Ignoring ingrown toenails can be harmful: What every diabetic must know

Foot health often takes a backseat until discomfort begins to interfere with daily life. An ingrown toenail, medically known as onychocryptosis, occurs when the edge of the toenail grows into the surrounding skin instead of growing outward. While it may begin with mild tenderness or redness, the condition can become particularly dangerous in people with diabetes.

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“Many people dismiss an ingrown toenail as a minor discomfort, but for someone living with diabetes, this seemingly small issue can quickly escalate into a serious medical concern. Early diagnosis and timely treatment are crucial because what starts as mild pain or swelling may progress to severe infection requiring surgical intervention,” Dr Pankaj Sharma, Metabolic Surgeon (for Diabetes), Fortis Hospital, tells Health Shots.

The connection between diabetes and foot complications is well established. High blood sugar levels can damage nerves and blood vessels over time, leading to reduced sensation and poor circulation in the feet. As a result, even a small cut, blister, or ingrown toenail may go unnoticed or heal slowly. This creates an ideal environment for infection to develop and spread.

What causes ingrown toenails?

Ingrown toenails can develop for several reasons, many of which are linked to everyday habits.

1. Improper nail trimming: Cutting toenails too short or rounding the edges are among the most common causes. Nails should ideally be trimmed straight across to prevent them from growing into the skin.
2. Tight footwear: Shoes that squeeze the toes place constant pressure on the nails, increasing the risk of the nail edge digging into the surrounding tissue.
3. Repeated trauma: Activities involving repeated pressure on the feet, such as running or wearing ill-fitting shoes, may contribute to the condition.
4. Poor foot hygiene: Sweaty or unclean feet can soften the skin around the nail, making it easier for the nail to penetrate the tissue and trigger inflammation.

Why do diabetics need to be more careful?

For individuals with diabetes, an ingrown toenail is more than a local nail problem. “Many diabetic patients experience neuropathy, which reduces their ability to feel pain or discomfort.” Because sensation is compromised, they may not notice redness, swelling or infection until the condition becomes advanced,” explains Dr Sharma.

Reduced blood circulation further complicates the issue. When blood supply to the feet is poor, healing slows down, and the body’s ability to fight infection weakens. What initially appears as mild redness may soon develop into pus formation, severe inflammation or tissue damage. In advanced cases, the infection may spread beyond the skin and involve deeper tissues or even the bone. Such situations may require surgical treatment and prolonged medical care.

Warning signs that should not be ignored

Recognising symptoms early can prevent complications:

1. Pain and tenderness: Pain along the edge of the nail, especially while walking or wearing shoes, is often the first sign.
2. Redness and swelling: Inflamed skin around the toenail usually indicates irritation or early infection.
3. Pus or discharge: Any fluid, pus or foul smell suggests that infection has developed and requires medical attention.
4. Skin darkening or persistent wounds: In people with diabetes, delayed healing or skin discolouration around the affected toe should never be ignored.

Treatment and prevention

Early-stage ingrown toenails may be managed with proper wound care, antibiotics when necessary, and correction of nail-cutting habits. However, if infection persists or the nail repeatedly grows inward, minor surgical procedures may be required to remove part or all of the affected nail. “Patients often try home remedies for too long, which delays treatment. Seeking medical advice early can prevent complications and avoid unnecessary surgery,” says Dr Sharma.

Preventive foot care is especially important for people with diabetes. Daily inspection of the feet, maintaining hygiene, wearing comfortable footwear and trimming nails correctly can significantly reduce the risk. Dr Pankaj Sharma summed up and said, “Diabetes demands extra attention to foot health. An ingrown toenail may appear insignificant, but ignoring it can have serious consequences. Timely care and awareness remain the best protection against preventable foot complications.”