Forget everything you think you know about “ingrown toenails.”

For MOST cases, the name “ingrown toenail” is misleading. It implies that the nail, or a piece of the nail, is growing into the skin. So, people think they there is a piece of nail that needs to be removed.

THIS IS USUALLY WRONG! And people end up making things WORSE when they try to pick or remove the nail.

The better way to describe what is going on is to think about these toenails as “Overgrown Toeskin”, a phrase developed by Dr. Henry Chapeskie.

There is usually an initial injury to the toe skin, like stubbing your toe, or wearing too tight of shoes. And what happens when skin gets injured? It can inflame and swell.

From there,

• that swollen skin around the nail starts rubbing up against the rigid nail, and this nail pushing into it causing even more irritation and swelling.

• So, it can be a vicious cycle of things getting worse and worse, more inflamed.

• Then people often make it worse by trying to pick at the nail, causing even more irritation.

There is usually an initial injury to the toe skin, like stubbing your toe, or wearing too tight of shoes. And what happens when skin gets injured? It can inflame and swell.

From there,

• that swollen skin around the nail starts rubbing up against the rigid nail, and this nail pushing into it causing even more irritation and swelling.

• So, it can be a vicious cycle of things getting worse and worse, more inflamed.

• Then people often make it worse by trying to pick at the nail, causing even more irritation.

Most mild to moderate cases can resolve with just a few simple things:

• Leave the toes alone! Stop picking at them. As above, this only irritates things and makes it worse!

• Soak the toes in warm water a couple times per day. That will help soften things up and heal.

• Try to use open-toed footwear like sandals. The pressure and irritation for regular shoes against the toe may continue to irritate things.

• For ongoing prevention, make sure your shoes and footwear are properly fitting and not too tight.

Give things time to heal. It may take several weeks, but things should slowly improve and resolve.

As a general rule, antibiotics are NOT required and do not help ingrown toenails. Most of the redness, pus, and inflammation is more due to irritation, not infection.

At most, you may try over-the-counter Polysporin cream or ointment, if you wish.

If you have tried all of the simple suggestions, but things are not improving, you may consider getting a referral for surgery.

For years, people have been treated with “wedge resections”. This is where the doctor freezes your toe and then cuts the edge of the NAIL out. BUT, as explained above, most the time the NAIL is NOT the problem. So, people may end up with a deformed looking nail when it all heals.

Another method is the “Vandenbos Procedure”. This is where all the inflamed, overgrown skin is cut away. This procedure is more aggressive, takes more time to heal, but the nail looks perfectly normal when it’s all healed up, and there is rarely ever a recurrence.