Ingrown Toenails & In-Clinic Treatment

by | Apr 20, 2023 | General Health | 2 comments

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Ingrown toenails seem to come out of nowhere.

The condition occurs when the width of your nail bed is mismatched to the space in which your toenail grows. This can result in your toenail digging into the fleshy bits next to your nail, usually one of your big toes.


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Typical symptoms include tenderness, swelling, and redness to one or both sides of your toe.

If left untreated, the area can become infected and seep pus. A course of antibiotics should clear it up, but you’ll need a doctor to treat your ingrown toenail.

Treatment may be as simple as providing advice on correct nail cutting and what footwear to avoid. However, a surgical procedure is often required to remove the offending part of the nail embedded in your toe.

In more severe cases, a doctor must remove your toenail for good.

It can be surprisingly tricky to find a GP who can treat an ingrown toenail – most will refer you to a podiatrist.

Luckily for my patients, I’ve had some additional surgical training and can perform most procedures at the clinic using local anaesthetic.

I aim to fix your ingrown toenail permanently.

Common Causes

Anyone can get an ingrown toenail, though I see it affect teenagers and young adults more than others.

ingrown toenail causes

Causes include injuring your toe, which can result from poor fitting footwear, and cutting your toenails incorrectly.

However, if your toenail is too big for your nailbed, bad luck and genetics could be to blame. Thanks, Mum and Dad!

If this is your diagnosis, we can work on reversible causes such as:

  • Avoiding tight or inappropriate footwear, including high heels
  • Addressing poor foot hygiene and treating fungal infections
  • Improving poor foot posture, possibly requiring alignment with the help of orthotic inserts

Ingrown Toenail Treatment Options

As with most skin and nail problems, the best treatment option depends on how severe or advanced your ingrown toenail is.

I start treatment by assessing if there are any underlying reversible causes to address. This is vital as we don’t want the problem to recur.

During your appointment, I’ll also treat any infections contributing to inflammation. We can then weigh the risks and benefits of surgery to fix your ingrown toenails permanently.

The big question: When is surgery required?

Non-surgical Treatments

If your toe isn’t showing any signs of inflammation, isn’t extremely painful, and you don’t have a fever, chances are you won’t require surgery to fix your ingrown nail.

Having your toe checked out by your GP is still a good idea. We can show you non-surgical, at-home treatments that may include:

  • Soaking your foot in warm salty water for 20 minutes a few times a day to help reduce pain and swelling. Repeat until your toenail grows out properly – anywhere from 2 to 12 weeks.
  • If you can easily access the ingrown edge of your toenail, carefully clip the offending part of the nail.
  • Cover your ingrown toenail with antiseptic cream to reduce skin bugs, then bandage it to keep clean and dry. You can also use petroleum jelly if there’s no infection.
  • Take over-the-counter pain medication as needed.

Depending on the condition of your affected toe, your GP may use tape to pull your nail away from the skin edge.

Surgical Treatments

If your toe is swollen, seeping pus, red, extremely painful, or you have a fever, you should quickly get to a doctor. In all likelihood, we’ll need to remove part of your toenail surgically.

Trust me – it sounds worse than it is.

Though various surgical treatments are available, I offer an effective and straightforward technique that will have you hopping out of the clinic within 30 minutes.

What’s Involved?

Assisted by our lovely nurses in the clinic’s dedicated treatment room, I’ll first make sure your toe is completely numbed with a local anaesthetic.

I’ll carefully cut a thin edge strip, or wedge, of your ingrown toenail down to its base before removing it completely.

I’ll then destroy (or ablate) the small section of tissue from which this nail wedge has grown, known as the germinal matrix or growth plate.

Next, I apply a diluted acid called phenol to the growth plate to stop your nail from growing back from that edge section, ensuring the problem never happens again.

The procedure is known as a partial nail avulsion, which results in your toenail being narrower and less prone to future irritation. Brilliant!

After the surgery, one of our nurses will bandage your toe, and we’ll give you clear at-home care instructions. Depending on how infected your toe was just before the procedure, treatment may include a course of antibiotics and regular salt soaks.

At home, it’s best to take it easy for a little while and wear open-toed shoes. If you work a desk job, returning to the office should be fine after a few days.

If you work on your feet or wear protective footwear, you’ll need to wait at least a fortnight to recover.

Take a short break from sports and exercise. I’ll need to see you again soon to check on your toe’s recovery.

DOs & DON’Ts of Toenail Care

To give you the best chance of an ingrown toenail not returning, follow these simple tips for toenail care.

clipping toenails

DO

  • Cut your toenail straight across
  • Maintain good foot hygiene – including immediately treating fungal infections (aka tinea or athlete’s foot)
  • Wear separate, sport-specific shoes
  • Ensure nail clippers or scissors are clean

DON’T

  • Cut the corners of your toenail
  • Cut your toenails too short
  • Wear poor-fitting shoes – too loose or tight
  • Pick at your ingrown toenail or try to fix it yourself
  • Bite your toenails – you’d be surprised how many people do this!

When to Visit your GP

Hotfoot it (pun intended) to your GP if at-home remedies aren’t working, if your toe becomes infected (pus, redness, swollen), if you develop a fever, or if you have diabetes.

Diabetics with foot problems require specialised monitoring and care due to associated nerve and circulation problems.

At a minimum, your GP should be able to diagnose the severity of your ingrown toenail easily and determine next steps.


Dr Jeanne North blog

Dr Jeanne North is a local GP at Doctors of South Melbourne.

She has special interests in skin health, minor surgical procedures, and chronic disease management.

You can make an appointment with Jeanne online or call us on 8579 6838.


2 Comments

  1. Maddie

    I have an ingrown big toe nail that’s suddenly came back when I used to have one when I was a child then suddenly got it again just wondering what should I do will it require surgery I’m 21 weeks pregnant it has smelly pus coming out it’s red bleeds occasionally and hurts a fair bit help please

    Reply
    • Doctors of South Melbourne

      Hi Maddie,

      Oh dear, it sounds like you need your toenail assessed in person.

      As we can’t provide medical advice without conducting a proper assessment, please make an appointment with a GP.

      Kind regards,
      Doctors of South Melbourne

      Reply

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