You may think toenail problems are small stuff, but trying to do the activities of daily survival with an ingrown toenail is a big deal in times of trouble. When you have to be at 110% efficiency, you sure don’t want to have pain every time you take a step.
An ingrown toenail (also known as Onychocryptosis) occurs when the edge of the nail grows down and into the skin of the toe. There may be pain, redness, and swelling around the nail. It can occur for a number of reasons, but poorly fitting shoes and poorly trimmed toenails are the most common causes. The big toe is usually affected, but any toenail can become ingrown.
Symptoms of an Ingrown Toenail
The skin along the edge of a toenail that is ingrown may appear:
- Vaguely warm to the touch
Infection could easily occur, even to the point of draing pus from the area.
Ingrown Toenails and Shoes That Are Too Tight or Loose
How do tight or loose shoes cause ingrown toenails? Ingrown toenails occur when extra pressure is placed on your toe. High heels are a culprit also, as more of your weight winds up on your big toe (you’re essentially standing on tiptoes in the highest heels). Loose shoes cause continual pounding of your big toe of the shoe due to movement within the show as you walk.
Nails that are not trimmed properly can also cause ingrown toenails. This happens when your toenails are trimmed too short or you cut your toenails in a rounded fashion instead of straight across. Rounded nails are the right way to cut fingernails, but not toenails. This causes the edges of the nails to curl downward and grow right into the skin.
While the above are ways you might prevent ingrown toenails, other factors like heredity, injuries, or medical conditions may also be a factor. Some people are born with nails that are curved and tend to grow downward. Injuries to the nail bed can also cause ingrown toenails (always wear appropriate and well-fitting boots).
See my article on nailbed injuries here:
People with diabetes or other illnesses that cause poor circulation are also higher risk for these problems. Certain medical conditions may damage the nerves that give you signals that something is wrong down there.
To figure out if an ingrown toenail is your problem, you’ll see that the nail may even seem to be growing underneath the skin. As previously mentioned, the skin may be swollen, firm, red, painful, or even a little warm if it’s infected. In that case, there may be a small amount of pus present. Infections will occur more often than you’d think in a survival setting, since most young, rugged individualists just don’t think it’s a big problem. If ignored, however, Ingrown nails can cause major issues with skin ulcers, blood infections, or even gangrene in the worst scenarios.
Of course, in normal times, there are doctors like podiatrists or orthopedic specialists you should visit to deal with the problem. Don’t try to do your own brain transplant; that’s a sure sign that you really need a new brain!
If you’re on your own in a survival situation, here’s how to treat an ingrown nail at home:
- Soak the foot in warm water with Epsom salts 3 to 4 times a day if possible. In between soaks, keep the toe dry.
- Use an antiseptic to decrease the bacterial count in the area
- Place a small piece of moist cotton or waxed dental floss under the nail to help it grow away from the skin.
You may CAREFULLY trim the toenail, if needed. When trimming your toenails:
- Soak your foot in warm water to soften the nail.
- Use a clean, sharp trimmer.
- Trim toenails straight across the top, and don’t trim too short.
- Consider wearing sandals until improved.
If your ingrown nail does not heal, part of a nail may require removal. They’ll take the ingrown side, about 1/5 of the nail or less, often all the way down to the very base. This happens,usually, after injecting some numbing medicine in the area. You might not find lidocaine, but you could find some freeze sprays like ethyl chloride might help in a grid-down situation. Poor substitute, but better than nothing. Without some type of anesthesia, it’ll hurt like a son of a gun.
If the toe is infected, antibiotics might be appropriate. Triple antibiotic ointment may be helpful here. If you need oral antibiotics, Keflex (fish-flex), Clindamycin (Fish-Cin) and Amoxicillin (fish-mox forte) will probably be effective. For more information about antibiotics, go here for the first of a 4 part series:
If a portion of the nail is cut off, it will take 2 to 4 months for the nail to regrow, so be patient. If you have a genetic tendency toward ingrown toenails, the condition could possibly recur.
Wearing properly-fitted and protetive shoes, managing medical conditions, and teaching appropriate foot grooming methods to your children will make sure that the steps on your journey to medical preparedness won’t be painful ones.
For my youtube video on this topic, go to: https://www.youtube.com/watch?v=MTo-uDS6pxA
Joe Alton, M.D. aka Dr. Bones The Disaster Doctor
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