Ingrown Toenails – Beware – An Advisory in 2004 from ROJoson et al – Still Relevant Today!

Prevent ingrown toenails to avoid operation!

(An advisory in 2004 and still valid today, 2012!)

Grace Naomi Braganza Galvan, MD (An Intern in Manila Doctors Hospital in 2004)

Hazel Turingan, MD (A Surgical Resident in Ospital ng Maynila Medical Center in 2004)

Reynaldo O. Joson, MD


Manila Doctors Hospital

Ospital ng Maynila Medical Center

What is an ingrown toenail?

Ingrown toenail is a condition in the toe in which a spicule of the nail plate lacerates the fold on the side of the nail and leads to painful irritation, inflammation, infection and growth of excessive tissue. The resultant site of injury may become inflamed and then infected.

How do ingrown toenails occur?

The common causes of ingrown toenail in the Philippines are wearing of tight-fitting shoes which causes the toes to be compressed together and forces the nail to grow abnormally and improper trimming of toenails which causes the corners of the nail to dig into the skin.

Ingrown toenail evolves in three stages:

  1. pain, slight induration (hardening), and redness along the lateral nail fold;
  2. increased pain and redness accompanied by infection and pus formation; and
  3. chronic infection leading to the development of excessive tissue in the lateral (on the side) nail fold.

How is ingrown toenail usually being treated?

Treatment of an ingrown toenail depends upon the patient’s stage at presentation and ranges from elevation to removal of lateral nail plate.

In the early stage, elevation of the lateral nail edge can be tried by using the sharp edge  of a  broken cotton- tipped applicator to gently place a cotton wisp under the nail which should be changed daily.

In the late stage, one already with excessive friable painful tissue on the lateral fold, operation under anesthesia will be needed to remove a longitudinal portion the lateral nail plate.

Analgesics are given to painful ingrown toenails.  Antibiotics are usually not needed as long as the toes are constantly cleansed with soap and water to keep them clean.

Magnitude of the ingrown toenail as a health problem in the Philippines

Ingrown toenails requiring operations are quite common in the Philippines.  They are seen in both sexes.  In a survey in Manila Doctors Hospital in 2003, a total of 31 patients with ingrown toenails were operated on.  Their ages ranged from 18 to 50 years of age with a 3:2 male:female ratio.  In a survey in Ospital ng Maynila Medical Center in 2003, a total of 40 patients were operated on.  Their ages ranged from 19 to 50 years of age with an equal male to female ratio.

Why is ingrown toenail considered a public health problem?

It is very common and it is totally preventable.  Preventing it will avoid the pain of a ingrown toenail and its subsequent operation and of course, medical expenses.

How to prevent an ingrown toenail?

The most important method of prevention is careful clipping of the toenails. They should be clipped straight across taking care to keep the end longer than the skin edge. This prevents the corners from digging into the skin. They should not be rounded or cut too short.  Those having their toenails trimmed by pedicurists should ask the latter to follow the aforementioned preventive measures.

Another important method of prevention of ingrown toenail is to avoid tight -fitting shoes.

Advisory: Please prevent ingrown toenail at all cost.  It is totally preventable.  We hate operating on you, on your toes.


Updated in 2012

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