Ingrown nails are a common nuisance and can be a source of pain that can run the gamut from annoying to severely painful. They can be present in any toe and at any age. It is not a disease of childhood, active people, or those who cut their nails too short. Ingrown nails may be inherited, as some people are simply born with them. They may also be seen later in life due to gradual damage to the cells under the skin that grow the nail (called the nail matrix). Repetitive injuries to the toe, such as heavy objects falling on it, pressure from poorly fitting shoes across the top of the toe, nail fungus creating thickness and loosening, or toe bruising (common in athletes) may cause irreversible changes to the nail matrix by causing undue pressure to these fragile cells. In time, the nail may abnormally grow inward toward the skin due to these changes, rather than flat outward as in normally shaped nails. It is possible that a poor nail trimming technique may leave a spike of nail that may protrude into the skin as the nail grows outward, although this is very uncommon. This is the heart of the big myth associated with ingrown nails: many people assume that nail cutting has a big role in their formation and cutting straight across is the only way to prevent this.
The truth is that one could cut one's nails in any shape and it would not change the fact that the nail grows FROM THE BASE OF THE NAIL ONWARD. One's cutting technique at the end of the toenail, after it has already grown out, generally has little to do with developing ingrown nail symptoms. More times than not, the reason people get ingrown nail symptoms after cutting the nail too short is that usually people nick the skin in some way, starting a skin inflammation process that eventually causes the pain by allowing the sensitive swollen skin to push against the ingrown nail side. This is really the underlying problem with ingrown nail pain. The nail itself is not the source of the pain as the skin is generally well suited to accept a curved nail next to it. The pain arises when inflammation to the skin along side the nail develops. The inflammation is painful, not the nail itself. Unfortunately, in many people, this inflammation begins to cycle regularly, with little to set it off, including tight shoes, an injury, a slightly close nail trim, et cetera. Eventually an infection can and will develop over time as bacteria becomes trapped under the swollen skin. If untreated, the chronic infection may spread along the toe skin and in very extreme cases may eventually involve the toe bone underneath, although this is very uncommon. Too many people seem to 'deal with' the infection for months at a time prior to seeking treatment, and the longer the infection sits in the toe, the greater the chance the infection can spread deeper, especially in people with lower immune systems or diabetics . It is also not uncommon for ingrown nail symptoms to resolve on their own, only to keep reappearing over and over again as mentioned above.
Temporary home-based treatment may consist of regular soaking in warm, soapy water, and application of an antibiotic ointment. Truly infected toes need prescription antibiotic medication to control the infection. However, the offending nail border must be removed in order to permanently resolve the condition. Often many people seek medical care in urgent care centers, emergency rooms, and even family practice offices where the procedure of choice due to lack of proper equipment or training is only a non-permanent removal of the ingrown nail side. The problem is that in 4-8 months the nail will grow back out along the side and the condition will return again eventually. Permanent nail border removal is quick, easy, and relatively painless, and will eliminate the chance of the condition returning again. This is accomplished through a short, simple office procedure where the nail border is removed under local anesthesia and a mild acid is used to prevent the nail matrix from ever growing the nail back into the skin along the side where the nail is ingrown. Only the process of getting numb is uncomfortable. However, this is brief and the procedure to follow is painless. The procedure can be performed on nearly everyone, with the exception of those with severe circulation disorders of the legs and feet.
Recovery from the procedure is very easy, consisting primarily of soaking the toe daily and antibiotic ointment use under a band aid. Most people have little to no discomfort following this procedure, and instantly feel better. Most people have full healing within three weeks, and during this time most people have little to no activity restrictions. No lost time from work, no restrictions from sports, and most importantly no lost time from enjoying life. It should be stressed again that it is not enough to simply have the side of the nail removed. Unless the nail matrix is treated and destroyed in the nail corner, the side of the toenail will re-grow. Unfortunately, some people still prefer to treat this on their own at home. Home based "bathroom surgery" is not recommended as this may significantly worsen the condition. Trying to dig out the nail accomplishes nothing, as the nail will continue to grow from its base and will again meet against the skin eventually. Repeated infections will soon follow, especially if bacteria is introduced by unclean home instruments. At times, digging a fingernail or unclean instrument into the infected nail area may even worsen an existing infection. This condition is best handled by a physician, usually a podiatrist who has likely done hundreds to thousands of these procedures. There is no need to suffer through this easily treated condition, and the old days of going to an operating room to have it fixed are long over. This common nuisance is completely and easily curable if one takes the simple step to have it done.