Ingrown toenails are one of the more common foot problems treated by a chiropodist or podiatrist. They can be very painful and can often limit your activities due to the pain.
What Is An Ingrown Toenail?
When a toenail becomes ingrown the nail usually curves downward at the side and grows into the flesh at the nail borders which are the sides of the nail. The nail will penetrate the skin often creating redness, swelling, increased warmth and pain. This is caused by bacteria entering the break in the skin, causing the infection which is often accompanied by drainage of pus or a watery discharge tinged with blood and a bad odour. Ingrown toenails are very common in teenage boys and girls.
What Causes an Ingrown Toenail?
- Many people have ingrown toenails as an inherited disorder. In other words a mother or father may have had a history of ingrown nails.
- Trauma such as stubbing the toe, dropping a heavy object on the toe or participating on sports that involve repeated pressure on the toe such as kicking a soccer ball.
- Improper or incomplete trimming of the toenails can cause a sharp spike of nail to penetrate the skin.
- Tight shoes, socks or nylons which squeeze the toes together.
- Abnormally wide or incurved nails.
- Some nail conditions such as fungal toenail infections or if you have lost a toenail due to trauma can cause ingrown nails as the new nail grows back.
Complications Of An Ingrown Toenail
- Infections if present can spread into the foot and leg causing cellulitis or into the bloodstream.
- Chronic ingrown toenails can cause deformity of the nail plate and or surrounding tissues.
- A small benign red tumour called a granuloma can form along the edge of the nail groove.
TREATMENT OF AN INGROWN TOENAIL
Initial treatment of mild ingrown toenails can be done at home however if you suspect you have an infection home treatment is not a good idea especially if you have a medical condition that puts your feet in a high risk category such as diabetics, people with loss of feeling or nerve damage or people with poor circulation.
Initial home treatment consisting of warm salt water foot soaks is advised if an infection is not present however if you have any high risk foot condition mentioned above or if there is an infection present then you need to see a chiropodist or podiatrist.
TREATMENT BY A CHIROPODIST OR PODIATRIST
Your toe will be examined and a chiropodist/podiatrist will decide which form of treatment is best for your particular situation. Treatments might include:
Oral antibiotic therapy
Oral antibiotics may be prescribed if an infection is present
In-Office minor surgical procedure.
A simple in-office procedure done under a local anaesthetic is commonly required to numb the toe to allow removal of either a small corner of the nail or the piece of nail that has penetrated the flesh, a larger part of the nail or the entire nail plate in extreme cases.
In-Office Surgical Correction of an ingrown toenail
This patient illustrated below suffered from a chronic ingrown toenail on both borders of the large toe. This condition requires a procedure called a partial toenail removal, which permanently removes a narrow piece of the toenail from the sides of the nail.
The procedure is painless as the toe is frozen with a local anaesthetic agent. There is no cutting or stitching with minimal post-operative discomfort. The wound heals in about four to six weeks. During this time it is simply dressed with a topical ointment and bandages. After healing, the nail is normal in appearance and somewhat narrower than before.
1. The patient presents to the office with a chronic ingrown and painful nail on both borders of the great toe.
2. The toe is prepped, frozen with a local anaesthetic and a tourniquet is applied. Both borders of the toenail have been removed.
3. Liquified phenol (acid) is applied to cauterize the nail matrix (growth area) and the nail bed to prevent the sections that were removed from growing back again.
4. The tourniquet is removed, the area is irrigated and the chemical cauterization with phenol on both sides of the nail is complete with no bleeding at the site.
5. The toe is dressed with a sterile bandage.
6. Six weeks post-op, the toe has healed with a nice cosmetic result. The toenail is slightly narrower and the pain from the ingrown toenail has disappeared.