Sometimes, moles are more than just moles

An ingrown toenail is a common medical condition among children and adults of all ages. It can lead to intense pain, swelling and even infection, if not properly treated. Surgery is the standard treatment option for ingrown toenails among many medical practitioners; however, considerable promise has been shown by nonsurgical alternatives. Below is information about the different causes of ingrown toenails as well as some of the latest and best nonsurgical treatments:

Causes of ingrown toenails

Ingrown toenails occur due to several causes. While an ingrown toenail is, by definition, the cutting or digging into the skin by the growing end of the nail, it is merely a secondary effect caused by another problem. Knowing the cause can help you and your doctor better treat the condition and prevent an ingrown toenail from returning. Here are a few of the most common causes:

• Improper nail cutting and toe compression – the most common cause of ingrown toenails, especially among children and young adults, is due to poor nail cutting practices and the wearing of overly-tight footwear. The good news is this cause is preventable by learning how to cut nails properly and wearing appropriately-fitting shoes.
• Pincer nail – a more common cause of ingrown toenails among older adults, a pincer nail is the term used to describe a toenail that begins to curve across its length, so the middle of the nail is elevated and the edges curl downward. In some cases, the curvature can be enough to cause the edges to cut into the nail bed beneath.
• Congenital misalignment of nail – another surprisingly-common cause of ingrown toenails is a birth defect that causes the big toenail to be poorly aligned within the nail bed. This can cause the nail to grow in a skewed direction and ultimately become ingrown. Some cases will resolve themselves as the person matures, but others require treatment.

Nonsurgical treatment options

Nonsurgical options for treatment have proven to be effective and less-invasive than surgery. Not all cases of ingrown toenail can be treated without surgery, but the following are good options to consider first with the help of a dermatologist or podiatrist. Below are a few common nonsurgical treatments that can also address some of the causes listed above:

Nail packing

Nail packing is the insertion of cotton or another material into the space between the side edges of the nail and the skin. This method helps elevate the nail above the nail bed so it can grow clear of the skin. Nail packing can be accompanied by the use of antiseptic products, such as creams or liquids, especially if infection has appeared.

Nail packing involves daily removal and insertion of clean material into the space with an intent to slowly lift the nail away from the bed and skin. Once the nail has grown past the skin, material can be glued into place for a longer term to condition the nail's growth. Nail packing is most appropriate for situations where improper nail cutting or a compressed toe is the incipient cause.

Nail taping

Another non-aggressive, but effective, treatment for ingrown toenails is the use of nail taping. With this option, elastic medical tape is applied to the skin edges by the affected nail. The tape applies force to the skin and pulls it away from the nail. The tape is reapplied on a daily basis, and the treatment is continued until the nail has cleared the skin. Taping is easy, as sufferers can be taught to tape their own nails, but excessive moisture such as perspiration can lessen the effectiveness of the treatment if the tape slips.

Nail bracing

A treatment option that is ideal for older adults with pincer nails is the use of nail braces. These braces consist of lateral pieces of wire, plastic or other stiff substances that apply pressure to the nail itself. Nail braces can either push down or pull up the toenail, depending on the desired result. For treating pincer nails, nail braces work well by lifting the sides of the nail to reduce its curvature and eliminate cutting into the nail bed.

Prevention

Ultimately, the best way to keep ingrown toenails from becoming a problem, or from returning, is by using a few simple foot care methods. Here are a few things you can do to keep ingrown toenails away:

• Regularly soak your feet in warm water – soaking your feet softens toenails and soothes adjoining tissues. This can be helpful if you have pincer nails or a congenital misalignment; removing rigidity and keeping toenails pliable can allow them to grow with less constriction and more flexibility.
• Cut your toenails properly – be sure to cut toenails straight across; cutting in an arc-shape allows the edges to intrude upon the nail bed and surrounding skin.
• Wear appropriate footwear - likewise, tight shoes can cause nails to be compressed downward and into the nail bed. Wear shoes with less-restrictive toe caps, and try to go barefoot for several hours per day to allow your nails to naturally pull away from the nail bed.