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An ingrown toenail, medically known as onychocryptosis, is a common complaint that affects people of all ages and genders, but it is mostly prevalent among older people and adolescents. (1)
As the name suggests, this condition is characterized by the downward growth of the toenail toward the nail fold. The nail spicule ultimately pierces into the adjoining skin to induce a lot of pain and swelling.
The ingrowth usually resolves with simple foot care at home, but only if tended to in the early stages. If not cared for properly, the site can become infected, necessitating medical attention.
Self-Care Measures: Dos and Don’ts
Caution: The following are some self-care measures to manage your ingrown toenail. It is important to note that these are not suggested for people with foot deformities and medical conditions that are characterized by poor blood flow to the feet and neuropathy, such as diabetes. If you suffer from either of these, go to a specialist for proper treatment.
Try these self-care measures and home remedies to manage your ingrown toenail at home: (2)
1. Soak your feet in an Epsom salt bath
The best way to use it is by preparing a soothing foot soak. Fill a bucket or tub with warm water, mix in 1 tablespoon of Epsom salt, and immerse your feet in the solution for 10–12 minutes every day. Make sure that the water is not too hot before putting your feet in.
The Epsom salt eases inflammation, while the warmth of the water softens the nail tissue and surrounding skin, making it easier to apply topical medication inside the curved edges.
2. Cleanse the site
Once you have soaked and dried your feet, it’s time to sterilize the wounded site.
Dip a small piece of cotton ball in a disinfectant, such as liquid Betadine, and place it under the curved corner of the ingrown nail. This dressing sanitizes the site to prevent infections and separate the nail from the lateral nail fold.
It is important to change this dressing at least once a day. If you are out of cotton, you can use a string of dental floss instead.
Caution: Inserting the cotton or dental floss can hurt a lot, but the pain quickly subsides within a minute or two.
3. Apply topical antibiotics
Several topical antibiotics can be used to prevent your toenail from getting infected. For starters, you can apply an over-the-counter antibiotic ointment such as Neosporin after soaking and drying your ingrown toenail.
Alternatively, you can apply tea tree oil diluted in a carrier oil, such as coconut or olive oil, to the affected site.
Another option is to mix a few drops of water in turmeric powder to form a paste and then smearing it all over the ingrown toenail. Use a Q-tip for easy application, because your finger will not be able to reach under the nail spicule. (5)(6)
4. Massage the nail fold
Gently massaging the painful nail fold can help release inflammation and can provide comfort, but make sure to soak your feet in comfortably warm water first. Also, wait till the toe is completely dry before massaging.
5. Choose your footwear wisely
Wear comfortable footwear, preferably with a wide and open front to give your toes space and proper ventilation. Sandals are much more preferred than tight, narrow shoes that squeeze and rub against the toes, allow no airflow, and make your feet sweaty.
Friction and sweat can greatly aggravate the condition by further injuring the curved toenail and increasing the risk of infection.
6. Try specially designed tools to protect your toe
Cover the affected toe with a bandage or Cutiplast Steril for a protective padding to keep it safe from further trauma and external irritants.
There are other devices for this purpose as well, such as toe protectors and braces. Toe protectors are worn over the affected toe to provide a cushion between the painful nail edge and the adjoining toes or footwear. This keeps the shoe or toes from rubbing against the ingrown nail spicule.
An ingrown toenail brace gently lifts and straightens each side of the affected toenail to ease the pressure the ingrowth applies to the skin. You can easily get these devices at local pharmacies or online stores.
7. Take pain medication
If the ingrowth causes unbearable or constant pain, you can take nonprescription analgesics, such as ibuprofen or acetaminophen, to ease your condition.
8. Avoid weight-bearing and strenuous activities
Rest your feet by limiting your day-to-day movement until the ingrowth heals. Even while standing or walking, try to keep the pressure off the affected toe but putting all your weight on the other foot.
Avoid activities that strain your feet such as running, jogging, and standing for long periods.
9. Take care of your toe after surgery
If you get your ingrown toenail surgically removed, make sure to observe post-operative care as prescribed by your doctor. It can take months for the operated toe to heal, and until then you must keep the wound clean and dry to avoid infections.
10. Get prompt treatment for infection
Monitor your ingrown toenail for any signs of infection, such as redness, swelling, and drainage of pus or watery discharge. If you notice any such signs, visit a doctor at once.
Here’s what not to do while caring for your ingrown toenail:
- Don’t try to correct the nail curvature by cutting or digging into it with sharp invasive instruments. This will not keep the nail from growing inward but can definitely cause further trauma to the surrounding tissue. Besides, using disinfected tools can contaminate the site and pave the way for infections.
- Don’t trim your nail edges repeatedly in the hopes that this will alter the way your nail grows. If anything, this will increase the risk of injury and worsen your condition.
- Don’t wear socks and shoes while at home. Instead, wear open footwear, such as sandals and slippers, to keep your feet ventilated. Exposure to fresh air helps dry out the sweat and moisture on your feet, preventing infections and promoting fast healing.
- Don’t let your feet stay damp for too long since moisture is conducive to the growth of microbes. This rule applies to both water and sweat. Always dry them out after taking a shower, including the spaces between your toes. If you have sweaty feet, ask your doctor for a suitable foot powder to soak in the perspiration.
Here are some preventive measures to avoid getting ingrown toenails:
- Don’t pick at your nails or tear them at the corners.
- Wear properly fitted shoes with a comfortable toe box. Your shoe size is not just about the length of the shoe but also its width. A general rule of thumb is to make sure the widest part of your foot fits snugly within the widest part of the footwear. Avoid high heels and pointy shoes that exert a great deal of strain on the toes.
- If your occupation puts you at risk of ingrown toenails, wear protective footwear.
- Wear stretchable socks and stockings that allow easy movement of the toes. Also, look for socks made of moisture-wicking fabric, such as merino wool, to keep your feet sweat-free.
- Proper nail hygiene entails that you cut your nails regularly, but doing this the wrong way will only invite problems such as ingrown nails. Don’t make the mistake of tapering or curving the nail border – you should be cutting it straight across. Also, make sure not to shorten your nails so much that it exposes the nail bed. Such deep cuts can lead to tissue damage, nail ingrowth, and infections.
- If you have small-sized toenails, avoid trimming them with clippers that can poke or cut the surrounding skin. Instead, use a nail file to straighten the corners of your toenails with a bit of a slope.
- If you stub your toe or suffer any other foot injury, keep an eye on the site for signs of toenail ingrowth. Detecting and treating the problem early will lead to a fast recovery and minimal risk of complications.
- Your feet gather a lot of sweat, dirt, and dead skin cells daily, but they are often neglected since they are at the bottom of the body. So it’s important to keep your feet squeaky clean by scrubbing them with a pumice stone from time to time.
Does Soaking the Ingrown Toenail in Apple Cider Vinegar or Hydrogen Peroxide Solution Help Prevent Infection?
Both apple cider vinegar (ACV) and hydrogen peroxide are extremely corrosive and can irritate or damage the sensitive skin around the ingrown toenail. Thus, using these topical agents to sterilize the toenail is ill-advised.
Besides, there’s no research to back the antimicrobial potential of apple cider vinegar, which disqualifies its use anyhow.
Hydrogen peroxide is, however, a strong antibacterial but not safe for application on an ingrown toenail. There are plenty of other far gentler topical antibiotics that can be used for this purpose instead, some of which are mentioned earlier in the article.
An ingrown toenail is a fairly common but painful condition that can restrict your movement and hamper your daily activities. Even though early treatment can heal the ingrown toenail quickly, it might recur after some time. In such a case, surgery is usually the only permanent cure.
For most people, proper foot care at home can go a long way in relieving the pain and discomfort associated with this condition. But it is still recommended that you get your toenail checked by a podiatrist to rule out any risks or complications.
People who suffer from foot deformities or medical conditions such as diabetes should not attempt to treat this condition at home. Poor management or delayed treatment can induce serious complications, such as foot ulcers and toenail infections that may spread to the underlying bone.