Introduction

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Any time an ingrown toenail has developed into an infection (drainage, a fever, lighter skin surrounded by red skin, or worsening pain and swelling), see a doctor.

Even if the ingrown toenail is only inflamed without infection, see a doctor if the following conditions also occur: :-

• If it has been more than 5 years since your last tetanus booster shot
• If there is no improvement after 3 days of home care
• If you are a diabetic, have poor circulation, AIDS, are on chemotherapy, or have another reason for poor healing or increased risk of infection

Most ingrown toenails can be managed in the doctor's office. However, go to the Emergency Department (by car, not ambulance) if these circumstances develop :-

• If you are a diabetic or at increased risk for infection and your regular physician is unavailable (even if the toe is not infected yet)
• If you are a diabetic or at increased risk for infection and have any fever or sign of infection in the toe

Self-Care at Home

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If it is early in the course of the ingrown toenail, then home care may be successful in preventing the need for surgery :-

• Soak the foot in warm water 4 times a day. You do not need to add soap or antibacterial agents to the water.
• Wash the foot including the affected area twice a day with soap and water. Keep the foot clean and dry during the rest of the day.
• Do not wear high heels or tight-fitting shoes. Consider wearing sandals, if appropriate, until the condition clears up.
• Try to lift up the corner of the nail that is digging into the skin. Take a small piece of cotton or gauze and roll it between your fingers to form a small roll or wick. Then place the roll between the nail and the skin to keep it elevated. This is painful but is the most important part of home treatment. After every soaking, try to push the roll a little farther in.
• You may take a pain reliever such as acetaminophenor ibuprofen.
• If you see no improvement within 3 days, call your doctor.

Follow-up

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• Keep the dressing that the doctor applied on for 2 days. On the second day, remove the dressing and wash with soap and water. Then apply triple antibiotic ointment (you can buy this at the drug store) and put on new gauze. Repeat this procedure twice a day until healed. The doctor may want to recheck the wound in 3-5 days. ake any antibiotics, if prescribed, as directed. Keep the wound clean and dry. Follow any specific wound care instructions given by the doctor. For the first 3 days, keep the foot propped up above the level of the heart as much as possible. If the doctor prescribed pain medicine, then take it as directed. Otherwise, acetaminophen (such as Tylenol) or ibuprofen (such as Motrin) may be used for pain control if you have no allergies to this medication.

Prevention

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• The best method of prevention is careful clipping of the toenails. Toenails should be clipped straight across—taking care to keep the end longer than the skin edge. This prevents the corners from digging into the skin. They should not be rounded or cut too short.
• Wear well-fitting shoes.
• Keep the feet clean and dry.

Outlook

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The toe usually heals well after this procedure. The primary concern is whether the nail will become ingrown again, which can occur even after destruction of the nail-growing cells.

If part of the toenail was removed, it will grow back within 12 months.