has an ingrown toenail. And you’ve read conflicting information online that’s left you wondering whether you should be soaking your foot in salty water or having the whole nail removed completed. We get it – it can be confusing. So today, we thought we’d give you the information you need to know where to start and what all the options really mean.

First thing’s first: Can I treat my ingrown toenail at home or should I see someone?

If you have an ingrown toenail, it means that a piece of your toenail has actually pierced the skin that surrounds it and has started to grow into it. The point at which the nail pierces varies from person to person – it could be towards the tip of the toe and it may be very obvious by the red, swollen bulge. Unfortunately, for the majority of the people we treat, this nail spicule is deep down the side of the nail and close to where the nail originates, making it incredibly hard to get to, especially if the nail starts to soften from being embedded in the skin for so long.   With the above in mind, let’s examine a few of the common online home remedies and their real effect on the ingrown nail: 1. Soak the toe in warm salty water Soaking the toe in warm salty water can definitely help to keep the area clean and help prevent, or reduce the symptoms of, an infection. What it doesn’t do is treat the ingrown nail and remove it from the skin. To clarify: your pain will continue for as long as the nail is embedded in the skin. While soaking the toe isn’t a bad idea in helping with swelling and preventing infection, it doesn’t treat the problem. 2. Cut a V in the nail This is a goodie. As the old tale goes, if you cut a V in the nail then the edges of the toenail at the ends will start growing inwards to remove the edges of the nail from the skin. Unfortunately, the nail doesn’t grow from the tip of the nail – it grows from the base of the nail at the nail matrix that contains the nail-growing cells. This means that cutting any pattern at the end of the nail won’t affect the growth at the base of the nail. 3. Trim the nail down the side Ah, the home bathroom job. We estimate that 50% of our patients that come see us for their ingrown toenail have tried some form of home treatment first. Unfortunately, without the right tools or being able to see down the side of the nail (not to mention the sometimes excruciating pain levels), this isn’t effective – and if you start cutting down the side and then stop part way because you can’t go any further or the pain gets too much – can actually leave you in a worse place than when you started. 4. Apply antiseptic to the toe Much like soaking in warm water, antiseptic is great for helping treat and prevent infection, but it doesn’t remove the nail spicule from your toe.  5. Wait for it to grow out If you had your nail removed entirely, it may take you 8-12 months for the entire nail to grow back. So we guess the question you have to ask yourself is if you’re happy waiting up to a year for the problem to hopefully resolve itself, assuming that the new nail doesn’t follow suit and just keep growing into the skin. Much more than this, the longer the nail stays in the skin, the longer you’re vulnerable to infection and ongoing pain, swelling and discomfort. You’ll definitely need it treated if an infection develops – so it never gets so bad that it gets to the bone and causes very serious problems. 6. Take anti-inflammatories Sure – anti-inflammatories, when your toe is red and swollen, can help reduce the swelling and hence reduce your pain. But, again. The nail stays in the skin. And when the meds wear off, the problem returns. 

So what treatments do work for ingrown toenails?

Effective treatments for ingrown toenails must remove the nail spicule completely from the skin. Even if a small piece is left, as the nail continues to grow, your pain and symptoms will return. We offer three solutions to ingrown toenails that are safe, proven and effective: 1. Manually removing the nail spicule We refer to this as conservative nail care as it doesn’t involve any ‘surgical’ aspects. We use simple and sterile podiatric tools to trim back and remove the small piece of the nail that has penetrated the skin. 2. Permanently removing the nail spicule Otherwise known as a partial nail avulsion, we class this as a minor surgical procedure as it involves numbing the toe with anaesthetic and then removing a small portion of the nail. What makes it permanent is that after the nail spicule is removed, we apply a chemical that destroys the nail growing cells in the one small section of nail, meaning that the nail edge won’t grow back. 3. Removing the whole nail Known as a total nail avulsion, this procedure involves the safe removal of the entire toenail. While this isn’t our go-to procedure for ingrown toenails, there are some circumstances that make it the best option for our patients, such as where both sides recurrently ingrow and there is a large curvature at the sides of the nail, or when the nail is also thickened or disfigured.

So where should you start?

The short answer is that if this is your first ingrown toenail, manually removing the nail spicule may be sufficient. If your ingrown toenail has recurred multiple times on the same nail, permanently removing the nail spicule is likely right for you. If both sides of the nail have ingrown repeatedly, and there are other problems with the nail like it’s thick, then removing the entire nail may be the way to go. The longer answer is that there are a number of considerations and implications of each treatment option – and factors like your medical conditions, any healing impairments, your work, footwear, daily activity levels, if an infection is present, and much more can greatly influence which option is best for you. This is where we come in – you don’t need to make a choice before you see us for treatment – just book an appointment and we’ll take all of these requirements into consideration and discuss all of your options – and which may be best for you. We’ll go through all the pros and cons, and what you can expect. Book your appointment online or call us on 09 523 2333.