Recurrent redness, swelling, and pain in toenails? Physician's analysis of ingrown toenails, curled toenails, and timing of seeking medical attention
The toenails are repeatedly painful, swollen, and even difficult to wear shoes or walk, so be careful that they may be embedded or curled. Many people think that cutting both sides of their nails short, or even digging out the nails stuck in the flesh, can solve the problem, but the more they cut, the more painful it becomes. Physicians remind that the symptoms of ingrown toenail, curled toenail, and paronychia are somewhat similar, but the causes and treatment methods are different. If not handled properly, it may lead to recurrent inflammation, infection, and even require further treatment.
Opening dermatologist Zhuang Liqian said that outpatient clinics often encounter people with recurrent pain and redness in their big toes. Some people have already cut their nails deep on both sides, even using tools to dig nail grooves, but it hasn't been good yet. After inspection, it was found that the fundamental problem was the direction of nail growth, degree of curvature, or long-term stimulation of surrounding tissues.
Zhuang Liqian pointed out that nail embedding, commonly known as "frozen nail", mainly occurs when the edge of the nail is embedded into the surrounding skin, most commonly in the big toe. If the nails keep rubbing and irritating the skin, it may cause pain, redness, and even suppuration, leading to paronychia. Curling the nail is when the nail is bent too much, gradually curling inward on both sides, and the appearance may be clearly curved, pressing down on the surrounding tissues of the nail groove.
Curling nails may not necessarily cause inflammation, but it may increase the risk of nail entrapment, and both may occur simultaneously. Choose different treatment methods based on the degree of nail deformation and the presence of infection. Zhuang Liqian said that many people are accustomed to cutting their nails as short as possible on both sides, thinking that this will not pierce into the flesh. In fact, excessive trimming on both sides may cause newly grown nails to pierce the skin again, forming a vicious cycle of repeated pain and inflammation.
If there is only slight nail embedding without obvious infection or suppuration, conservative treatment can usually be carried out first, including adjusting the nail cutting method, choosing shoes with wide toe tips, and reducing toe compression. If necessary, cooperate with local treatment to allow the stimulated skin to slowly recover. But if there are already obvious symptoms of paronychia such as redness, swelling, pain, and pus discharge, it is not enough to rely solely on nail trimming. Physicians will perform wound cleaning, local care, and medication if necessary to prevent the infection from worsening based on the degree of inflammation or infection.
For patients with recurrent attacks, frequent nail penetration into the skin, or obvious deformities, it is not necessary to remove the entire nail. Zhuang Liqian said that some patients can improve by locally removing the nails that cause irritation, while others require further treatment of some nail roots to reduce the chance of recurrence. Some patients with embedded or curled nails can also evaluate the use of a nail correction bracket, which continuously applies force through a device fixed to the nail, gradually adjusting the direction of nail bending.
Zhuang Liqian reminds that to prevent nail biting, do not cut too deeply, especially on both sides of the nails, and do not wear shoes that squeeze your toes. If toenails repeatedly hurt, become red, swollen, or suppurative, or if nails become increasingly curved and often get stuck in the flesh, it is important to see a doctor early to assess and identify the true cause. Don't dig or cut your nails yourself, lest small problems become long-term troubles.
