If you have seen your family doctor about a foot problem, there’s a 1-in-5 chance you made the appointment to deal with an ingrown toenail. This common malady, which usually involves your big toe, can be the source of significant discomfort and aggravation, especially if it keeps recurring. Although you can always go to your doctor for a painful toenail extraction, there are some things you can do at home to correct an existing ingrown nail and – hopefully – prevent the problem from occurring again.
Before you can really address an ingrown toenail, it helps to know what causes them in the first place. Although many factors are thought to contribute to ingrown toenails – genetics, repetitive trauma, acute injury, tight-fitting shoes, obesity, increased foot moisture and poor hygiene – one factor that most experts feel is common to many ingrown nails is improper trimming. Your nails should be trimmed straight across at a point just beyond the end of the pink nail bed, leaving a thin margin of white nail. Do not round off the corners of your nails, and never tear off a partially trimmed nail.
Soak and Wick
One useful technique for managing an ingrown toenail involves placing a cotton wick – a small wisp torn from a cotton ball – beneath the affected margin of your nail after soaking your foot in warm, soapy water for 10 to 20 minutes. After drying your foot, elevate the affected edge of your toenail and gently tuck the wick beneath it. Various instruments can be used to raise the nail margin – curettes, nail elevators or orange sticks used by manicurists – but take care to not injure the soft tissue around your nail. Repeat this procedure three to four times daily. A 1986 study conducted at the United Kingdom’s Kent and Canterbury Hospital showed that 79 percent of patients using this method improved within a few weeks. Sliding a length of dental floss obliquely beneath the nail margin also works, particularly if your toe is too tender or the nail is too thick to lift its edge.
Splints formed from short lengths of vertically slit, narrow-caliber plastic tubing can be affixed to the offending margin of your ingrown toenail to force it outward. Doctors use short lengths of IV tubing, but a stirring straw from your favorite coffee shop makes a reasonable substitute. Cut a section of tubing slightly longer than your toenail, slice it carefully from end to end, insert the corner of your nail into the slit in the tubing and slide it gently down the gutter along the edge of your toenail. Fix the splint in place with adhesive tape or a drop of cyanoacrylate glue and trim so it doesn’t protrude beyond the end of your toe. It may take up to three months for your nail to "outgrow" a gutter splint, so trim the splint whenever you trim your nails, and re-tape or re-glue as needed. If the splint falls out, replace it.
To increase their effectiveness, gutter splints can be combined with sculptured acrylic nails, which can be placed and maintained by a manicurist or nail specialist after you insert your splint. A group of physicians at Yokohama City University School of Medicine in Yokohama, Japan, found the combination of gutter splints and acrylic nails far superior to other conservative methods.
Ingrown toenails that are draining, foul-smelling, reddened or extremely tender should be evaluated by your doctor. If your ingrown nail isn’t too painful or obviously infected, however, some easy measures might save you a trip to a foot-care specialist: If you develop ingrown toenails on a regular basis, reevaluate your toenail trimming technique, and consider buying wide box-toe shoes to prevent toe crowding. If your feet sweat a lot, wear cotton socks and change them two or three times daily. If you still get ingrown nails despite conscientious foot care, consult your physician about options for surgical treatment.
- “American Family Physician”; Management of the Ingrown Toenail; Joel J. Heidelbaugh, et al.; February 2009
- “Journal of the Royal Society of Medicine”; Conservative Outpatient Management of Ingrowing Toenails; Asha Senapati; June 1986
- “International Journal of Dermatology”; Formable Acrylic Treatment for Ingrowing Nail With Gutter Splint and Sculptured Nail; H. Arai, et al.; October 2004