Infected Ingrown Toenail and Granuloma Removal

An ingrown toenail occurs either when the skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin, causing pain and inflammation.

This happens because it causes the blood supply to that part of the toe to increase. Any toenail can become ingrown, but it mostly affects the big toe.

Sometimes new tissue begins to grow over the nail and forms a small benign tumor known as a granuloma along the margins of the toe.

This is one of the most commonly treated conditions by the experts at JAWs Podiatry.

Ingrown Toenail

What Exactly Are Granulomas

The name Granulomas derives from the fact that this round, small vascular tumor resembles tiny granules.

While the exact cause of its appearance in conjunction with ingrown toenails isn’t exactly known, this benign growth contains many blood vessels that bleed easily even when slightly bumped.

They sometimes go away without any intervention, but in most instances, medical intervention is necessary. 

Ingrown Toenail Causes, Symptoms And Risk Factors

Ingrown toenails may develop for a number of reasons. Trimming nails too short, especially on the sides of big toes, can encourage a pathway for the nail to grow and dig into the skin.

Ingrown Toenail Causes Trimming Nails

Wearing shoes too tight or too short that crowd the toenails is another no no. Some less common causes are congenital.

A person can be born with a nail that is too large for the toe. Also, the stubbing of a toe or having a toe stepped on can cause an ingrown toenail to arise.

Symptomatically, an ingrown toenail in early stages may appear hard and tender to the touch. Later, it can become red, sore and infected at the corner of the nail and sometimes pus drains from the area.

This painful state is particularly common among teenagers due to hormonal alterations in their young bodies, which tend to sweat more than adults. This softens both the nail and skin.

Ingrown toenails also frequently appear in seniors suffering from diabetes and other medical maladies that hinder a normal blood flow to the feet.

3 Tips To Help Prevent An Ingrown Toenail

The following tips suggested by our expert staff can help to prevent an ingrown toenail before it begins.

1. Trim Your Toenails Straight Across

Never curve your nails to match the shape of the front of your toes even though that may that may seem the most logical thing to do at the moment. 

2. Maintain A Moderate Length On Toenails

Toe nails should always be even with the tips of your toes. If they are trimmed too short, shoe pressure on the toes can direct a nail to grow directly into the tissue.

3. Always Wear Properly Fitting Shoes

Shoes that are too tight can pinch or place pressure on toes and cause a nail to grow into surrounding tissue. Nerve damage from diabetes and other medical conditions may deaden sensations, and that is why it is important to check feet every day. Opt for protective footwear, like steel-toed shoes, if daily activities put your toes at risk for injury.

7 Common Misconceptions About Ingrown Toenails

Ingrown Toenails Always Go Away on Their Own – This couldn’t be further from the truth. If an ingrown toe nail is not cared for, it is destined to painfully return to the scene (your poor toe). In addition, there could be something else causing the pain, and only a proper diagnosis from a professional such as the experts at JAWS Podiatry, can really tell you what you are dealing with.

Ingrown Toe Nail Treatment can Always Be Performed At Home – This is partially true, as there are some conservative treatment measures that you can try before consulting an expert. The crux of the issue is to know if the problem really is an ingrown toenail and only an expert can tell you that. Action must be taken for resolution if home treatments do not resolve the problem.

The Shoes You Wear Have Nothing To Do With Ingrown Toenails – The wrong shoes provide the perfect avenue for the formation of an ingrown toenail. High-heels and other types of shoes that are too tight, too loose, or just don’t properly fit your foot are often the cause of painful ingrown toenails.

Cutting A Notch Or Curve Into The Nail Will Make It Grow Correctly – There is only one way to properly cut toenails and that is straight across the nail. Never cut a notch or curve into the nail and always sterilize clippers before use.

Using Dental Floss To Lift An Ingrown Toenail Will Solve The Problem – Not only won’t this action solve the problem, doing this can easily cause another bigger one; namely, an infection. An ingrown toe nail usually requires professional intervention for lifting, splinting or toenail removal.

Ingrown Toenail Treatments Are Always Complex and Painful – The experts at JAWS Podiatry can properly diagnose and treat an ingrown toenail with a 15 minute procedure that will not only remove the infected nail but also help prevent it from ever coming back again.

Ingrown Toenails Are Always Hereditary – While in its entirety, this is a false statement, there is a kernel of truth to it because ingrown toenails do tend to run in families. That being said, having a predisposition to this condition doesn’t mean it will happen, especially if you know how to prevent it in the first place. A little education from a trained professional can go a long way in keeping ingrown toenails out of your life.

What Are The Treatment Options For An Ingrown Toenail?

If there is inflammation, swelling, pain and a pus discharge, a toe nail is likely to be infected and must be treated. Antibiotics may be prescribed, and the nail may need either partial or complete removal.

In the case of the former, a portion of the nail, underlying nail bed, some soft tissue and even a segment of the growth center may be surgically removed in a process known as partial nail avulsion.

This treatment can effectively prevent the nail edge from growing inward and cutting into the flesh as the toenail grows. Permanent removal (complete nail avulsion ) is often recommended for children who suffer from chronically recurrent ingrown toenails.

In Conclusion

If you reside in southern Florida and are suffering from recurring foot pain, our highly trained experts at JAWS Podiatry are always here to help.

We are an avant garde, lower extremity center headed by Dr. Abraham Wagner, the region’s top-rated and highly-acclaimed Doctor of Podiatric Medicine (DPM). 

Collectively, his carefully culled staff are all highly specialized experts in foot and ankle care and serve patients living in Florida, the United States and beyond.

Services include: podiatric care, treatment and therapy, foot and ankle surgical procedures, regenerative medicine as well as platelet rich plasma (PRP) therapy. 

If you are suffering from foot or ankle pain of any kind, call our teams at JAWS Podiatry.

We can relieve your pain and improve the quality of your life. Don’t wait any longer to reclaim your quality of life!


Watch as Dr. Wagner quickly removes an ingrown toenail and pyogenic granuloma.

Video Transcription

Welcome everyone to….JAWs Podiatry. I have a dear friend of mine here whom I have known for many, many, many years. This is going to be quite interesting. We won’t laugh too, too much. He has presented this office today with a severe ingrown toe nail that is also known as a parneke. He calls me up and he’s like, Wagner, I need your help. I said, so what’s going on? He sends me a picture of the…We have an ingrown toenail, lateral border. So without further adieu,…we will decide what we will do with the granuloma…The… nail plate has been removed…The granuloma we are talking about is a benign, vascular proliferation of tissue, and I am going to go ahead and take this little piece off. Why not? And take that one. Okay- this here is known as Proud or Proud Flesh. Some people would cauterize it with a little silver nitrate. I am going to go ahead and do that. Let me just check back here. There is nothing here. The …granuloma will definitely reabsorb on its own. This definitely is going to alleviate the pain and I already feel better for him. As always,…go ahead and smile. I’m not sure if he is laughing at me or with me. Like always, if anyone has any questions, you guys know where to find us and I hope everyone has a wonderful weekend. Enjoy.