The big toe is the most common one to have an ingrown nail, but any of the toenails can be affected.

Infected ingrown toenail (paronychia).

Toenail fungus (onychomycosis). This is a mild case, with minor discoloration and thickening of the nail.

Toenail Disorders

Ingrown Toenails

Ingrown toenails (onychocryptosis) is a common problem that Dr. Sheff treats on a daily basis. Often if left untreated, the toe may become infected (paronychia) which is not only very painful, but also potentially dangerous, as the underlying bone is suseptible to infection as well.

What causes a nail to become ingrown?

There are several causes of an ingrown toenail. Wearing shoes that are too tight is a common culprit in women. Improper nail trimming is another common cause, more often seen in men as well as adolescents who trim their own nails. However, sometimes a toenail will become ingrown simply because, well, that's how it grows. This can be due to prior injury to the toe, or may simply reflect a genetic propensity.


When a nail is ingrown and infected, Dr. Sheff simply removes the part of the nail causing the pain and infection. Usually, the patient has relief that day, and sometimes they will also be placed on an antibiotic, depending on their overall health as well as the severity of their infection. For those who have ingrown toenails over and over because, as mentioned earlier, they just grow that way, there is a simple procedure that Dr. Sheff performs in his office under local anesthesia that can cure the problem by removing the one piece of toenail permanently.

Toenail Fungus

Fungal toenails (onychomycosis) is an infection of the nail as well as the portion of the toe where the nail grows from, called the nail matrix. There are several different type of toenail fungus. Each causes discoloration of the nail, and often thick nails that are difficult to trim, prone to infection as well as painful. A common misconception is that the problem is the result of poor hygiene, but the truth is that even the most fastidious person can catch this problem, as it is nothing more than an infection. There are, however, many things one can do to help prevent it: If you use public showers, public swimming pools or public locker rooms, be sure to always wear flip flops to avoid contact with the bare floor; Always be sure to keep your feet dry as well, as fungi need darkness and moisture to grow, so if your feet perspire a lot, or if you do not dry well and then put socks and shoes on, you have created a perfect environment for the fungus to grow.


There are several FDA approved oral as well as topical medicines that Dr. Sheff often will prescribe to treat toenail fungus. There are also minor nail surgeries that Dr. Sheff performs under local anesthesia in the office that have proved extremely effective in treating this annoying, often painful as well as cosmetically unappealling problem.