I was teaching physicians the other day and helped take off a pus-filled, red and angry  ingrown toenail.  This is immensely rewarding.  When the toenail digs into the skin folds on the feet and every step causes pain, we physicians can help.

Ingrown toenails occur when the nail grows downward on the sides (especially of the big toe) and inflames the skin around the nail border.  This may happen because of trauma (like a stubbed toe), but it more commonly is caused by trimming the sides of the toenail too much.  If it is only mild, soaking the toes for 15 minutes three times a day for 2 weeks may help. After the soak, gently nudge the skin surrounding the nail away from the nail.  Wedging a toothpick or dental floss under the corner of the nail that is imbedded in the skin may help elevate it and relieve the problem.  Epsom salts can be placed in the water, if desired (your feet will be softer, too!)  Your doctor can prescribe a high potency steroid cream to help decrease the inflammation in the tissue.

If this does not help, or there’s a raging  pain/infection, we can take that part of the toenail off.  Your physician will

• numb the toe with a digital block which will feel like a pinch on both sides of your toe.  That’ll make your entire toe numb.
• remove a portion of the toenail so that it may regrow in the correct manner.  This new nail should not be trimmed until it is even with the end part of the nail.
• An antibiotic ointment may be suggested by your physician on the bare nailbed until the nail has started to grow.
• Oral antibiotics have not been shown to decrease the recovery time.

Like I tell my kids. . . let’s cut those toenails straight across.  Not angled like the fingernails.

Hope this helps.