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Understanding ingrown nails
Ingrown nails don’t just happen to your toes. Your fingernails can also become ingrown. This occurs less frequently in fingers because you’re not squeezing your fingers into shoes that don’t fit well. Also, the shape of your fingernails makes it less likely that they will become ingrown.
However, ingrown fingernails do happen and they can become infected. This makes everyday tasks such as typing on a keyboard or doing the dishes painful.
Your nails and skin are made of a protein called keratin. Nails are formed when dense layers of keratinized cells push to the surface of your finger. Ridges on your nails correspond to skin ridges underneath your nails. These help hold your nails in place.
When the shape of your nail changes, the ridges that hold your nail in place can lose their connection. This can cause the nail to grow into the sides or corners of your skin. This is known as an ingrown nail. A number of things can cause this, including:
Paronychia is an infection in the tissues surrounding a fingernail or toenail. In most instances, the finger is infected by Staphylococcus aureus, a common staph bacterium, or by the fungus candida. Infections may progress to full-blown, painful abscesses. If an infection persists without treatment, there is risk of more serious infection and permanent damage to the nail.
Unless you have diabetes or another medical condition that places you at special risk, you may be able to successfully treat an infected fingernail at home. The steps are simple.
- Apply warm compresses or soak the finger in warm, soapy water for 10 to 20 minutes, at least twice a day.
- Apply antibiotic or antifungal cream.
- Keep the infected area covered with a sterile bandage.
When an ingrown fingernail causes a severe infection, particularly if an abscess forms, your doctor may recommend one of several medical procedures.
You or your doctor may gently lift up the nail and insert a small wedge of medicated cotton between your nail and the inflamed skin next to the nail. This can relieve pain and enable the nail to grow properly.
Draining an abscess
If your ingrown fingernail has developed into an abscess, a doctor should drain it. Your finger will be numbed with local anesthesia in the doctor’s office before an incision is made to drain the pus. If there is significant drainage, the doctor may place a gauze piece, or wick, in the incision so it may continue to drain for a day or two.
Ingrown fingernails rarely require surgical treatment. Surgery is more common with ingrown toenails. However, if an ingrown nail doesn’t resolve on its own, you may need to see a family doctor or dermatologist for a surgical solution.
Doctors commonly use a procedure called nail avulsion. This involves removing a portion of the nail to allow the infected area to drain and heal. It’s performed in the doctor’s office using local anesthesia to keep the area numb.
You generally don’t need to go to the doctor for an ingrown fingernail, but you do need to be vigilant about your care. What may seem like a routine infection can rapidly progress to something more serious.
A felon is an infection that has spread deep into the fingertip. More uncommonly, an untreated infection from an ingrown fingernail can cause an inflammation of the underlying bone, called osteomyelitis. These infections require medical attention.
See your doctor immediately if you have any of the following symptoms: