You procrastinated making an appointment to see us, and now that painful, throbbing red ingrown toenail is waking you up in the middle of the night. We here at Central Massachusetts Podiatry see this scenario all the time. Better late than never, though. Once an ingrown toenail becomes seriously infected or chronic, soaking it at home in warm water is no longer enough. You need professional podiatric care.

Ingrown toenails, medically known as onychocryptosis, are extremely common and occur when the toenail grows into the skin on one or both sides, becoming painful and inflamed. Any toenail can become ingrown, but usually it occurs to the big toe.

The cause is most often either: ill-fitting shoes (sure, those tight pointy pumps look great), improperly trimmed toenails (usually too short), or an injury, such as stubbing your toe.

If you’re an avid walker, runner, or participate in sports, footwear that’s even slightly tight can result in an ingrown toenail. Countless professional athletes, from Nationals pitcher Stephen Strasburg to Chicago White Sox outfielder Avisail Garcia, have missed games while nursing ingrown toenails.

There are a few couple of different methods we use to treat infected or chronic ingrown toenails. The most common is partial removal of the nail at the edge where it’s ingrown. In severe cases, where the toenail is lifted and likely to eventually fall off, the entire nail may be removed. Both are office procedures and not nearly as scary as they may sound.

Often, antibiotics are prescribed in advance of ingrown toenail surgery, also known as toenail matricectomy or toenail avulsion, to wipe out any infection.

After that, here’s what you can expect when having a partial matricectomy. First, numbing medication is injected into the toe. Then, using special instrumentation a sliver of the ingrown nail is cut away and removed, along with a small portion of soft tissue at the edge of the nail. The area is then treated with three applications of the topical medication, phenol, followed by flushing the area with a solution of phenol and alcohol. The toe is then wrapped in a disinfectant-soaked gauze, dry sterile gauze and a bandage.

Once your ingrown toenail has healed, typically about 2-3 weeks, it’s important to practice healthy foot hygiene. That means: wearing shoes that fit, properly trimming toenails straight across and not too short, and not picking at or tearing your nails. And, as always, if you’re diabetic be sure and have routine foot examinations.