asking for a friend: ‘amputation is all too common’ — why an ingrown toenail is a big deal

dear asking for a friend,  

signed, painful ugly foot  

dear painful ugly foot,  

ouch! an ingrown toenail , usually on the big toe, happens when the nail plate grows into the soft skin surrounding the nail, known as the nail folds. most people know when they have one because it can be sore when they bump their toe or slide their foot into a shoe, and it often comes with swelling and redness from inflammation.  

the real trouble starts if you just ignore it and the nail penetrates the skin, offering an entryway for bacteria — the result can be a bad infection, complete with yellow pus and stinky feet.  

worse, the infection can spread to the bone beneath the nail . then you could be facing problems with blood circulation within the bone and possible surgery to remove areas where the bone has died so that antibiotics can be effective.  

any infection can also lead to sepsis , which is blood poisoning by bacteria when your immune system goes into overdrive in response. it causes reduced blood flow to limbs and organs, and can lead to organ failure and even death.   

‘an ingrown toenail is a wake-up call to take care of your feet’

consider your ingrown toenail a wake-up call to take care of your feet, says peter ferguson, vice president of the college of chiropodists of ontario and a chiropodist in private practice for more than 30 years in peterborough, ont.   

“we get to see the ramifications of people who don’t take care of an ingrown toenail,” he says of foot doctors like himself. roughly one-third of patients have ingrown toenails. “you don’t want to ignore it and end up with a nasty infection.”   

the most common cause of an ingrown toenail is cutting toenails incorrectly. they need to be cut and filed straight across, since angling the sides of the nail encourages the nail to grow into the skin.   

other causes can be genetic predisposition where the nails are curved to begin with or the nail bed underneath the nail is really too wide for the toe. this could mean that “every month, you’re in this constant cycle of pain and discomfort of the nail growing into the skin,” says ferguson.  

another big offender is ill-fitting footwear that puts a lot of pressure on the big toes, so do socks and nylons that are too tight, or shoes that fit too closely or are too narrow for your feet.  

foot problems rising with wfh slippers

foot problems, including ingrown toenails, are on the rise because of the pandemic’s shift to working and schooling from home. people are wearing slippers a lot of the time where the foot slides around — that’s not good for toes and feet.  

ferguson recommends supportive, proper-fitting footwear like a running shoe, for example, that is snug, but not tight. and socks are fine, too, for some of the time.  

the effects of ill-fitting shoes are exacerbated by the “micro-trauma” to the feet that often comes with sports like football and soccer.  

in fact, ferguson has seen more than his share of teens, particularly males, with infected ingrown toenails. “usually a parent notices blood on a sock, sees the toe in horrible condition and gets them to the doctor,” he says. “ if you’re 15 and playing ball hockey and rugby in that gear, you can get an infection. they tend to ignore it, even if you can smell it down the corridor at school.”  

be careful, too, with salon pedicures that can lead to fungal infections that cause unusual nail growth and possible ingrown toenails, he warns. tools should be sterilized between clients and foot baths or bowls should be cleaned with hospital-grade disinfectant.      

the best remedy for an ingrown toenail is early treatment  

for healthy patients, he says start with soaking your feet in warm saltwater or water with epsom salts that calms inflammation and helps to draw out infection. if there’s a sharp point at the edge, gently lift the edge of the nail and file the nail. then, apply a topical antibiotic to help prevent infection.    

if the problem persists or pain worsens, see a foot doctor for consultation. partial nail removal is a highly successful in-clinic surgery where the doctor removes the piece of nail that is digging into your skin. the sides of the nail are cut away so that the edges are straight to avoid a recurrence.   

an ingrown toenail, however, can be far more serious for diabetics and people with chronic vascular circulation issues — more common for seniors — that put them at risk for amputation because they can’t fight off infection as easily.  

“amputation is way too common,” says ferguson. “i can’t overemphasize the need to see a specialist.”  

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asking for a friend: ‘amputation is all too common’ — why an ingrown toenail is a big deal

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