Ingrown Toenails

Ingrown Toenails

Ingrown toenails can be some of the most painful conditions. It is a very common complaint in a podiatrist office. The medical term for an ingrown nail is onychocryptosis. The nail plate may be curved into the skin, or the skin may be enlarged and the folds cut into the normal nail.

Symptoms of an ingrown nail usually first start as a mild pain along the side of a toenail. In time the soft tisse may swell, become red, and with extreme pain to touch. There may be an infection where the toe is warm, with drainage or pus seen if the nail punctures the skin. The reaction of the skin and soft tissue from an ingrown nail is called paronychia. An ingrown nail is more commonly seen on the big toe, but lesser toes may also be ingrown.

Causes of ingrown nails can be actually from a genetic factor. Shoe pressure also plays a role in the formation of an ingrown nail. Some doctors will advise you to trim your nail straight across at the end to prevent an ingrown nail and do not curve towards the skin as this will cause a sharp nail edge. Trauma to the nail may cause permanent damage to the matrix (the cells the nail grows from) causing them to grow in a curved direction. A fungus, calledonychomycosis may also deform the nail causing it to grow differently.

Prevention of an ingrown nail can be accomplished sometimes by proper trimming of your nails and avoiding “bathroom surgery”. A proper fitting shoe is always the best approach but may not completely prevent an ingrown nail. The best prevention may be to get advice from your podiatrist at the first sign of a problem.

Podiatric Care of an ingrown nail may include use of antibiotics and soaking the foot to prevent or treat an infection of the toe. If there is an infection you must keep it clean and get proper treatment to avoid worse problems. For a simple ingrown nail sometimes your podiatrist can trim the nail border for you to see if the nail will grow back straight. More often then not, if you have one problem with an ingrown nail, you will probably have a reoccurrence sometime in your life. For recurrent ingrown nails or fairly severe problems the nail border or the entire nail may be removed permanently. This is technically a surgical procedure.

Surgery to correct an ingrown nail is a very frequent procedure. This can frequently be performed with local anesthetic in the doctors office. In certain situations this can be done as well at a hospital or surgery center. The worst part of the procedure is usually the injection to numb your toe. Many patients are in severe pain when they come to the office that the pain after surgery is minimal. As with any procedure everyone tolerates pain differently, typically an aspirin or Tylenol is all that is needed to control post-operative pain. The entire procedure could last less than 10 minutes including the time to numb you toe. The nail is removed where needed and sometimes the part of the nail that it grows from (the matrix) is destroyed. This can be destroyed by surgical cuts, a rasp, or a chemical. Typically a chemical is utilized forming a burn wound that will require time to heal. The day of the procedure a larger bandage is used to avoid excessive bleeding, you may need a larger shoe to wear. Usually the second day you may begin showering and soaking your foot in Epsom Salt Solution to drain any infection or drainage from the burn wound. This usually last 1-2 weeks, sometimes longer if you are a slower healer. A simple bandage to keep things clean with some antibiotic cream is used for a dressing.

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