Ingrown toenails? Do's and don'ts

Ingrown toenails are real pains, and for working professionals, it can cause many inconveniences, leading to reduced focus and concerns about complications such as an infection.

A mental visual about the nature and misnomer of "ingrown nails". The name itself is an oxymoron because nails do not grow downward, only forward. Instead, the nail folds are pushed onto the nail in these cases (Wiki image).

Before jumping into how to manage ingrown nails, some tips to prevent ingrown nails

• Avoid cutting your toenails below the nail fold lines (left/right edges)
• Ensure the shoe tip is wide enough without putting pressure on the sides of the toes
• Ensure shoes allow good ventilation (use powder to absorb moisture if necessary)
• Specialized footwear for sports must be a good fit to reduce nail trauma

Without addressing the underlying issue the problem may persist or recur.

UpToDate- Ingrown nails

The progression of an ingrown nail occurs in stages

• Early stage = Redness/pain/swelling -->
• discharge (infection) -->
• late stage = nail fold skin overlapping to nail (hypertrophy)

Medscape- Onychocryptosis

Treatments for the early stages of an ingrown nail

• Traction nail fold skin away from nail while soaking in Epsom salt
• Apply topical antibiotic ointment by massaging it into the nail fold affected
• Put sports tape on the edge of the affected nail fold --> pull it underneath the toe and wrap it around to the top middle of the nail --> Keep traction on the nail fold away from the nail
• Follow the tips to prevent ingrown nails above*

*Patients want to cut the nail further into the nailbed, but recall that it's not an "ingrown" nail issue. Traction skin away from the nail instead and let the nail grow above the nail bed.

Complications of mismanaged ingrown nails may require surgery that includes nail removal. No one would like that to happen since it's a very unpleasant experience, therefore addressing ingrown nails in the early stage is crucial.