What is an ingrown toenail, and when should you have it treated. So your toenail is hurting you and you see it is ingrown. Will it get worse. can it get infected. How does this happen. Below you can see a few pictures of different types of ingrown toenails. Ingrown nails are common in children and adults. It can come from tight shoes. There are some studies that certain foot types such as a flatfoot can cause the toe to rotate and rub your shoe and get ingrown. Overpronation or excessive pronation ( a certain amount of pronation is normal for everyday activities- it is a myth that all pronation is bad) can cause an excessive rolling in of the ankle thus putting more pressure on the nail fold and causing an ingrown nail. I have had some great results treating those types of ingrown nails with orthotics to solve this issue.

osteochondroma

Some ingrown toenails come from a bony growth on the tip of the toe, the distal phalanx of the hallux can have an osteochondroma. Below is a patient of mine with an osteochondroma that the nail fell off of, it was a chronic ingrown nail as well. In those cases either you live with the nail being as is or you have the excess bone removed.

ingrown nail

There are some other biomechanical reasons for ingrown toe nails that can be evaluated by your podiatrist. Ultimately an ingrown toenail will either get infected or resolve. I do not recommend putting devices such as wood and parts of toothpicks or cotton in the ingrown area. It will become a nidus for infection.  If it gets infected sometimes soaking in epsom salt can solve your issue and sometimes it needs to be removed. Taking a course of antibiotics will be the decision of your doctor. Do not take an infected ingrown toenail (paronychia) lightly. I have had many diabetics lose their toe to amputation for not taking the situation seriously. Even healthy teenagers have to be very careful as i have seen many that have had MRSA infections from this. The take home lesson is get your ingrown nail looked at by a professional. Also be careful at nail salons that their instruments are clean. Who wants someone else nail fungus and infections implanted into your toes.