Toenail Pain: Causes and Treatment Options - Dermatology

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Hello Tong Tong,
I'm sorry to hear about the discomfort you're experiencing with your toenail. Toenail pain can arise from various causes, and it’s essential to understand the underlying issues to determine the best treatment options. Based on your description, it sounds like you may be dealing with a condition known as "ingrown toenail," which occurs when the edge of the toenail grows into the surrounding skin. This can lead to pain, swelling, and even infection, especially if you have been trimming the nail excessively and causing bleeding.


Causes of Toenail Pain
1. Ingrown Toenails: This is the most common cause of toenail pain. It often occurs when the toenail is cut too short or grows abnormally. The nail can dig into the skin, causing inflammation and pain.

2. Trauma: If you have injured your toe, whether from stubbing it or from tight footwear, this can lead to pain and discomfort.

3. Fungal Infections: Fungal infections can cause the toenail to become discolored, thickened, and painful. This is often accompanied by a foul odor.

4. Paronychia: This is an infection of the skin around the nail, which can occur if the skin is broken (for example, from excessive trimming) and bacteria enter.

5. Nail Disorders: Other nail disorders, such as nail psoriasis or nail dystrophy, can also cause pain and discomfort.


Treatment Options
1. Home Care:
- Soaking: Soaking your foot in warm, soapy water can help reduce swelling and relieve pain. You can do this for about 15-20 minutes, a few times a day.

- Proper Trimming: Avoid cutting your toenails too short or rounding the edges. Instead, cut them straight across to prevent them from growing into the skin.

- Footwear: Wear comfortable shoes that provide enough room for your toes. Avoid tight shoes that can exacerbate the problem.

2. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.

3. Antibiotics: If there is an infection (indicated by increased redness, swelling, or pus), a healthcare provider may prescribe antibiotics.

4. Medical Treatment: If home remedies do not alleviate the pain, or if the condition worsens, it’s important to see a healthcare professional. A podiatrist or dermatologist can assess the situation and may perform procedures such as:
- Partial Nail Avulsion: This involves removing part of the toenail to relieve pressure and pain.

- Matrixectomy: In severe cases, the nail matrix (the tissue under the base of the nail) may be destroyed to prevent the nail from growing back.

5. Preventive Measures: Once the immediate issue is resolved, consider preventive measures such as regular foot care, wearing appropriate footwear, and maintaining proper nail hygiene.


When to Seek Medical Attention
You should seek medical attention if:
- The pain is severe and not relieved by home treatments.

- You notice signs of infection, such as increased redness, swelling, or pus.

- You have underlying health conditions, such as diabetes, which can complicate foot issues.

In summary, while it’s possible that you may have an ingrown toenail or another condition causing your toenail pain, proper care and treatment can help alleviate your symptoms. If the pain persists or worsens, please consult a healthcare professional for a thorough evaluation and appropriate treatment. Take care of your feet, and I hope you feel better soon!