Well Worth It: Ingrown Toenail Care

There have been some great science reviews of practical tips recently! Here is the second of four proven, data-driven studies that you may not hear much about in the main-stream media (usually because of a lack of profit-driven PR). Be sure to forward the Well Worth It information along to those you care about who might benefit from the information! And stay tuned this month for two more.

Ingrown Toenail Review – Yeouch! Another painful, recurring problem – ingrown toenails. Medscape News did a nice summary of the review article on this problem in the journal American Family Physician (the journal article includes rankings of the quality of evidence to support all recommendations). While the article was written for doctors, is there anything that we mere mortals can use? The good news it – lots and lots.

First, ingrown toenail management recommendations include information about some factors which make you more likely to get ingrown toenails -

Toe (47)
Image via Wikipedia

information that you can use to reduce your chances of getting one. Things to avoid include 1) rounding your toenails (cutting straight across- and not too short – is best), 2) repetitive or unintentional trauma (get shoes that fit well and have what’s called a large “toebox” – and try to avoid having teammates land on your toes when you go up for a rebound!), 3) poor foot hygiene (give your tootsies a scrub every night and a regular straight-across nail-trim) and 4) wet feet (take a hand towel to the gym to dry off your feet and change socks after a sweaty work-out).

If you do all those things, will you avoid an ingrown toenail? Well, there are also other factors that are much harder to change: 1) genetic “bad luck” 2) design flaws in your lovely toes (worst = wider nail folds, thinner/flatter nails – although this has not been proven) and 3) diseases that cause your feet to swell.

So what do you do if you get an ingrown toenail? We like prevention best, but after prevention, what are the proven, evaluated recommendations for treatment? Nicely, many of them are cheap, relatively safe, and easy!

Including: 1) for mild to moderate redness, pain and swelling, “these may include foot soaks in warm, soapy water and application of topical antibiotic ointment or mid-potency to high-potency steroid cream or ointment; placement of cotton wisps or dental floss under the edge of the ingrown toenail; and gutter splinting, which may sometimes involve the placement of a sculptured acrylic nail.” There is no proven benefit to taking antibiotics by mouth. At all. None.

2) For moderate to severe ingrown toenail symptoms, the authors summarize the studies to recommend “surgical treatments may be appropriate, such as partial nail avulsion or complete nail excision with or without phenolization.” Even then oral antibiotics have shown no improved results, except in the case of treating post-surgical-procedure obvious infections.

Cautions: If you have diabetes, or damage to your nerves, your foot care is something your healthcare provider should coach! Don’t go it alone! And, for everyone, if you have an obvious toe infection, don’t assume it’s “just” an ingrown toenail without getting an evaluation. Bottom line: Effective treatment for ingrown toenails can be started at home – and often the recommended treatment does not require surgery, or antibiotics by mouth. Soak, soak, soak, carefully trim straight across, consider antibiotic ointment, and use floss or cotton fluff to pad the pokey-part of the nail.

Have a Well Worth It Tip up your sleeve? Be sure to share in the comments section.

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