Therapeutic pedicure in Coimbra
Ingrown toenail in Coimbra
Onychocryptosis
An ingrown toenail is not fixed by cutting deeper. At the appointment the fragment that is hurting is removed, the inflammation is treated and, when the shape of the nail is the cause, a brace corrects it so it does not return.
What it is
An ingrown toenail (onychocryptosis) happens when the edge of the nail — almost always on the big toe — grows into the surrounding skin and pierces it. The skin reacts as it would to any foreign body: it becomes inflamed, painful and, if nothing is done, infected.
There are three stages. At first there is only pain on pressure and some redness. Then the area swells, feels warm and may discharge pus. In a more advanced stage a red, bleeding tissue forms around the edge — granulation tissue, or “proud flesh” — a sign the problem has become chronic.
Signs and symptoms
- Pain when wearing shoes, walking, or when the bedsheet touches the toe.
- Redness and swelling on one side of the nail, or both.
- Warm, shiny skin that is tender to the touch.
- Pus or blood coming from the nail edge.
- Red tissue growing over the nail that bleeds easily.
Most common causes
- Wrong cutting: nails cut too short or rounded at the corners leave a point that digs into the skin as it grows back.
- Tight or narrow-toed shoes that push the skin against the nail.
- Nail shape: strongly curved (“pincer”) nails ingrow more easily, and the tendency often runs in families.
- Repeated trauma, as in football or running, or a knock to the toe.
- Excessive sweating, which softens the skin and lets the nail penetrate.
- Nail changes from fungus or age that make it thicker and irregular.
How it is treated
In the vast majority of cases an ingrown toenail is treated conservatively, without surgery or anaesthesia. The aim is to remove what is hurting — the spicule, the small fragment of nail embedded in the skin — and leave a smooth edge so the skin can settle and heal.
When the nail keeps ingrowing because it is too curved, the solution is a nail brace: a small spring or band bonded to the nail that, over weeks to months, gently lifts and straightens it as it grows. It is painless, does not stop you walking or wearing shoes, and is followed up with periodic reviews to adjust the tension.
As a nurse, Priscila also treats the inflammation and any associated wound. Cases that do not respond to conservative treatment — extensive infection, persistent recurrence — are referred for medical assessment, where partial surgical correction of the nail (matricectomy) may be indicated.
What happens at the appointment
- 1Assessment of the toe, the nail shape, your footwear and how you cut your nails.
- 2Careful removal of the spicule and cleaning of the nail groove.
- 3Treatment of the inflammation and, if there is a wound, an appropriate dressing.
- 4Fitting of a nail brace when the curvature is the cause, with maintenance every 4 to 8 weeks.
- 5Cutting and footwear instructions to stop it coming back.
What you can do at home
- Cut nails straight across, without rounding the corners, and not too short: the edge should extend slightly beyond the skin.
- Do not try to dig out the corner with scissors or clippers: it worsens the inflammation and invites infection.
- Warm salt-water foot baths, 10 to 15 minutes, 2 to 3 times a day, ease the pain and help keep it clean.
- Wear shoes with room for the toes and cotton socks; avoid pointed toes and high heels while the nail is inflamed.
- Keep feet clean and dry and change socks daily.
When not to wait
Book without delay — or see a doctor — if you notice any of these signs:
- Pus, an unpleasant smell, redness spreading along the toe or foot, or fever.
- You have diabetes, poor circulation or reduced sensation in your feet: do not treat at home; book at the first signs.
- The pain does not improve after 2 to 3 days of home care, or gets worse.
- The nail keeps ingrowing despite cutting it correctly.
Frequently asked questions
Does an ingrown toenail need surgery?+
In most cases, no. Spicule removal and a nail brace resolve most situations without surgery. Surgery — removing part of the nail and its root — is reserved for recurrent or very advanced cases and is done by a doctor, to whom we refer when needed.
Does the treatment hurt?+
Removing the spicule is quick and, with the right technique, very well tolerated — relief is immediate because nothing is digging into the skin any more. Fitting the brace is painless.
How long does the brace take to work?+
Pressure relief is almost immediate. Correcting the nail shape follows nail growth, which is slow on the foot: as a rule, a few months, with periodic reviews to adjust the brace.
Can I treat an ingrown toenail if I have diabetes?+
You should, and the sooner the better. With diabetes, a small inflammation next to the nail can turn into a serious infection. Tell us when booking that you have diabetes so the appointment can be prepared accordingly.
This information is general and meant to help you understand the problem. It does not replace an individual assessment or medical follow-up. If in doubt, book an appointment. Content reviewed by Priscila Arantes, registered nurse (Ordem dos Enfermeiros no. 117508).
Other problems we treat
Thick or deformed nails
Nails that thicken or change shape become impossible to cut at home and hurt inside the shoe. With the right instruments they become thin, short and comfortable again — and the reason for the change is looked into.
Learn more →Wounds and dressings
A wound on the foot has body weight, shoes and, often, circulation that is no longer at its best working against it. Healing well depends on cleaning, protecting and relieving pressure — and on seeing the wound at the right intervals.
Learn more →Podiatric risk
With diabetes, and other conditions that affect circulation or sensation, the feet need monitoring even without complaints — because the problem is often that you stop feeling. The appointment is there to see what you cannot feel and to treat safely what would be a risk at home.
Learn more →Corns and calluses · Nail fungus · Plantar wart · Cracked heels and fissures