An ingrown toenail can be an annoying and often painful condition that occurs when the corner or side of a toenail grows into the soft flesh of the toe. While ingrown toenails can sometimes heal on their own, they often require treatment to prevent complications. So what exactly happens if you just leave an ingrown toenail alone and let it keep growing? Here’s a look at some of the potential effects.
It will likely become more painful
One of the first things that will happen if an ingrown toenail is left untreated is an increase in pain and discomfort. As the nail digs deeper into the skin, it can cause swelling, redness, and a buildup of fluid. This added pressure and irritation will make the area around the nail increasingly tender and achy.
Many people describe ingrown toenail pain as a sharp or even throbbing sensation. This is the body’s way of signaling that something is wrong and needs attention. Ignoring this pain and avoiding treatment allows the problem to become more severe, making everyday activities like walking, wearing shoes, and even just having a sheet or sock touch the area very unpleasant.
Infection may develop
Another common consequence of leaving an ingrown toenail untreated is the development of an infection. When the toenail grows into the skin, it creates an entry point for bacteria. The warm, moist environment under the nail is ideal for germs to multiply.
Signs of an infected ingrown toenail include:
- Increased pain, swelling, and redness around the nail
- Presence of thick, smelly pus or drainage
- Streaks of redness spreading from the site
- Fever
If the infection progresses, antibiotics may be needed to clear it up. Severe infections can even require hospitalization.
Greater risk of the nail growing into the toe
The longer an ingrown toenail is left alone, the more embedded into the toe it can become. It’s not uncommon for untreated nails to curve downward and dig deep into the flesh, sometimes as far down as the bone.
Attempting to dig out an ingrown nail that has grown extensively into the toe can be incredibly painful. It often requires a podiatrist to numb the area before using specialized tools to carefully extricate the overgrown nail.
Letting the nail continue invading the toe increases the odds of permanent damage and scarring. It also raises the risks of the nail growing back ingrown again after it’s finally removed.
Chronic ingrown nail may develop
An ingrown nail that keeps growing untreated can eventually become chronic, meaning it doesn’t get better on its own and persists or keeps recurring. These long-term ingrown nails are more difficult to manage.
The surrounding toe tissue often becomes very swollen, tender, and misshapen after coping with an embedded nail for so long. Extensive ingrown nails may need to be partially or fully removed for good healing to occur.
Can lead to more serious complications
While rare, further problems can develop if an ingrown toenail is allowed to progress unchecked. Some potential complications include:
- Cellulitis – a serious spreading bacterial skin infection that extends beyond just the site of the nail into the deeper tissue.
- Gangrene – dead skin tissue due to a loss of blood supply, often requiring surgical removal to stop it from extending.
- Foot ulcer – an open sore that won’t heal, which can increase the risk of a limb-threatening foot infection in people with diabetes.
- Osteomyelitis – an infection of the bone that may necessitate intravenous antibiotics or even amputation in severe cases.
These extreme complications reinforce the importance of having an ingrown nail evaluated and treated promptly before the problem progresses.
Permanent toenail loss
In rare instances, a badly neglected ingrown toenail may cause permanent damage leading to loss of the nail altogether. This can occur if the chronic irritation and swelling distorts the nail matrix – the part of the toe that controls nail growth.
Total nail loss is more likely if the ingrown nail also becomes severely infected. Surgical removal of the toenail may be recommended in cases where the nail matrix is too damaged for the nail to properly regrow.
When to seek ingrown toenail treatment
While it’s possible for mild ingrown toenails to improve on their own, it’s always a good idea to have a podiatrist evaluate any nail that is starting to dig into the skin. Signs that it’s time to seek medical treatment include:
- Unremitting pain and tenderness in the toe that lasts more than a few days
- Swelling, redness, drainage, or bleeding around or under the nail
- Discoloration of the nail
- Difficulty walking normally
- Visible distortion in the shape or direction of nail growth
- Inability to properly trim or manipulate the ingrown section of nail
The earlier an ingrown nail is professionally treated, the better the outcome. Catching the problem before the nail burrows too far into the toe improves healing time and reduces the need for more invasive procedures.
Home remedies to try
For milder cases of ingrown toenails without infection, some home care methods may help provide relief while waiting for a doctor’s appointment:
- Soak the foot in warm water several times a day
- Wedge a small cotton ball or dental floss under the nail edge to help lift it out of the skin
- Apply over-the-counter antibiotic ointment to prevent infection
- Take over-the-counter pain relievers like acetaminophen or ibuprofen
- Wear open-toed shoes or sandals until it heals
- Avoid tight shoes and socks that put pressure on the toe
However, see a foot doctor promptly if home care doesn’t bring improvement within a couple days. Self-treatment is not a substitute for professional ingrown toenail care.
Medical treatment options
Doctors have several approaches for dealing with troublesome ingrown nails:
Nail trimming
Careful trimming and thinning of the nail edge to remove any embedded portions can provide rapid pain relief if done properly. This minor procedure may be enough to allow mild or partial ingrown nails to recede out of the skin on their own.
Surgical nail edge removal
For nails that remain painfully ingrown despite conservative trimming, surgical removal of the side edge digging into the skin may be warranted. This can be done using a scalpel or laser under local anesthesia.
Permanent nail edge destruction
Some methods like phenol or sodium hydroxide can be applied to chemically destroy the nail matrix on the affected side to prevent regrowth. Electrical or surgical cauterization can also permanently prevent recurrence.
Partial nail removal
In severe cases, permanent partial removal of the toenail may provide definitive relief when a significant portion is embedded. This can be done with a laser or surgical excision. The remaining nail is left to regrow normally.
Complete nail removal (matricectomy)
Total permanent toenail removal is sometimes required for badly chronic ingrown nails, especially if the nail matrix is damaged. Chemical matricectomy uses phenol to ablate the entire nail matrix and prevent regrowth.
Outlook for untreated ingrown toenails
The prognosis for an ingrown nail depends on multiple factors, including:
- How long it has been present
- Depth of nail penetration into the skin
- Presence of complications like infection or chronic inflammation
- Any underlying medical conditions like diabetes
- Adherence with recommended treatment
While many mild cases will resolve on their own with simple at-home care, professionals encourage having any ingrown nail assessed to ensure proper healing. Waiting too long raises the risks of a painful infection, chronic recurrence, and other potential complications.
With timely treatment, most people can get prompt relief and avoid any long-term issues with the affected toenail. Catching it early is key.
Preventing ingrown toenails from recurring
Someone who has experienced one ingrown toenail is at higher risk of getting another. Here are some tips to help prevent recurrence:
- Trim nails straight across instead of rounded or tightly curved at the edges
- Avoid picking at nail edges
- Wear properly fitted shoes to avoid pressure on the sides of nails
- Apply petroleum jelly to nail edges to soften skin and keep the nail growing out normally
- Have a podiatrist remove the permanently destroyed nail matrix if you’ve had reoccurring ingrown nails (chemical matricectomy)
Keeping nails neatly trimmed and allowing them to grow out over the ends of the toes can also help prevent future ingrown toenail issues. See a podiatrist promptly at the first sign of recurrence.
When to see a doctor
Ingrown toenails that show no improvement within 2-3 days of home treatment or that exhibit signs of infection should be evaluated right away. Other reasons to schedule an urgent podiatry appointment include:
- Unbearable, throbbing pain in the affected toe
- Sudden difficulty walking
- Pus or blood draining from the nail
- Fatigue, fever, and chills signaling infection
- Diabetes or impaired circulation in the lower extremities
- Very red, warm, swollen toe
Severe ingrown nails may need antibiotics or even surgical procedures like partial nail removal and matricectomy. Don’t delay getting professional care.
Takeaway
Ingrown toenails can often be treated at home with conservative measures during the early stages. However, allowing them to progress can lead to complications like unpredictable pain, infection, chronic recurrence, and toenail deformity or permanent loss in some cases.
While complete nail loss is relatively uncommon, the potentially infective and debilitating nature of uncontrolled ingrown nails means timely treatment is highly recommended. Seek podiatry care promptly if you notice a nail edge beginning to dig into the skin. Resist any urge to just leave it alone – early intervention leads to the best outcome.