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| Ingrown nails occur most commonly on the big toe and are cause by either poor
nail cutting technique, tight shoes, or just plain bad luck if you have wide or highly
curved nails. Nails can become painful along the sides if the curve downwards
into flesh or toe or become excessively thick: when this happens there is often a
buildup of hard, dry skin underneath the edge of the nail plate which may
become as painful as, and indistinguishable from an ingrown nail. Sometimes,
the skin will become infected, and antibiotics may be advisable. Regardless of
antibiotic, the problem will not be resolved until the "spike" of toenail is excised,
or if the nail edge that is creating the painful callous is avulsed. This is typically a
painless procedure performed in the office setting. In long-standing, chronic or
recurrent cases, a more definitive type of procedure is performed to narrow the
toenail on the affected side.
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