A corner of nail growing into the flesh. A big toe that starts protesting the moment a shoe presses on it, then wakes you at night when the bedsheet brushes against it. Maybe you have already tried to cut the corner out yourself — and that is often when things got worse.
Let's walk into the clinic and see what a podiatrist actually does with that toe.
What the podiatrist does, step by step
She starts by looking — and by working out why it went ingrown in the first place. Is it the shape of the nail, naturally very curved or very wide? A nail cut too short and rounded at the corners? A shoe squeezing the forefoot? A deformity that makes the nail rub against the neighbouring toe? Heavy sweating that softens the skin? A sports injury or a knock? This step is not a formality: if the cause stays, the problem comes back.
Then she frees the edge of the nail. This is the heart of the treatment. Using fine sterile instruments — a slim nipper, a burr, a curette — she gently clears the nail groove, removes the debris and trapped keratin, and above all goes looking for the nail spike: that small pointed fragment, usually invisible from the outside, left under the skin by a clumsy cut, acting like a thorn driven into the flesh. It is almost always the culprit. Removing it usually brings fast relief.
Next she packs the nail. Packing means sliding a fine sterile wisp of material — a dressing, a specific cotton, sometimes a soft gutter-shaped sleeve — between the nail edge and the swollen fold of skin. That small barrier holds the nail away from the skin, stops it diving back in, and gives the irritated flesh time to settle while the nail grows out over it rather than into it. She will show you how to keep the area clean and dry between appointments.
And if the shape of the nail is the real problem: she fits an orthonyxia brace.
Orthonyxia: the tiny brace that straightens the nail
This is the part of the job patients most often discover with surprise — and it is probably the most elegant.
An orthonyxia is a miniature brace fitted onto the nail itself. Depending on the technique, it may be:
- a very fine metal wire, bent and hooked onto both edges of the nail;
- a clip or spring, fixed the same way;
- a composite strip or plate bonded onto the surface of the nail.
They all work on the same principle: applying gentle, continuous, permanent traction to the nail edges to uncurl them and lift them out of the flesh. It is not a dressing — it is slow mechanical work. A nail is a material that can be reshaped, and the brace guides it into a better shape as it grows.
In practice: fitting it is painless and takes a few minutes. The brace is invisible under a sock and does not stop you walking, exercising or showering. You then come back for check-ups: the podiatrist inspects the tension, repositions or replaces the brace, and follows the regrowth. How long the treatment takes depends entirely on your nail, how fast it grows and how deformed it was to begin with — that is something your podiatrist will tell you while looking at your foot, not a number anyone can promise in advance.
It is a particularly valuable solution when the nail is ingrown because of its shape — a barrel nail, a curled or pincer nail — because care alone would relieve the pain without ever addressing the cause.
A toe that has been hurting for weeks has no reason to keep hurting. Find a podiatrist near you on OlamKal and book in a few clicks — a single treatment session is often enough to get you walking comfortably again.
What you must never do: operate on your own nail
This has to be said plainly, because it is the number one cause of things getting worse and of infection: do not perform surgery on your own toe.
Specifically, avoid:
- digging a V out of the nail corner, or cutting it on a slant to "let it out";
- tearing off a piece of nail with tweezers or with your fingers;
- sliding scissors or a file under the edge to "lift it off";
- piercing or squeezing the swollen fold of skin to make something come out;
- using harsh products or home remedies on skin that is already raw.
The reason is mechanical and unforgiving: these actions break the nail and leave a sharp fragment under the skin. You feel better for a few days — then that fragment grows straight back into the flesh, deeper than before, and this time through a wide-open door for bacteria. An ingrown toenail becomes an infected ingrown toenail, and treatment becomes longer, more painful and sometimes surgical.
While waiting for your appointment, there is nothing wrong with doing what actually helps: warm foot soaks, careful drying, a wide open shoe, and above all keeping pressure off the toe. That is all. The rest is the job of someone with the right instruments and a clear picture of what lies under the skin.
When it becomes a medical emergency: signs of infection
An ingrown toenail can become infected, and you need to recognise it.
See a doctor without waiting if you notice:
- redness that is spreading around the toe, beyond the nail edge;
- unusual warmth in the toe, or swelling that keeps growing;
- pus or any discharge, however small;
- throbbing pain that beats with your pulse and wakes you at night;
- fever;
- a red streak travelling up your foot or leg — a sign that must never be ignored.
In these situations medical care is required: antibiotics are sometimes necessary, and the doctor will decide whether the area also needs draining or a procedure on the nail edge. This is not the moment for comfort care. In an emergency in Israel, the number to call is 101.
Diabetes, blood thinners, poor circulation: the rules are different
If you have diabetes, take a blood thinner, or have poor circulation in your legs (peripheral arterial disease, cold feet, wounds that heal badly), read this paragraph twice.
Never attempt anything on your toe yourself, and get an opinion quickly — even if the pain feels mild.
Why so strict? Because diabetes can reduce sensation in the foot: you do not feel the wound deepening, and pain — your natural alarm — arrives late or not at all. Because impaired circulation slows healing and weakens the body's defence against infection. In a person with diabetes, an ordinary ingrown toenail can progress into a serious wound, and that is not a figure of speech. Regular podiatric foot care is in fact part of diabetes management. Both the NHS and the World Health Organization stress the importance of foot care in people living with diabetes.
On blood thinners, the smallest cut around the nail can bleed in a way that is hard to stop. Again: do nothing yourself.
How to cut your toenails, once and for all
This is the most effective prevention there is, and it fits in a few lines.
Cut straight across. A toenail is not a fingernail: you do not round it off. A straight cut, following the line of the end of the toe, keeps the corners from diving into the nail groove.
Never dig into the corners. That is precisely the action that creates a nail spike. If a corner sticks out and bothers you, file it lightly — do not go hunting for it deep in the groove.
Do not cut too short. Leave a millimetre or so of nail beyond the end of the toe. A nail cut flush lets the flesh ride up over the edge, and the regrowing nail runs straight into it.
Cut after a shower, when the nail is soft, with a clean straight nail nipper — not curved scissors, not a tiny fingernail clipper.
And check your shoes. A compressed forefoot, a narrow toe box, running shoes that are half a size too short: constant pressure on the nail edge is a cause of ingrowth in its own right. In sporty teenagers it is often the main cause.
When surgery becomes the right answer
Let's be honest: not everything can be solved without a scalpel, and dragging out a treatment that is not working serves no one.
A partial removal of the nail edge, performed by a doctor under local anaesthetic, becomes the sensible solution when:
- the nail is very wide or very curved and keeps recurring despite a well-conducted brace treatment;
- the surrounding flesh is chronically overgrown and inflamed;
- the toe becomes infected again and again;
- pain has been limiting your walking for a long time.
The procedure removes the offending lateral strip of nail, sometimes treating the nail matrix so it does not grow back in the same place. The nail still looks like a nail — simply a little narrower. This is neither a failure nor a disaster: sometimes it is just the right decision, and part of your podiatrist's job is to tell you so at the right moment and point you to the right doctor.
After the procedure, the podiatrist usually takes over again: monitoring regrowth, cutting advice, footwear correction, and preventing the same thing happening on the other toe.
In practice, in Israel
You can see a podiatrist directly, without going through your doctor first. Some health funds and supplementary insurance plans contribute to the cost of podiatric care, particularly for patients with diabetes: conditions vary a great deal between funds and between plans — check with your health fund before the appointment. For your rights within the health system, the reference is the Israeli Ministry of Health.
Finally
An ingrown toenail is not something you are stuck with, and it is not something you "let pass" either. In the vast majority of cases, expert hands relieve the pain quickly, packing lets the flesh breathe, and orthonyxia solves the underlying problem when the shape of the nail is to blame — without surgery.
The only thing genuinely inadvisable is to wait, and to keep picking at it yourself.
Don't let one toe dictate the way you walk. Find a podiatrist near you on OlamKal, book online, and come with your questions — that is exactly what a good practitioner hopes for.
