Every so often, we have a patient come to our clinic with a severe ingrown toenail that had started weeks ago – or sometimes even months ago. The reason for waiting so long in pain? They were waiting for it to grow out.
Truthfully, the idea that an ingrown toenail will just ‘grow out’ if it’s left for long enough is inaccurate – and has led many people to endure a lot of pain. Here’s what really happens when you leave your ingrown toenail untreated.
The Nail Will Keep Growing Deeper Into The Skin
Given that the hard nail sits on top of our toe, it’s easy to think that the painful ingrown area is along the surface of the nail too, and so will easily grow out in time, taking the pain away with it. In most of the cases we see, the reality is quite different. The ingrown portion of the nail, which we call the nail spicule, is usually located quite deep down the side of the nail – often much deeper beneath the swollen skin than you can visibly see. Waiting for your nail to grow out then means driving this nail spicule deeper into an already tender toe.
Given that toenails grow much slower than fingernails at an average rate of 1.62mm per month, and you may have multiple centimetres of skin to go through, this can mean months of severe pain, difficulty wearing shoes – and the risk of infection.
Your Toe Can Become Infected
An ingrown toenail is when the nail spicule has pierced your skin, leaving an open wound. Open wounds are susceptible to infection for the entire time before they heal, and given the proximity of the feet to the dirtier ground, you’re left with a significant risk of infection and further pain.
Treating infections isn’t always as simple as picking up a script for antibiotics, either. While antibiotics can treat simple infections, if your infection spreads to the toe bone or becomes complicated, antibiotics may not be enough, and you may develop conditions like gangrene, sepsis or osteonecrosis (bone death).
The Vicious Cycle
Another problem with leaving ingrown toenails untreated is the snowballing cycle of pain and swelling. When an ingrown nail first starts, it grows into the skin, swelling develops. The swelling puts more pressure on the nail, driving the ingrown spicule deeper into the nail. As it grows deeper, the swelling continues and may worsen, further aggravating the problem.
Ingrown Toenails Can Only Heal Once The Nail Spicule Is Removed
The only way to stop the swelling/pain cycle, remove the risk of infection, and stop the problem worsening is to remove the often small nail spicule from the skin. Once it is removed, the skin can heal, the swelling can go down, and you can get back to painless walking.
How Are Ingrown Toenails Treated?
Here at the Auckland Ingrown Toenail Clinic, our experienced podiatrists make treating ingrown toenails easy, simple and painless. Using local anaesthetic (if you want it), 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.
We can either do this as a one-off, 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. Read about both of these services here.
Don’t Delay Treatment
The faster you have your ingrown nail treated, the better for your health and easier for your recovery. Book your appointment by calling 09 523 2333 or book your appointment online.
While the most common descriptors of ingrown toenails from our patients include painful, frustrating, uncomfortable, annoying, excruciating, can’t-wear-shoes-anymore and can’t-sleep-at-night, we recently had a patient call in to book an appointment because he’d had an ingrown toenail for a couple of weeks now, and alongside some pain and discomfort, it was feeling quite numb.
Meeting him at the clinic, we discussed that he’d tried looking up online whether numbness, particularly around one side of his big toe, was normal or if it could be a sign of something more sinister – with no luck at all from Dr. Google. So today, our podiatrists at the Auckland Ingrown Toenail Clinic thought we’d answer this question for anyone else stuck in the same boat: Is numbness normal in ingrown toenails?
No, we don’t usually expect your toe to feel numb
First thing’s first: in our experience, numbness is not on the ‘typical’ or ‘expected’ list for common symptoms associated with ingrown toenails. We expect feelings of pain, swelling, redness, bleeding, and even clear/yellow discharge if an infection is present, because given that a piece of nail is currently piercing into your skin, these are all fairly normal responses from your body.
Your body wants to stimulate quick healing and direct your immune cells to the site to fight off infection or prevent it – and hence your toe swells and becomes red with the increased blood flow. The action of the nail piercing the skin is painful, and any additional pressure to the area from shoes or bed sheets will exacerbate the pain. This is all expected.
Numbness, on the other hand, is a ‘neural symptom’, meaning that it starts from a problem or interruption in one of the nerves in your foot, leg or back that then, instead of delivering clear messages of sensation or pain to your brain, provides a numb feeling. Is the cause of the nerve interruption having your nail pierce the skin? It’s unlikely – especially given that the problem is at the tip of the toe, and if your whole toe is numb, we’d expect the nerve interruption/damage to occur further up the toe or foot.
But, it’s definitely possible
With that said, it could be that your toe is so intensely swollen – and you’ll know if this is happening to you – that all the extra fluid and pressure in your toe is pressing on a nerve and creating those neural symptoms, which can include numbness, pins and needles, burning, tingling and more. So we’re not ruling it out completely or saying that it doesn’t happen, it’s just not the ‘norm’. If this is the case, the numbness would be very localised to the tip of that toe – and wouldn’t extend far down the toe, the foot, or to the other toes. That’s just due to the way our nerves work and give sensation to different areas of the feet.
It could be the symptoms of two problems, simultaneously
It may well be that the numbness you’re feeling is a symptom of another problem, that just so happens to be affecting your problematic ingrown toe, as well as potentially other parts of your feet or legs. There are a number of causes of numbness in the toes and feet, including:
- Diabetes – this is the most common cause, and arises because, over time, diabetes causes damage to our nerves, which leads to a problem called peripheral neuropathy – which causes numbness and other neural symptoms in our feet. It can also ultimately lead to the complete absence of sensation, so you’ve got to be very careful
- Arthritis – whether it’s rheumatoid arthritis, osteoarthritis or gout, if you’ve got arthritis in the joints of your feet, particularly at your big toe, and particularly if you’ve got some notable swelling happening, then this may be compressing the nerves in your feet and resulting in numbness in the big toe
- A new injury – following similar principles to arthritis, if you’ve recently injured your foot, whether it’s a muscle, tissue or bone, and you’ve still got some new or lingering swelling, it may be compressing a nerve and causing your numbness. Or the injury itself may have damaged a nerve, resulting in the same symptoms
- It’s winter, and the blood vessels in your feet have constricted – a less common but possible cause is vasoconstriction, meaning the narrowing of the blood vessels, in your feet. Cold is a big cause of this, as our body wants to minimise heat loss and so our blood vessels constrict. The result is decreased blood flow, especially at the tips of the toes, which leads to problems like Raynaud’s, frostbite and more. If this is the case, you’ll also likely notice your feet feel quite cold, and may be white and patchy
- Circulation problems – following on from the above, you may just have circulation problems, and the same process is happening, except that the weather isn’t the cause, but it’s the changes or damage to the blood vessels creating the problem
- It’s your bunion (if you have one) – finally, it could be related to the joint changes you’re experiencing in the big toe joint at the ball of the foot directly related to your bunion
It’s a clear indicator that you need to treat your ingrown toenail – as your risks increase
Whatever the reason, one thing that’s definitely for sure is that you need to have your ingrown toenail treated ASAP. We rely on our body’s ability to feel to inform us of so much – including when things are going wrong, which we feel as pain. If the numbness is taking over to the point where instead of pain, we feel numb, then our body isn’t alerted to the problems we may be experiencing – including ingrown toenails. This puts you at risk of your nail significantly worsening, developing an infection, or even a secondary infection (which is when it gets pretty bad!), and you being unable to detect it due to the numbness. When you don’t detect it, you don’t know that you need to treat it – and so the problem worsens.
It’s a vicious and dangerous cycle, and the long story short is that if you have an ingrown toenail and you’re getting any numbness, reduce your risks and have your ingrown toenail treated ASAP. Most ingrown toenails do not get better on their own, so for most people, they are just delaying the inevitable.
Uncertain as to what’s happening with your toe?
We’re here to help. We’re Auckland’s leading ingrown toenail experts, and offer a number of solutions for painful, frustrating and numb ingrown toenails, including options to fix the problem permanently using a minor surgical procedure.
For any questions, or to book an appointment with our team, give us a call on 09 523 2333 or book online. We’re located within the One Health Clinic in Remuera, inside Perform Podiatry.
Ingrown toenails are painful and frustrating enough, so the last thing you want is to add an infection to the mix. Unfortunately, in our experience, a large number of ingrown toenails will get infected if proper treatment is undertaken – and it makes sense when you think about it.
Today, our ingrown toenail specialists will be sharing:
- Why the risk of developing an infection once you have an ingrown toenail is high
- What you can do to prevent an infection before it develops
- How you can treat your ingrown toenail and infection once it has occurred
You Have A Significant Risk Of Developing An Infection. Here’s Why
Let’s clear something up: ingrown toenails and infections are not a case of the chicken and the egg – the ingrown toenail comes first.
What classifies a sore toe as an ‘ingrown toenail’ is the moment that the sharp piece of nail goes from merely pushing against the surrounding skin, to actually piercing it and penetrating it.
Think about that for a second – you have a piece of nail that is now constantly inside the skin through a cut down the side of the nail. Every time you walk and move, it’ll move slightly with vibrations of pressures from shoes and socks. Ouch! This also means that while a normal cut occurs and then can heal, this cut can’t – because the ingrown toenail is still constantly piercing it and so keeping the cut open.
An infection occurs when bacteria and other nasties enter the body. Usually, our skin is a fantastic barrier, so while there may be many nasties around us regularly, they never have an ‘in’. Until now. And especially at the ground where you may walk barefooted. And when you give it a perfectly placed entrance – there’s a strong chance that the infection will take hold and start to develop.
Once the infection takes hold, it means increased swelling, pain and oozy discharge (and maybe blood) that is yellow/green/clear in nature and may ‘crust over’.
Preventing An Infection From Your Ingrown Toenail Before It Develops
So how, then, can we prevent – or at least reduce the risk – of developing an infection? It’s quite simple, really. And no – no Epsom salts required just yet!
As the cut from ingrown toenail creates an ‘in’ for the bacteria to take hold, the way to prevent an infection is to remove this ‘in’. This means removing the penetrating nail edge so that the cut can heal, close, and no longer be vulnerable to the infection. Simple, right? – Absolutely.
So How Do I Treat My Ingrown Toenail – And The Infection If I Already Have One?
The best way to ensure the proper care of your ingrown toenail is to see your Podiatrist. Our team here at the Ingrown Toenail Clinic are Podiatrists that are trained in simple and painless ingrown toenail surgeries, as well as conservative care where we safely remove that small, pesky nail edge in a matter of minutes. You’ll feel the relief almost instantly!
We don’t recommend trying to cut back the nail at home because often the nail runs much deeper than you can see, so most people will miss removing the complete penetrating edge and their pain will only continue to worsen. You also won’t have the right tools for the job – whereas we have everything needed to do it quickly and easily – even anaesthetic if you need or want it! (though most people don’t).
Once the sliver of nail is removed, the body will be able to effectively heal the wound and fight the infection – and of course, we’ll help it along by dressing it with betadine (antiseptic). You’re welcome to soak it in some Epsom salts too – but once the nail is out, it should be relatively simple and straightforward for it to heal and the infection to subside.
No more painful, swollen discharge – hooray!
Auckland’s Ingrown Toenail Experts
We’re proud to be Auckland’s only Podiatry clinic that specialises in the safe and effective care of ingrown toenails – and we do a really good job of it. From simple and easy care to quickly remove the small nail edge, to minor nail surgery to permanently correct ingrown toenails, we’ve got you covered.
You can book online here or give us a call on (09) 523 2333.