Ingrowing Toe Nails and the antibiotic dilemma

Do I need antibiotics?

Ingrowing toe nails are a common problem that we see in our Urgent Care Centre. You can get them on any of your toes. They are often over treated with antibiotics and unnecessary medications.

Symptoms of an ingrowing toe nail include:

1. Swelling around the nail

2. Pain when applying pressure to the affected toe

3. Overgrowth of skin around the toe nail

4. Bleeding around the nail

5. White or yellow puss coming from the side of the nail

So what causes them?

1. Badly cut nails

2. Wearing tight shoes, socks or tights

3. Sweaty feet

4. Stubbing your toe or injuring the nail

5. Sometimes just the natural shape of the nail cuts cuts into the skin

The general advice to look after them is:

1. Soak in salty water at least twice daily

2. Keep your foot clean and dry for the rest of the day

3. Wear wide comfortable shoes to avoid any friction

4. Take simple painkillers to reduce any discomfort

5. Cut your nails straight across to avoid getting them in the first place

6. Gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin)

Things you should avoid:

1. Do not cut your toe nail any more-just leave it to grow out

2. Do not pick at your toe nail

3. Don’t wear tight, high healed or pointy shoes

You should only see a medical professional if:

1. You have diabetes and an infection could lead to significant harm

2. You have swelling and puss collected around your nail

3. There is redness extending past just around the nail bed itself

4. You have a fever or it is making you feel unwell

5. Pain is getting worse and home treatments have not helped after 2 weeks

A podiatrist should always be the first port of call for foot problems as they will be able to help you much more than a nurse practitioner or doctor can and will advice you to see a doctor if they feel you need antibiotics as this is their area of expertise.

We often get patients returning to Urgent Care Centres with ingrowing toe nails for repeat antibiotics as they have not helped over and over again, but most of the time the redness is just inflammation from the nail growing into the skin not actually an infection, so antibiotics will not help.