Podiatrists and in-grown toenails

Foot care is an important means by which we can maintain our day to day mobility. People of all ages rely on their feet for even the most mundane of everyday tasks, which is why when something does go wrong with our feet, getting the right treatment and care for them is absolutely necessary. Podiatrists are specialists in foot care responsible for diagnosing, treating, and preventing conditions of the foot, and in this article we look at how podiatrists deal with in-grown toenails, a common diseases that can cause pain and discomfort.

What is an in-grown toenail?

In-grown toenails are relatively common across the world, and are also known by the term unguis incarnatus. The condition develops when a nail grows in such a manner that it cuts into its underlying tissue, also known as the nail bed. The nail bed is rich in blood vessels and once pierced, is vulnerable to infections.


Interestingly in-grown toenails are only known to affect people who wear shoes, and is almost never observed in locations where the population go about bare foot. This is because a steady downwards application of force, as from an ill-fitting shoe, is necessary to cause in-grown toenails.

Once the nail bed is pierced the signs are swelling and pain alongside the borders of the nail, all symptoms which worsen when a shoe is put on. Any sudden aggravation of the affected toe can cause a sharp pain as the nail is pushed deeper into its bed. As the condition worsens and infection sets in, pus and a watery discharge, both often tinted with blood, can be observed.

In-grown toenails are, as mentioned above, usually caused by poorly fitted footwear. However another major cause of the condition is poor nail-care. When nails are cut too short or in a jagged and uneven manner they are more likely to grow in unusual and painful ways.  A small number of cases of in-grown toenail are actually caused by acute injury to the toes, by dropping a heavy item or stubbing a toe violently.

Treatment of in-grown toenails

Podiatrists are closely involved in the treatment of in-grown toenails, of which there are a number of options. In-growing toenails can often be treated with antibiotics to counter microbial infection, and these can be prescribed by podiatrists who have attained the appropriate postgraduate qualifications. It is important to note that not all podiatrists can prescribe medication, and in some cases you will need to see your doctor for a prescription. In very mild cases a podiatrist may use a splint or other tool to create an opening in which the nail can safely grow, however in more severe instances more extensive surgery is needed to remove an in-growing toenail.

There are two surgical procedures associated with in-grown toenails, and the appropriate method is chosen depending on the severity and position of an in-growing toenail. A wedge resection involves removing a section of the nail which includes the in-growing portion, but in the most severe of cases a complete toenail removal is necessary to treat the condition, followed by a course of antibiotics.

Podiatrists are also responsible for producing customized orthotics (usually shoe inserts) to preserve and protect the foot from further in-growing toenails. He or she will also provide instruction on the correct way to take care of your nails, all to prevent a further occurrence of this condition.

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