Ingrown toenails are a universal problem--anyone can suffer from them! The term "ingrown toenail" refers to the way the edge of your toenail curves down and pokes into your skin. Any toe can be affected, although big toes are the most susceptible to develop ingrown nails. Left untreated, ingrown toenails can lead to potentially serious complications, such as skin and bone infections.

Causes
Poorly fitting shoes are often held responsible for ingrown toenails, particularly if the toe box is too tight. In teenagers, ingrown toenails sometimes occur because their feet sweat more. This abundant sweat causes their skin and nails to become soft and easier to split. The split pieces of nail can in turn easily puncturethe skin on the nail edges. In older individuals, ingrown toenails often result from their inability to properly take care of their feet. Improper nail trimming can also lead to ingrown toenails, particularly in people who habitually "round off" the cornersof their toenails. Traumatic toe injuries and infection can also cause ingrown toenails. In some cases, ingrown toenails run in families.

Signs & Symptoms
Ingrown toenails often cause pain and can therefore limit your activities, particularly physical exercise. You may also notice hardness, swelling and redness in the skin around the affected ingrown toenail. Typically, the pain and redness are proportional to an ingrown toenail's severity. If the area becomes infected or turns black, consult a doctor as soon as possible. Possible signs of an infected ingrown toenail include fever, fluid or pus formation in the affected area.The change of color to black could indicate necrosis, which is the death of cells or tissues in the affected area.

Diagnosis
A doctor typically assesses and diagnoses ingrown toenails by examining your nails and toes. If there are signs of infection, he or she may takea sample of pus or fluid and request a laboratory study to determine the specific organisms that are causing the infection. Knowing this would help select the most effective antibiotic. The amount of swelling, redness, drainage and pain generally determines the severity of your case. However, even if you're not in severe pain, an infected ingrown toenail will usually be considered as severe.

Conservative Treatment
Mild to moderate ingrown toenails respond well to conservative care. You may treat them with10 to 20 minute-long foot soaks in warm, soapy water. After each soak, applya topical antibiotic ointment, such aspolymyxin/neomycin (Neosporin). An alternative to the antibiotic ointment would be a mid- to high-potency steroid cream or ointment applied to the affected area several times daily for a few days until the symptoms resolve. Another conservative approach consists in gently lifting the nail edge and placing wisps of cotton under it. In the office, your doctor may also opt for a gutter splint affixed to the ingrownnail edge with either adhesive tape or a formableacrylic resin.In some cases, a sculptured acrylic artificial nail can also be used. Treatment duration generally ranges from two weeks to three months, which is the time required for normal nail to grow.

Surgical Treatment
Severely infected or recurrent ingrown toenails may require nail removal. Your doctor will usually remove part of nail, but in some cases, total nail removal may be recommended. He or she will typically numb the affected toe and use surgical instruments to cut away the ingrown part of the toenail. If you have an infected toe with an ingrown toenail, you will also need prescription-strength antibiotics. Promptly seeking care is especially important for diabetics who have ingrown toenails, because they can lead to serious complications, such as foot ulcers.

Management &Prevention Guidelines
- Always wear clean socks.
- If you're currently undergoing conservative treatment or recently surgical treatment, wear open-toed shoes while your toeheals.
- Maintain clean feet and make sure to clean the areas around your nails after a bath or shower.
- Only wear well-fitting shoes. For a more accurate fit, have your feet measured and shop for shoes in the evening, when your feet are more swollen.
- Cut your toenails properly, straight across withno rounded corners
- Do not leave sharp edges when cut your nails, as they could grow into the toe around thenail.
- Do not tear your toenails off.
- Call your doctor if you develop a fever or notice a red streak going from your foot up your leg.