Does your big toe hurt whenever you take a step? You may have an ingrown nail that's grown into the soft flesh of your big toe. An ingrown nail can get infected when left untreated, resulting in more pain and bleeding. It is also more dangerous to have an ingrown nail when you are diabetic. You must get rid of the ingrown nail immediately to avoid any complications.

What Causes an Ingrown Nail?

There are many causes of ingrown nails. Some are congenital, while others are caused by personal nail care practices. Knowing what exactly causes your ingrown nails helps prevent the condition from recurring. The most common causes of ingrown nails are the following:

• The nail's shape: The shape of the nail is probably the most common cause of ingrown nails. Contrary to what some people believe, a curved nail doesn't prevent an ingrown nail from occurring, but in fact causes it. Nails that are flat at the top have a lower risk of becoming ingrown nails. “Pincer nails” that are extremely curved at both sides also often cause the condition. The shape of your nail is congenital, but can be influenced by nail care practices.
• Poor nail cutting: Cutting your nail too much can cause an ingrown nail, because the nail puts too much pressure on your skin. Nails with sharp corners or pikes may also become ingrown nails when they grow.
• Tight footwear: Tight shoes, boots, and other kinds of footwear may increase the pressure between the nail and the skin, increasing your risk of developing an ingrown nail.
• Nail trauma: Dropping a heavy object on your nail or damaging it badly can alter its shape, and make it more prone to grow an ingrown nail.
• Chubby toes: Chubby toes put more pressure between the skin and nail, making ingrown nails more likely to develop.

Symptoms of Ingrown Nails

Any nail can become an ingrown nail, but the condition often occurs in the big toe. It's important to see the early symptoms of an ingrown nail to avoid infection and more pain. You most likely have an ingrown nail if you have the following symptoms:

• Pain: An ingrown nail typically starts out as a minor discomfort in the affected toe. Eventually, you'll feel more pain as the nail penetrates deeper into the skin. At this stage, the toe may still not be infected, but it can develop an infection later on if the ingrown nail is not removed.
• Tenderness, redness, and swelling: As the toe becomes infected, the skin around the ingrown nail can increase in redness, tenderness, and size. It may even cover a part of the nail, making it extremely painful to walk.
• Pus: Pus indicates that the toe is already infected. Whitish pus may form around the ingrown nail and produce a foul odor. If you don't treat the ingrown nail at this stage, the infection may spread into other areas of the toe and foot.

Self-Treatment for Ingrown Nails

The purpose of treating an ingrown nail at home is to reduce the pain until the nail grows above the edge of the skin, or until you can set an appointment with your doctor. Remember that you can't completely get rid of the pain until you remove the ingrown nail. Here are some self-treatment tips to make an ingrown nail more manageable.

• Soak you feet in warm salt water: Doing this helps prevent infection, and relieves swelling and tenderness. Do this for 15 minutes thrice a day, and your toe will feel much better.
• Cushion the nail: You may cushion the ingrown nail with cotton after soaking it in warm salt water. This helps the nail grow above the skin while reducing the pain.
• Apply a topical antibiotic: Prevent infection by applying a topical antibiotic on the affected area. Bandage the toe to protect it from moisture and more trauma.
• Wear loose footwear: Never wear tight footwear because it puts unnecessary pressure on your toes. As much as possible, wear loose footwear that allows your toes to move. Experts recommend wearing sandals to reduce your risk of having an ingrown nail.
• Take some pain relievers: Ingrown nails are known to cause excruciating pain, so if you can't endure the pain, take some over-the-counter pain relievers like ibuprofen and acetaminophen. Don't rely entirely on pain relievers to treat your condition, though. Set an appointment with your doctor so the ingrown nail can be removed.
• Take extra care if you're diabetic: It may take a longer time to recover if you're diabetic. Check your toe daily for signs of infection and other complications. Consult your doctor to avoid further damage.

Medical Treatment for Ingrown Nails

The pain caused by the ingrown nail will not disappear until the nail is cut, removed, or grows over the skin. A doctor will usually only cut the part of the nail that digs into the skin, but he may also remove the entire nail if needed. These are the common medical procedures for ingrown nail treatment:

• Phenol application: Phenol is a colorless crystalline solid and aromatic compound that can be used as an exfoliant. Phenolisation involves the application of phenol to the affected toe to prevent it from regrowing nail. Anesthesia is usually injected at the base of the nail, which is quite painful because the needle reaches deep into the muscle. This procedure reduces the risk of recurrence, and leaves no visible scars.

• Complete nail removal: Removing the whole nail is easier and faster than cutting part of the nail. It can be done in about 10 minutes in the doctor's office. The doctor injects a local anesthetic on the affected area so the procedure can be performed painlessly. The problem with this procedure is that the nail may grow back deformed or thicker, eventually becoming another ingrown nail. Many experts don't recommend this procedure because it is quite ineffective, and the patient may feel too much pain if he's not sensitive to anesthesia.

  Permanent complete nail removal can also be done by applying a chemical on the sides of the nail. This prevents the nail from going back, but exposes the fleshy part of the toe. The drawback with this option is that your toe will look unattractive because it's bare. You may use a fake nail or varnish to hide the bare spot.

• Cutting part of the nail: Instead of removing the whole nail, the doctor may only cut parts of the nail that are ingrown. This procedure is called nail ablation or wedge resection and it can be done in the doctor's office very easily. First, a local anesthetic is injected into the affected area to reduce pain. The doctor then simply cuts the part of the nail that pierces the skin, or he cuts both sides of the nail even if one side is not ingrown. He may apply an acid on the sides of the nail to prevent the nail from growing back, although some doctors opt to skip this step. Recovery time for this procedure is usually two weeks to two months if the area doesn't get infected.

Go to your doctor immediately if you feel discomfort in your big toe or any of your fingers. An ingrown nail may be difficult to spot in its early stages. Don't put off consultation because if the toe gets infected, it will cause more pain and complications.