Ingrown nail

You will be treated by our team, led by Tina Jordan, BSc in Podiatry, the first person in Slovenia to complete a degree in podiatry. She wrote her thesis on ingrown toenail correction in Slovenian beauty and pedicure salons. Your first check-up is free.

An ingrown toenail (unguis incarnatus) is a very common condition. It can appear at any age, though we see it more often in younger people. It occurs when the nail starts growing into the surrounding tissue (skin). It most often affects the big toe, which carries the most load: it is key to walking and does up to 30% of the work in each step. The nail usually grows in along its sides, towards the free edge, and only rarely at the free edge itself.

The two most common causes are incorrect nail trimming and unsuitable or too-narrow footwear. Other frequent causes include

• nail injuries,
• heredity,
• diabetes,
• excessive sweating,
• obesity,
• skeletal abnormalities and arthritis.

An ingrown nail has a major impact on quality of life, as it causes sharp pain along the side, and sometimes the middle, of the toe. Walking becomes difficult, and if it is not treated in time, the ingrowth leads to more serious complications. The surrounding tissue can become inflamed: it turns redder, feels warm and painful to the touch, and the side fold swells more and more, which can even lead to a bacterial infection.

Ingrown toenails affect both men and women. Age is no barrier either: at our clinic we have even treated a two-month-old baby, so it is not necessarily linked to walking or load. This painful problem affects every generation. People who sweat heavily, such as teenagers, are somewhat more exposed. Older people are also at risk, as nails thicken with age.

Ingrown toenails are most often caused by incorrect nail trimming. We often see people cut their nails very short and “round”. The next most common cause is footwear that is too narrow or too tight, along with narrow or overly tight socks. There are many other causes too, such as

• nail infections (most often fungal),
• nail injuries from sport (football, basketball, running, hiking, ballet, etc.),
• taking certain medicines,
• various serious health conditions,
• a hereditary predisposition,
• obesity.
• The risk of complications is higher if you have diabetes, which causes poor blood circulation.

The nail plate has no nerves, so the nail itself does not hurt. You feel pain when the growing nail irritates the surrounding soft tissue. The deeper layers of the skin do have nerves, so even slight pressure from the nail can cause a throbbing pain. With every step and every bit of pressure, the nail damages the surrounding tissue, and the skin switches on its defence mechanism. The tissue around the nail starts to swell, turns reddish and feels noticeably warmer to the touch than elsewhere. Together with pain, these signs point to inflammation. Add to this the fact that microorganisms are present on our skin and all around us, and complications become inevitable if the nail is not treated correctly.

Yes, basic hygiene is key to avoiding complications with an ingrown toenail. It includes washing your feet every day with lukewarm running water and a neutral soap. Dry your feet thoroughly afterwards, and do not forget the spaces between your toes. Basic hygiene also means fresh socks every day, which is still not common practice.

The internet is full of advice on home remedies and treatments. A home ointment that softens the nail can certainly help, as can a foot bath with added sea salt. Dry and disinfect your feet after soaking. Above all, remember that the problem is the nail physically irritating the soft tissue around it, and as long as that irritation remains, no remedy will solve the problem.

The choice is yours, but we can share the experience of our patients who have tried one or the other. If you see a doctor, they will usually assess the stage of the ingrowth and, if it can be treated without surgery, recommend a local antibiotic ointment, or in advanced stages systemic treatment as well. If they decide this will not be enough, they will refer you for surgery. If you choose a pedicurist, choose carefully. Not everyone is trained to correct ingrown nails, so ask about their methods and references first. The pedicurist will draw up a treatment plan based on the stage of the ingrowth. There are several options: a small spike of the nail may need to be cut away, a tamponade may be enough, or, depending on the shape and growth of your nail, they may recommend a longer-lasting correction with a medical brace (there are several types).

Here too, the decision is of course yours. We can tell you, though, that our ingrown nail correction methods successfully resolve up to 98% of cases at our clinic. We also see patients who have already had surgery, only for the problem to come back. Before you decide on surgery, visit our clinic: the check-up is free, and we will advise you on the options for treating your ingrown nail.

A visit to a pedicurist is the alternative: ingrown nail problems are treated without surgery, using a conservative approach. Most of these treatments are painless, and the pain eases significantly within a very short time. There are several types of medical braces, chosen according to the problem. After a check-up, which is free at our clinic, we will assess which type of brace you need. An ingrown nail can also be treated without a brace, through correction and padding alone.

A medical brace is made of medical-grade steel and guides the nail’s natural growth. Each brace is fitted individually and custom-made for your nail. It works much like dental braces: a wire and spring gradually correct the nail. Right after fitting, you feel immediate relief because the pressure on the tissue drops considerably. As it is a conservative treatment, no local anaesthetic is needed. It is more effective than any other method and a real alternative to surgery. The brace does not limit your daily or sporting activities.

Anyone with a nail problem can wear the 3TO brace. It is also effective for correcting nails that are strongly curved due to deformity or injury. Young children can wear it too, and it is suitable for people with diabetes and those allergic to nickel.