Aloha Foot Centers

Kailua Kaneohe Foot & Ankle Specialists

Robert LaReaux, DPM
Sandra Au, DPM
Ken Tsubata, DPM

Ingrown Toenail

What Are Ingrown Toenails?

Ingrown nails, the most common nail impairment, are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is the most common location for this condition, but other toes can also become affected.


Ingrown toenails may be caused by the following:

  • Improperly trimmed nails
  • Heredity
  • Shoe pressure; crowding of toes
  • Repeated trauma to the feet from normal activities

    The following symptoms may be present with ingrown toenails:

    • Pain
    • Redness and swelling
    • Drainage
    • Odor
    • Prominent skin tissue (proud flesh)
    Home Treatment

    If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.

    People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self-treatment and seek podiatric medical care as soon as possible.

    Other “do-it-yourself” treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided. Nail problems should be evaluated and treated by your podiatrist, who can diagnose the ailment, and then prescribe medication or another appropriate treatment.

    When to Visit a Podiatrist

    You should see a podiatrist immediately if any drainage or excessive redness is present around the toenail. Also, if a short trial of home treatment has not resulted in improvement of the condition, see your podiatrist. If you have diabetes or poor circulation, you should seek immediate treatment at the first signs of an ingrown toenail, as it can lead to more severe complications.

      Diagnosis and Treatment

      A podiatrist will remove the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of that piece of nail, are removed by use of a chemical, a laser, or other methods.

      • Trim toenails properly: cut them straight across, not longer than the tip of the toes. Do not dig into corners and only gently round off corners with a nail file. Use toenail clippers.
      • Avoid shoes with pointy or narrow toe boxes.
      • Never rip or tear edges of nails
      Instructions following Nail Surgery
      Stay off your feet as much as possible today. You may wear any shoe, sandal or open toe footwear that does not squeeze, constrict or put pressure on your toe(s). Your toe(s) may remain numb for up to 6-10 hours after the procedure. Slight bleeding,
      discoloration or drainage is normal. Please contact our office if you have any questions or concerns.

      You may elevate your foot to help reduce minor swelling and discomfort. You may also take over-the-counter pain relievers as directed. If the pain or discomfort is not controlled adequately, then
      contact our office.

      Removing the surgical bandage:
      Starting the day after surgery, carefully remove the dressing and shower or bathe as normal. To make the bandage easier to remove with little or no
      discomfort, saturate it with Amerigel® Wound Wash Solution (bottle). Wait several minutes then remove.

      Daily dressing changes:
      Step 1. Remove the existing bandage and gauze then shower or bathe as normal. Following shower or bath, thoroughly rinse the surgical site (nail bed) with Amerigel® Wound Wash Solution (bottle) and blot dry. Apply a liberal amount of AmeriGel® Wound Dressing (tube). Stinging may occur and is normal.
      Step 2. Cut a piece of gauze to fit directly over the entire surgical site. The gauze will help absorb drainage as the nail
      bed heals. 
      Step 3. Secure the gauze in place with the fabric bandage. IMPORTANT - The bandage should be applied around the toe resembling a ring. (When bandaging your toe, apply the bandage
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