6 Reasons Why Your Ingrown Toenail Keeps Coming Back

Ingrown toenails are more than a just a looks thing, they can cause swelling, pain, or even infection. Even after surgery, there is a chance that your toenail can still grow back ingrown. Wondering why it keeps happening? Here's what to know.

6 Reasons Why Your Ingrown Toenail Keeps Coming Back

1. You're trimming your nails incorrectly

There is a proper way to trim your nails to lower the risk of getting an ingrown.

Your goal when trimming your nail is to trim either straight across with a nail clipper or with a very slight curve. File the corners with an emery board or glass file to smooth the edges.

Do not over-round the corners of your nails, or trim your nails in a U or V shape. Also, do not trim your nails too short.

Source: Melbourne Podiatry Clinic

2. Your shoes are too tight

Many types of shoes that are worn nowadays have a very narrow or tapered toebox, that comes to a point at the front. These styles of shoes cause pressure on your toenails and squeeze your toes against each other, and inside the shoe, which over time can increase your risk of developing an ingrown toenail.

An example of your average shoe vs a shoe with a natural shape (barefoot shoe). Source: Feelgrounds

3. You are picking at the skin around your toenails

Picking at the skin around your toenails, in an attempt to get rid of dry, rough, callused skin, or just as a habit will increase your risk of developing an ingrown toenail.

If you are dealing with dry, calloused, or rough skin around your toenails, using a pumice stone, or increasing how much you moisturize your feet can help with this.

4. If you had ingrown toenail surgery, the root of the nail wasn't burned

The medical term for ingrown toenail surgery is called partial nail avulsion or PNA. When the nail root is burned during this procedure, this is known as a partial nail avulsion with matrixectomy.

The majority of the time, when a partial nail avulsion or ingrown toenail surgery is done, the root is burned (matrixectomy) so that the corner never comes back. The nail looks normal, and within weeks, this area will be covered with skin. Without the nail root being burned or removed, the majority of ingrown nails, even if removed surgically, will come back ingrown again.

As a foot doctor, for the majority of my patients, I recommend the burning of the nail root.

5. If you had ingrown toenail surgery where Phenol was used, you could be resistant to it.

The two most common chemicals used for ingrown toenail surgery are Phenol and sodium hydroxide, or NaOH. There is no "wrong" chemical to use for this procedure, but people can respond to each chemical differently depending on their age, any health issues, and other reasons.

Phenol is typically gentler on the surrounding skin when it comes to ingrown toenail surgery, and for this reason, phenol is more commonly used to burn the nail root and prevent an ingrown toenail from coming back. The healing process is typically easier with Phenol, there is less redness, swelling, drainage, and pain.

Even though Phenol in partial nail avulsion with chemical matrixectomy has many benefits, there are some downsides as well:

Phenol is light-sensitive

• Phenol when exposed to light, weakens this chemical over time. When it is used in a partial nail avulsion, it will not work, and your ingrown toenail will keep coming back.

• Phenol should always be stored in a dark container, in a cabinet, away from any light, and only exposed to light once it's ready to be used during this procedure

Some people are more resistant to Phenol

• Even if the phenol is stored properly, and the partial nail avulsion is performed correctly, some people simply just do not respond to Phenol. This is another reason why your ingrown toenail keeps coming back.

If your ingrown toenail keeps coming back after surgery, it's worth it to have this procedure done again but using something like laser to burn the root, with minimal trauma to the rest of your toe, and a much faster healing time than using a chemical.

6. Your foot doctor attempted to burn your nail root with an infection in your toe

If an attempt to burn the nail root is done while there is active infection, specficially pus around the nail root, there is a high chance that the burning will not work.

This is because infection creates an acidic environment in your skin, and this type of environment neutralizes the chemicals used in ingrown toenail removal, making them not as strong.

If your foot doctor sees that you have a lot of pus around your nail root, they should allow this infection to drain for several days, then have you come back to the office to have the nail root burned. Sometimes, depending on how bad the infection is, an antibiotic can also be prescribed.

Allowing your toe time to drain is the best bet to be sure that once the nail root is finally burned, nothing comes back.

Key Takeaways:

When your ingrown toenail keeps coming back, it can be very distressing. From changing how you trim your nails, changing your shoes, or repeating the surgery to get rid of the ingrown toenail for good, there are several options you have to deal with this and get rid of your ingrown toenail for good.

Schedule Your Appointment At Direct Podiatry Arizona

Are you looking for a podiatrist in Phoenix who does surgical and non-surgical ingrown toenail removal? My name is Dr. Tarr, and I own Direct Podiatry Arizona in Tempe. To view my available appointment times, click here.