Ingrown Toenail (Excised)
You've had an ingrown toenail removed (excised) by a healthcare provider. An ingrown toenail occurs when the nail grows sideways into the skin next to the nail. This can cause pain and may lead to an infection with redness, swelling, and sometimes drainage.
An ingrown toenail may seem more like an inconvenience than a serious problem. But if you have diabetes, poor circulation, or a history of foot ulcers, an ingrown toenail can lead to serious complications. If you have any of those conditions, get medical care at the first sign of an ingrown toenail.
The most common cause of an ingrown toenail is trimming your toenails wrong. Some people trim the nails too close to the skin and try to round the nail too tightly around the shape of the toe. When you do this, the nail can grow into the skin and cause infection. It's safer to trim the nail to end in a straight line rather than a curve.
Other causes include injury or wearing shoes that are too short or tight. This can cause the same problem that happens when trimming your toenails. Sometimes you are born with a toenail that grows too large for your toe. Repeated trauma to the toes can also cause an ingrown toenail.
The most common symptoms of an ingrown toenail include:
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Pain
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Redness
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Swelling
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Drainage
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Odor
It's important to treat an ingrown toenail as soon as you notice there's a problem. If the irritation is mild, you may be able to take care of it at home. Home care includes:
Another method to help the toe heal is to use a small piece of cotton or waxed dental floss to gently lift the corner of the problem nail. Change the cotton or floss often, especially if it gets dirty.
If your infection is mild but home care isn't working, or the toenail is getting worse, see your healthcare provider. Signs that the infection is getting worse include:
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Swelling
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Redness
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Pus drainage
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Pain gets worse
In some cases, part of the toenail needs to be removed by your healthcare provider so that the infection can be drained.
If there's a lot of redness and swelling, then an antibiotic may also be used. The redness and pain should go away within 48 hours. It will take about 2 weeks for the exposed nail bed to become dry and for the swelling to go down.
If only the side of the nail was removed, it will start to grow back in a few months. To prevent recurrence, sometimes the side of the nail bed may be treated with a strong chemical to prevent the nail from growing back.
Home care
Wound care
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Change the dressing or bandage every time you soak or clean it. Or whenever it gets wet or dirty.
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If you were prescribed antibiotics, take them as directed until they're all gone.
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While your toe is healing, wear comfortable shoes with a lot of toe room or wear open-toe sandals.
Medicines
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You can take over-the-counter medicine for pain, unless you were given a different pain medicine to use. Talk with your healthcare provider before using these medicines if you have chronic liver or kidney disease. Also talk with your provider if you've had a stomach ulcer or digestive tract bleeding, or you're taking blood-thinner medicines.
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If you were given antibiotics, take them until they're all gone. It's important to finish the antibiotics even if the wound looks better. This ensures that the infection completely clears.
Prevention
To prevent ingrown toenails:
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Wear shoes that fit well. Don't wear shoes that pinch the toes together.
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When you trim your toenails, don’t cut them too short. Cut straight across at the top and don’t round the edges.
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Don’t use a sharp object to clean under your nail since this might cause an infection.
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If the toenail starts to grow into the skin again, put a small piece of cotton under that side of the nail to help it grow out straight.
Follow-up care
Follow up as advised by your healthcare provider. If the ingrown toenail recurs, follow up with a foot specialist (podiatrist) for nail bed ablation.
When to get medical care
Call your healthcare provider right away if any of these occur:
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You notice an ingrown toenail and you have one of these conditions:
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Diabetes
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Poor circulation
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A history of foot ulcers
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Increasing redness, pain, or swelling of the toe
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Red streaks in the skin leading away from the wound
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Pus or fluid keeps leaking for more than 24 hours
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Fever of 100.4°F (38°C) or higher, or as advised by your provider