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Arlington/Mansfield Foot & Ankle Centers: Podiatrists

Pain and swelling around your toe and the inability to wear certain shoes might be signs of an ingrown toenail. It’s a common condition that you can sometimes take care of at home. But if the pain becomes unbearable, or you can see an infection in the tissue around your toenail, you may need to seek medical treatment.

Here at Arlington/Mansfield Foot & Ankle Centers, our skilled podiatrists treat ingrown toenails to get rid of the infection and alleviate painful symptoms. To help you discern if your symptoms are beyond home remedies, we’ve put together this guide to help you identify when your ingrown toenail requires medical attention.

Ingrown toenails are a common condition

If you’ve ever had the corner or side of your toenail become red and inflamed, you’ve probably had an ingrown toenail. This common condition most often occurs when you cut your toenails too short, wear tight shoes, or stub your toe. Additionally, some people have toenails that naturally curve into the skin, making them more susceptible to ingrown toenails and infections.

While you can resolve most ingrown toenails on your own, if they become infected and the infection spreads, or if you have certain pre-existing health conditions, an ingrown toenail can become more serious than just an irritated toe.

Assess your symptoms

Ingrown toenails commonly occur in your big toe. Signs that you have an ingrown toenail include:

  • Swollen, red skin on one side of the affected toenail
  • Pain and tenderness in your toe
  • Pain from the pressure of wearing shoes
  • Overgrown skin at the tip of the toe or alongside the nail
  • Blood or pus that leaks from the toenail or an open sore

If at first your symptoms are just uncomfortable, but not too serious, home remedies may alleviate your discomfort and prevent infection.

Try these home remedies

At first sign of an ingrown toenail, try these home remedies to reduce pain and swelling and to see if your ingrown nail will resolve on its own:

  • Soak your toe in warm water for 15-20 minutes several times a day
  • Apply antibiotic ointment to the toe and cover it with a bandage
  • Wear sandals so there’s no pressure on your toe
  • Take an over-the-counter pain reliever
  • Avoid cutting the toenail

If your toe begins to feel better after a couple days with these solutions, you’re probably not at risk of the infection spreading or becoming debilitating. However, if your symptoms worsen, or get better at first, but then the pain and swelling return, it’s a good idea to seek medical treatment.

When to make an appointment with one of our podiatrists

When home remedies don’t work, or you have recurring ingrown toenails, it’s time to schedule an appointment with us. Your podiatrist at Arlington/Mansfield Foot & Ankle Centers can determine what’s causing the recurring ingrown toenail and treat it accordingly.

If you have diabetes or a condition that causes poor circulation in your feet, you have a greater risk for an ingrown toenail becoming a serious medical problem. It’s especially important that you don’t wait to seek medical attention. Left untreated, an ingrown toenail can lead to an infection or an abscess on your toe that may require surgical intervention. Or the infection can spread into the bone in your toe.

How a podiatrist treats your ingrown toenail

After careful examination and talking to you about your overall health and wellness, your podiatrist may be able to carefully lift your toenail to separate the nail from the skin. This helps your nail grow above the skin instead of into it.

In more severe cases, your doctor may need to remove some or all of your toenail. If necessary, your podiatrist may use a local anesthetic to numb your toe and remove the nail and a small area of skin that’s contributing to the problem.

To treat the infection, you may need to use a topical antibiotic or take one orally. If you’re prone to ingrown toenails or foot infections, your doctor will discuss preventive methods to minimize problems for you in the long term.

If you’re concerned about an ingrown toenail becoming a more serious health complication, don’t hesitate to schedule a consultation at one of our offices in Arlington or Mansfield, Texas. Click the “book online” button or call us to get the medical attention you need in a friendly, welcoming atmosphere.

Ingrown toenail: Treatment, causes, and symptoms

An ingrown toenail happens when the edges or corners of the nail grow into the skin next to the nail and break the skin.

It is a common condition, and it can be painful, causing swelling, redness, and sometimes infection. It usually affects the big toe, either on one or both sides of the toe.

Ingrown toenails can usually be treated at home, but if the pain is severe or spreading, it may be necessary to see a health care provider, to prevent complications and relieve symptoms.

People with poor circulation, such as those with diabetes or peripheral vascular disease, are more likely to have complications.

Ingrown toenails should be treated as soon as symptoms appear, especially if the person has diabetes, nerve damage in the foot or leg, or poor circulation in the foot. Otherwise, complications can occur.

The American College of Foot and Ankle Surgeons (ACFAS) advise seeing a doctor rather than using over-the-counter (OTC) medications, as these may mask the pain, but they will not solve the problem.

Seeing a doctor

The patient should see a doctor if:

  • they have diabetes or a circulatory problem
  • symptoms do not go away
  • an infection develops

A healthcare professional may remove some of the nail that is pushing into the skin.

They may need to remove a portion of the nail and the underlying nail bed to prevent the problem from coming back.

As the nail grows back, the healthcare provider may place a piece of cotton wool under the nail to stop it from digging into the skin again. It is important to change the cotton wool every day.

ACFAS do not recommend putting cotton under the nail as a home remedy because it increases the risk of infection.

If the area is infected, the doctor may prescribe antibiotics.

Surgery

If the problem remains, the doctor or podiatrist may recommend removing part of the nail through surgery. This is called a toenail avulsion.

The doctor will cut away the edges of the toenail, to make it narrower. They may also remove the folds of skin on either side of the toenail. If it is done under a local anesthetic, the patient will be awake but the area is numbed, so they will not feel anything. In some cases, a general anesthetic may be necessary.

If the nail has become very thick or distorted, the whole nail may be taken out, again under a local anesthetic.

This is not usually very painful, and most people can get back to normal activity the next day.

If the ingrown toenail keeps coming back, the cells in the nail bed may be removed so that the toenail cannot grow again.

These cells may be destroyed using a chemical called phenol, or another method, such as a laser.

Although the doctor will use a local anesthetic, the toe may feel tender when the anesthetic wears off. Ibuprofen or acetaminophen, for example, Tylenol, or paracetamol, may help.

For 1 to 2 weeks, the patient will have to wear either very soft and spacious footwear or open-toed sandals.

When the nail pierces the skin, bacteria can enter the wound.

This can result in infection. The area affected becomes red, swollen, warm, and painful. There may be bleeding and pus.

If you suspect that you may have an ingrowing toenail, it is important to keep the area clean and dry to prevent infection.

Anyone with symptoms of infection should seek medical help, either with a primary care physician, orthopedic surgeon, or a foot care specialist known as a podiatrist.

Most healthcare providers will advise the patient to treat the nail themselves.

Here are some tips:

  • Soak the foot in warm water three to four times a day, while using a cotton bud to gently push the skin away from the toenail. A doctor may advise you to add Epsom’s salt.
  • Wear footwear that leaves the toes plenty of room for movement.

The symptoms of an ingrowing toenail can be quite painful.

At first, the skin next to the nail may be tender, swollen, or hard.

The nail may feel painful in response to pressure, and there may be inflamed and overgrown skin at the tip of the toe. The ingrowing toenail may also leak blood and white or yellow pus.

Fluid may also build up in the area.

Here are some of the causes of ingrown toenails:

Footwear: Shoes and socks that crowd the toes and toenails increase the chance of an ingrown toenail. Shoes can be too tight because they are too short, too narrow at the end, or too flat at the end. Tight-fitting socks, tights, or stockings may cause ingrown toenails.

Cutting the toenails too short: Not cutting straight across or cutting the edges of the toenail can encourage the surrounding skin to fold over the nail. The nail can then push into that skin and pierce it.

Toenail injury: Dropping something on the toe, kicking something hard, and other accidents can lead to ingrown toenails.

An unusual curvature: This increases the risk that the toenail will grow into the soft tissue, causing inflammation and possible infection.

Posture: How a person walks or stands can affect the likelihood of developing ingrown toenails.

Poor foot hygiene or excessive sweating: If the skin on the toes and feet is moist and warm, there is a higher chance of developing an ingrown toenail. A fungal infection can increase the risk.

Heredity: ingrown toenails can run in families.

Genetic factors: Some people are born with larger toenails.

To prevent ingrown toenails from developing:

Cut the nails across in a straight line, not rounded at the corners, and not too short. It is easier to cut the nails after a bath or a shower.

See a podiatrist regularly for professional trimming, especially if you have circulatory problems in the feet, or cannot cut your own nails. Patients with diabetes or peripheral vascular disease need to be particularly careful.

Maintain hygiene and dryness, because an ingrown toenail is less likely if the feet are clean and dry.

Choose footwear that fits properly, including shoes, socks, tights and stockings. Shoes must be the right length and width so that the toes do not crowd. Tight shoes cause pressure, but if shoes are too loose, the toes may hit against the tip of the shoe. This, too, adds pressure and could cause an ingrown toenail.

Ingrown Toenail Treatment, Surgery, Causes, Symptoms & Remedies

Medically reveiwed by Joseph Palermo, DO; American Osteopathic Board Certified Internal Medicine

Aksoy, B., et al. “Lateral Foldplasty with or without Partial Matricectomy for the Management of Ingrown Toenails.” Dermatol Surg 35 (2009): 462-468.

Borges, A.P.P., V.P.C. Pelafsky, L.D.B. Miot, and H.A. Miot. “Quality of Life With Ingrown Toenails: A Cross-Sectional Study.” Dermatol Surg 43.5 May 2017: 751-753. doi: 10.1097/DSS.0000000000000954.

Chapeskie, H., et al. “Soft-Tissue Nail Fold Excision: a Definitive Treatment for Ingrown Toenails.”
Can J Surg 53.4 (2010): 282-286.

Cordoba, D.D., et al. “Evidence of Efficacy of Alcohol Lavage in the Phenolization Treatment of Ingrown Toenails.”
J Eur Acad Dermatol Venereol 25.7 (2011): 794-798.

Di Chiacchio, Nilton, and Nilton Gioia Di Chiacchio. “Best Way to Treat an Ingrown Toenail.” Dermatol Clin 33 (2015): 277-282.

Erdogan, F.G., and G. Erdogan. “Long-Term Results of Nail Brace Application in Diabetic Patients with Ingrown Nails.” Dermatol Surg
34 (2008): 84-87.

Farrelly, P.J., et al. “Comment on: Surgical Treatment of Ingrown Toenails in Children: What is Best Practice?”
Ann R Coll Surg Engl 93.4 (2011): 336.

Heidelbaugh, J.J., et al. “Management of the Ingrown Toenail.” Am Fam Physician
79.4 (2009): 303-308.

Li, J., et al. “Clinical Study of Treatment for Recalcitrant Ingrown Toenail by Partial Distal phalanx Removal.”
J Plast Reconstr Aesthet Sug 62.10 (2009): 1327-1330.

Majcen, M.E., et al. “Interpretation of Radiologic Abnormalities in Patients with Chronically Infected Ingrown Toenails with Regard to a Possible Exogenic Osteomyelitis.”
J Pediatr Surg 44.11 (2009): 2179-2183.

Matsumoto, K., et al. “Resin Splint as a New Conservative Treatment for Ingrown Toenails.”
J Med Invest 57.3-4 (2010): 321-325.

Mitchell, S., et al. “Surgical Treatment of Ingrown Toenails in Children: What is Best Practice?”
Ann R Coll Surg Engl 93.2 (2011): 99-102.

Noel, B. “Surgical Treatment of Ingrown Toenail Without Matricectomy.” Dermatol Surg
34 (2008): 79-83.

Peyvandi, H., et al. “Comparison of Two Surgical Methods (Winograd and Sleeve Method) in the Treatment of Ingrown Toenail.”
Dermatol Surg 37.3 (2011): 331-335.

Taheri, Arash, et al. “A Conservative Method to Gutter Splint Ingrown Toenails.” JAMA Dermatology 150.12 December 2014: 1359-1360.

Tatlican, S., et al. “Chemical Matricectomy with 10% Sodium Hydroxide for the Treatment of Ingrown Toenails in people with Diabetes.”
Dermatol Surg 36.2 (2010): 219-222.

Vanhooteghem, O., et al. “Scedosporium apiospermum Septicemia Following a Wedge Excision of an Ingrown Toenail.”
Int J Dermatol 48.10 (2009): 1137-1139.

Won, J-H, J-S Chun, and Y-H Won. “A non-invasive method for treating ingrown nail recurrence due to incomplete matricectomy.” Journal of the American Academy of Dermatology 2018. doi: 10.1016/j.jaad.2018.08.026.

Signs, Causes, Diagnosis, Treatments, Prevention



Overview

Ingrown toenail

What is an ingrown toenail?

An ingrown toenail is a foot condition that develops when the corner of the toenail grows down into the skin. It usually affects the big toe. Ingrown toenails often happen when people cut their toenails by tapering the corner of their toenail. If the toenail curves with the shape of the toe, it can grow into your skin. Ingrown toenails are common and don’t usually pose a health risk to healthy people.

Who is likely to have an ingrown toenail?

Anyone can get an ingrown toenail. People at higher risk include adolescents, athletes and those who have:

  • Diabetes.
  • Severe nerve damage in the leg or foot.
  • Poor blood circulation.
  • An infection around the nail.

How common are ingrown toenails?

Ingrown toenails are a common foot condition. Two out of 10 people who see their healthcare provider for a foot problem have an ingrown toenail.



Symptoms and Causes

What causes an ingrown toenail?

An ingrown toenail can have many causes:

  • Incorrectly cut toenails. If you cut your toenails too short or rounded, the nail may grow into the skin.
  • Improperly fitting shoes.
  • Tearing the corner of the nail.
  • Toe trauma, such as banging your toe or getting stepped on.
  • Congenital (your foot shape) — for instance, if your nail is larger comparatively with your toe, or the surrounding tissue of the nail border naturally grows around your nail.
  • What are the signs and symptoms of an infected ingrown toenail?

At first, an ingrown toenail can feel hard and swollen. If the nail grows into the skin, or the skin grows over the nail edge, bacteria can enter. The nail may become infected. Signs of ingrown toenail infection include:

  • Liquid or pus coming out of the toe.
  • Pain.
  • Redness or darkening of the area.
  • Swelling.
  • Toe feeling warm or hot.



Diagnosis and Tests

How is an ingrown toenail diagnosed?

You can often diagnose an ingrown toenail yourself, based on your symptoms and how the toe looks.

Your healthcare provider (which may be your regular provider or a foot specialist called a podiatrist) will likely diagnose an ingrown toenail by inspecting it. They’ll examine the skin at the edge of the nail. They will diagnose an ingrown toenail if the skin is:

  • Growing over the nail.
  • Swollen, tender, warm and red.

What tests might I have for an ingrown toenail?

You typically don’t need any tests or X-rays to diagnose an ingrown toenail. In rare cases, when the toenail is severely infected, your healthcare provider might take a sample culture to identify the infection. X-ray may also be required in more serious infections.



Management and Treatment

How is an ingrown toenail treated?

You can treat an ingrown toenail at home. These steps help control the infection and prevent further pain:

  • Soak the foot in warm water and Epsom salts twice daily.
  • Keep the foot dry the rest of the time.
  • Gently lift the edge of the nail and place some cotton or dental floss between the nail and the skin. Change the pad every day.
  • Use an antibiotic cream and a bandage.
  • Wear roomy shoes or sandals.
  • Use pain relievers such as ibuprofen or acetaminophen, if needed.

Can I cut the ingrown nail myself?

If you have an ingrown toenail, do not attempt to cut it yourself. If you cut the nail, the condition may get worse. If symptoms aren’t getting better with at-home remedies, see a healthcare provider.

Do I need a healthcare provider to treat an ingrown toenail?

If your symptoms haven’t improved within a few days, or the nail looks worse, call your healthcare provider.

You should also see your provider as soon as possible if you develop an ingrown toenail and you have:

Does an ingrown toenail require surgery?

Most of the time, an ingrown toenail heals without surgery. In severe cases, your healthcare provider may need to remove part of the nail surgically. The procedure is called a nail avulsion. Surgery keeps the edge of the nail from growing inward and cutting into the skin. For children who keep getting infected ingrown toenails, permanently removing the nail can help.

During a partial or complete nail avulsion, your provider injects an anesthetic (numbing medicine) in your toe. Then the provider cuts away part or all of the toenail. It can take a few months for the nail to regrow. For recurrent ingrown nails these avulsion procedures can be done permanently with the assistance of a chemical to kill the nail root.

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Prevention

How can I prevent an ingrown toenail?

You can take these steps to prevent an ingrown toenail:

  • Soak the nail in warm water before cutting, or cut nails after a shower or bath.
  • Clean your nail trimmer before using it.
  • Do not tear or rip nails.
  • Trim toenails across the top. Don’t round the corners.
  • Wear shoes that fit correctly. They should not be too loose or tight around the toes.
  • Avoid repetitive trauma to the sides of the nails.
  • If you have diabetes, follow all foot care recommendations from your healthcare provider. With diabetes, do NOT be hesitant about seeking medical help.



Outlook / Prognosis

What is the outlook for someone with an ingrown toenail?

Most of the time, an ingrown toenail is not a serious health problem. Ingrown toenail treatment usually works. The ingrown toenail won’t grow back if you practice good foot care.

You may need regular foot care exams if you have a condition that causes foot problems, such as nerve damage or diabetes.



Living With

When should I see my healthcare provider about an ingrown toenail?

See your healthcare provider for an ingrown toenail if you have:

  • Diabetes.
  • Signs of an infection (pus or liquid drainage, extreme pain or redness).
  • Poor circulation.
  • Tried topical antibiotic ointment, soaking and self-care but the toe still hurts.

What should I ask my healthcare provider?

If you have an ingrown toenail, ask your provider:

  • Is the nail infected?
  • How can I best treat it?
  • Do I need surgery?
  • How can I keep it from coming back?
  • Do I need medication?
  • How should I cut my nails to avoid ingrown toenails?

A note from Cleveland Clinic

An ingrown toenail is annoying and painful but very treatable. Often, soaking the nail will improve symptoms within a few days. If it doesn’t get better, see your healthcare provider who can treat it. Don’t attempt to cut the ingrown nail yourself at home. In the future, to prevent ingrown toenails, wear roomy shoes and cut your nails straight across, rather than tapering them to the shape of your toe.

What are the Beginning Stages of an Ingrown Toenail?

Dr. Brian Nagy | March 1st, 2018

Posted In: Ingrown Toenails

If you have pain in your toe but don’t know what the problem is, you might be suffering from the beginning stages of an ingrown toenail. There are many conditions that might cause discomfort in your feet and toes including a bunion, stubbed toe, fungal infection, sprain, or other injury, so how do you know if you are getting an ingrown toenail?

 

Early Stages of an Ingrown Toenail

There are three stages of an ingrown toenail. In the earliest stage your symptoms will include redness, swelling, and discomfort or pain where your toenail meets the bed of your toe.  If you are experiencing these symptoms in the absence of a bump on the outside of your toe (bunion), rotting nail and oozing pus (fungus), and have not stubbed your toe or injured your foot in some other manner, you could be getting an ingrown toenail.

During the second stage of an ingrown toenail, you’re likely to have even more pain and may see a little discharge at the edge of your nail. You might also notice swelling in the folds of skin along the affected toenail. If you are in the early stages of an ingrown toenail, there are a few things you can do at home to try and prevent it from getting to an advanced stage.

Treating Ingrown Toenails at Home

It is imperative that you trim the affected toenail very carefully (there’s a right way and a wrong way!), soak the foot, use ointment you can make yourself from essential oils to reduce pain and prevent infection, and wear proper footwear. You should not wear socks and shoes when you’re at home, and try wearing flip-flops when you go out. This allows your toe to get air while protecting your foot from dirt that can lead to infection.

When cutting or trimming an ingrown toenail, begin by soaking your foot for 20 minutes in Epsom salts or Castile soap. Make sure your fingers are clean as you push the swollen skin carefully away from the nail being careful not to force the skin farther away from the nail than it will go. Beginning at the sides of the toenail and finishing in the middle, carefully cut the nail. Avoid trimming your toenails with too much of a curve as this can cause the corners to be cut too far back. Follow the natural curve of the toe but make sure that when you are finished you can still see the entire leading edge of the toenail from one side to the other. Gently place a small bit of clean cotton between your skin and the ingrown toenail. This helps the toenail to grow back in the right way and prevents ingrown toenails from coming back. Apply ointment and put a bandage on the toe.

It’s Time to See Your Podiatrist

If you notice excessive growth and redness, or oozing pus where your toenail meets your toe bed, it is time to make an appointment with your New Hampshire podiatrist. This is the third stage of an ingrown toenail during which you have an infection. An infection must be treated with antibiotics prescribed by your podiatrist. You might have a fever by this point, and the toe will probably feel warm and tender to the touch. It is best if you can see your foot doctor before your ingrown toenail gets to this stage if home treatment has not worked.

Nagy Footcare Can Help You

When you are experiencing toe pain or discomfort, you might be in the early stages of an ingrown toenail. You should immediately begin the home treatment methods mentioned above in order to prevent the problem from getting worse. If you have any questions or concerns, or are unable to properly cut the ingrown toenail by yourself, call Nagy Footcare. We firmly believe you should not have to suffer from foot or toe pain; offer the most advanced treatment options available in a professional, caring environment; and make it our mission to exceed your expectations in every way. Are you in the beginning stages of an ingrown toenail?  Contact Nagy Footcare today!

At Nagy Footcare, our best day is when you wake up with no foot pain.

Ingrown Toenail – Foot Health Facts



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What Is an Ingrown Toenail?  

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe is not painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection.

Causes

Causes of ingrown toenails include:

  • Heredity. In many people, the tendency for ingrown toenails is inherited.
  • Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe or engaging in activities that involve repeated pressure on the toes, such as kicking or running.
  • Improper trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail. 
  • Improperly sized footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.
  • Nail conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.

     

Treatment

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot or poor circulation.

Home Care

If you do not have an infection or any of the above medical conditions, you can soak your foot in room-temperature water (adding Epsom salt may be recommended by your doctor) and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it is time to see a foot and ankle surgeon.

Physician Care

After examining the toe, the foot and ankle surgeon will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, the doctor removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

Preventing Ingrown Toenails

Many cases of ingrown toenails may be prevented by:

  • Proper trimming. Cut toenails in a fairly straight line, and do not cut them too short. You should be able to get your fingernail under the sides and end of the nail.
  • Well-fitting shoes and socks. Do not wear shoes that are short or tight in the toe area. Avoid shoes that are loose because they too cause pressure on the toes, especially when running or walking briskly.

     

What You Should Know About Home Treatment

  • Do not cut a notch in the nail. Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.
  • Do not repeatedly trim nail borders. Repeated trimming does not change the way the nail grows and can make the condition worse.
  • Do not place cotton under the nail. Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.
  • Over-the-counter medications are ineffective. Topical medications may mask the pain, but they do not correct the underlying problem.

Ingrown toenail stages and treatment

Ingrown toenail stages and treatment

Ingrown toenail stages and treatment options | Dallas & Plano is a condition that occurs when the edge of the toenail grows into the skin. Ingrown toenail mostly affects the big toe. The edge of the big toenail grows into the skin.

According to reports by the National Foot Health Assessment conducted in 2012 for the Institute for Preventive Foot Health, about 18 percent (40 million people) of U.S. adults from the age of 21 and above have experienced ingrown toenail at a point in their lives.

One of the most common causes of feet pain is ingrown toenails. Ingrown toenail is not a severe condition if treated on time. It becomes severe when not timely treated and could get infected. You have a higher risk of complications if you have diabetes or other conditions causing poor circulation. 

Stages of ingrown toenails

There are three stages of ingrown toenails. These include:

Stage 1:

In stage 1, there is mild erythema, edema and pain at the lateral nail fold with pressure.

Stage 2:

In stage 2, there is significant erythema, edema, and discharge from the edge of the nail. You will also see signs of bacteria infection.

Stage 3:

In stage 3, there is granulation tissue formation and hypertrophy of the lateral wall.

Causes of ingrown toenails

According to the National Health Services, people with sweaty feet have higher risks of having ingrown toenails. Older people with thicken toenails may also be at higher risk of having ingrown toenails.

Ingrown toenails can be caused by different factors and lifestyle. These include:

Incorrect cutting of toenails

Incorrect cutting of the toenails can cause ingrown. Angling the sides of the nail can encourage the nails to grow into the skin. You should cut your nails straight across.

Irregular and curved toenails

Some toenails that are curved and irregular in shape can grow into the skin.

Tightly-fitted footwear

Wearing very tight footwear places a lot of pressure on the big toes, causing the toenail to grow into the skin. Footwears that are narrow don’t allow enough space for the big toe.

Toenail injury

Toenail injuries such as dropping a heavy object on your foot, kicking a ball repeatedly, hitting your toe against a hard object, can all lead to ingrown toenails.

Improper foot hygiene

Not keeping your feet very clean and dry can also increase your risk of ingrown toenail. Not cutting your toenails on time may also lead to ingrown.

Athletic activities

Engaging in frequent athletic activities that put pressure on your feet and toes can increase your risk of ingrown toenail.

Genetic predisposition

Ingrown toenails can be inherited genetically. If your parents or a member of your family has ingrown, you’re at a higher risk of getting ingrown.

Symptoms of ingrown toenails

Ingrown toenail stages and treatment | Dallas & Plano can be painful if not timely managed or treated. They can also get worse and even get infected if not treated at early stage. The symptoms you will experience at the early stages are quite different from the symptoms of later stages.

Symptoms of early stage of ingrown toenail include:

  • The skin next to the ingrown nail become tender, swollen, or hard
  • Feeling of pain when pressure is placed on the toe
  • Build up of fluid in the skin around the ingrown toenail

Symptoms of later stage include:

  • Red and swollen skin
  • Increased pain
  • Bleeding around the ingrown
  • Oozing pus in the skin around the ingrown
  • Overgrowth of skin, causing hard skin around the toe
  • Scaly skin around the toe

Diagnosis of ingrown toenails

A podiatrist is the medical specialist most qualified and experienced for the diagnosis and treatment of ingrown toenails. During diagnosis, your podiatrist may conduct some physical exams and ask you some questions about your feet hygiene. Your podiatrist may recommend an X-ray if your toe seems infected. This will help your podiatrist to know how deep the nail has grown into the skin.

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90,000 Ingrown toenail: symptoms, causes, treatment

An ingrown toenail is a common ailment. It represents the ingrowth of the edge of the nail plate into human flesh. This usually occurs on one or two sides, but central ingrowth can also occur.

Main reasons

In the overwhelming majority of cases, pathology is formed on the legs, and one of the main reasons for this is the wrong selection of shoes. It puts pressure on the nail, and it moves towards the skin.

The most common causes of an ingrown toenail are:

  • Inability to cut nails correctly;
  • 90,011 genetic facts;

  • fungal disease: some types of fungi destroy the nail plate, causing it to change its shape;
  • deformity of the foot (often as a result of wearing smaller shoes), flat feet;
  • Injury to the finger that touched the nail plate and prevented it from growing as before.

Symptoms of the disease

The first manifestations of the disease are usually not paid too much attention, although it is quite easy to prevent complications at an early stage. Signs of an ingrown toenail are as follows:

  • first, the skin surrounding the nail turns red, then puffiness forms in this area, painful sensations appear when you touch it;
  • pus and blood begin to ooze from the damaged area, as the nail digs deeper into the skin, provoking an infection;
  • If nothing is done, the ingrown nail particle becomes denser, its deformation is almost irreversible; bone tissue is affected.At this stage, the disease becomes chronic. It is no longer possible to completely fix the nail, but there is a chance to avoid relapse with proper care.

Do you have symptoms of an ingrown toenail?

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Diagnosis of ailment

Having found in yourself the symptoms of an ingrown nail, it is necessary as soon as possible to go for an examination to a specialist – a surgeon in order to prevent the possible development of the disease.

In an advanced stage, when there is an obvious infection (strong redness and swelling speak of it), laboratory tests may be prescribed:

  • general blood test;
  • blood sugar test (carried out to exclude diabetes).

In rare, especially advanced cases, an X-ray of the hand or foot is performed to exclude the fact of damage to the bone tissue.

Features of treatment

Treatment of an ingrown nail begins with getting rid of acute symptoms, namely, with the surgical removal of the interfering edge of the nail plate, and removal of inflammation.

Initial treatment

Further, the following options are possible to prevent a recurrence of the situation:

  • Correction of an ingrown nail with acrylic – it is carried out approximately once every 6 months. Contrary to popular belief, conventional nail extension performs not only an aesthetic, but also a healing function. With its help, the nail plate acquires the correct shape without growing into the skin of the finger;
  • hardware pedicure – can be cosmetic and performed by a pedicure master, as well as medical: with fixation of special plates (performed by a specialist with medical education).

However, both options are effective only in the initial stages of ingrowth of the nail into the skin. In the case when pus has formed or bone tissue has suffered, they are ineffective.

Treatment at an advanced stage

If an ingrown toenail is a serious concern, then you will most likely have to resort to more radical action.

  • Correction of the nail with a plate. A special plate is applied to a part of the nail from the outside, which controls the degree of pressure on it.It gently aligns the nail from the edge, thereby giving it a different shape, harmless to the skin.
  • Laser correction of an ingrown toenail – allows you to achieve a quick and effective result. The downside of such a procedure is its relative high cost. Does not completely remove the nail plate, gently removing only its excess part. The procedure is completely painless, however, if there is an inflammatory process on the nail, it first needs to be removed with anti-inflammatory drugs.
  • Radio wave exposure – is the removal of the regrown part of the nail using radio waves.The procedure is fast, effective, painless and does not require additional preparatory steps. It implies the introduction of local anesthesia, treatment of the nail with a scalpel, the necessary attachments and an antiseptic.
  • Surgical treatment of an ingrown toenail – used in advanced cases, when pus accumulates under the skin around. It is carried out under local anesthesia, requires separate preparation (preliminary diet, refusal of antibiotics and a number of other drugs).The entire operation takes about half an hour and requires some postoperative care (in particular, changing the dressing, washing the finger, applying an antibiotic ointment, and visiting the surgeon on time).

Questions-answers

Can an ingrown toenail be cured at home?

It is possible to correct the situation only at the very initial stage, but, unfortunately, in most cases, patients skip it, noticing the problem only when additional help is already required.

What does an ingrown toenail look like?

It is an overgrown nail plate, one edge of which digs into the skin. May cause soreness when pressed.

What preventive measures should be taken to avoid the problem of an ingrown toenail?

You should purchase high-quality shoes that have the appropriate certificates, mainly from natural materials and always in size.Smaller shoes should not be worn. If the shoes are crushing, they should be discarded. You also need to properly trim your nails (use nail clippers or nail clippers) and periodically give your foot a break from wearing any shoes.

Ingrown toenail: which specialist should you contact?

The following specialists are involved in the treatment, depending on the stage of development of the disease: pedicure master, podologist, surgeon.

90,000 Ingrown toenail! How to treat?

Date of publication: .

Doctor-surgeon Alnadfa M.N.
Surgical department number 1

Ingrown nail is an ingrowth of the nail plate into the lateral edge of the periungual fold. As a result, the periungual fold swells, becomes inflamed, and severe pain appears. Most often, the toenail grows into the outer edge of the roller.

Causes of ingrown toenail

  • In the overwhelming majority of cases, this is an incorrectly performed pedicure (as a rule, an independent one), when, when cutting the nail, its corner is rounded or left with a sharp edge, burrs or the nail is cut very shortly.
  • In second place are improperly selected shoes: smaller, tight, too narrow shoes, flat-soled shoes. If the shoe constantly presses on the nail, the direction of its growth changes. In addition, the constant load on the legs contributes to this pathology.
  • Flat feet, the hallux valgus are brought by the pressure of the second toe on the big toe, as a result the foot is deformed and the big toe is bent.
  • Nail fungus is another cause of ingrown toenails.With a fungus, the nail thickens, deforms and grows into the nail roller.
  • Pregnancy can also lead to ingrown toenails, often late or shortly after childbirth.
  • Skin diseases that contribute to deformation of nails – warts, psoriasis, lichen, etc.
  • Diseases in which nail nutrition is disturbed: diabetes mellitus, cardiovascular diseases, obesity, endocrine disorders.

Signs of an ingrown toenail

This is primarily pain at the site of ingrowth of the nail, which increases with walking.Permanent nail injury to the tissue leads to the appearance of an ulcer. The periungual roller turns red, swells. When an infection joins, there is a throbbing pain and pus is released. At the site of damage, the tissue grows, acquiring the color of raw meat (hypergranulation). With a long course of the disease, irreversible changes occur in the nail plate – it is deformed, thickened and shortened.

Where to go for an ingrown toenail

With the problem of an ingrown toenail, you should contact either a surgeon or a podiatrist – a specialist in foot diseases.If there is a suspicion of nail fungus, you should visit a dermatologist and undergo treatment for the fungal infection.

If there are complications, an X-ray of the foot is taken to determine if the purulent process has affected the bone, and to exclude (or confirm) osteophyte (bony outgrowth on the toe), since it is similar in symptoms to an ingrown toenail.

Ingrown nail home correction

It can only help in the initial stage.

Disinfecting warm baths with solutions of baking soda, furacilin, potassium permanganate, sea salt (alternately) are made 2-4 times a day until the signs of an ingrown nail disappear.After the bath, cotton wool is inserted under the edge of the ingrown nail, lifting it. When the tissues soften, gently remove the nail and treat the affected area with iodine solution.

Saw a vertical groove on the stratum corneum of the diseased nail with a file. It will tighten, and the edge of the nail will rise.

A piece of sterile bandage with an antiseptic (chlorhexidine) is placed between the nail and the roller, wetting it as it dries.Every day, the bandage is pushed forward, gradually freeing the nail.

Conservative correction of ingrown toenail

It is carried out with the help of special devices attached to the nail: springs, staples, plates that raise the ingrown nail and gradually unbend the deformed nail plate. These devices are very small, they are almost invisible and do not interfere with wearing shoes.

Special ointments and balms are used to soften the nail, relieve inflammation and pain and facilitate nail cutting.

And of course, during treatment (and preferably in the future), you must wear loose shoes that do not compress your fingers, and cut your nails correctly: in a straight line, with straight-bladed scissors, not too short – along the tip of the toe. If any sharp edges remain, they need to be filed at the corners to avoid irritating the skin.

Laser correction of ingrown toenail

When using a laser, the ingrown part of the nail and the edge of the growth zone evaporate.At the same time, foci of inflammation are also destroyed. After laser correction, the inner edge of the nail plate does not grow, therefore, cases of repeated nail ingrowth are quite rare. If the ingrown toenail is caused by a fungus, the laser also destroys the fungal spores on the subungual surface.

Radio wave correction of ingrown nail

The ingrown part of the nail is removed by exposure to radio waves and the growth zone is treated. After the procedure, no suture remains, the likelihood of recurrence and complications is minimal.

Surgical correction of ingrown nail

Depending on the severity of the disease, either part of the nail or nail fold is removed, or the nail is removed completely. The latter usually occurs with suppuration and severe deformation of the nail. A new nail grows back in 3 months.

Unfortunately, after such an intervention, relapses of the disease are not uncommon. To prevent this from happening, prophylaxis is carried out: granulations and parts of the skin are removed from the lateral surface of the finger so that the nail does not come into contact with the nail roller.

After the ingrown nail has been removed, the nail bed remains open, and for some time pain is felt at the site of the operation. The operating wound heals within a week, and at this time the main thing is to prevent its infection. The wound is treated with antiseptics, sterile dressings are applied. Pain relievers are prescribed if required.

90,000 causes, symptoms and treatment in the article of the surgeon Kostromin R.A.

Date of publication July 26, 2019 Updated October 7, 2019

Definition of the disease.Causes of the disease

Ingrown nail, or Onychocryptosis is a disease in which the nail plate grows into the lateral edge of the periungual ridge. The tissues around the nail become inflamed, redden, and painful swelling with pus appears. Most often, onychocryptosis affects the big toes. In the initial stage, it is manifested by pain when walking, and in the future, the discomfort does not go away even at rest. In the absence of specialized treatment, the disease often recurs.The periods of inflammation are replaced by periods of remission for years, and drug treatment (anti-inflammatory, antibiotic therapy) gives a short-term effect.

The main causes of the disease:

  1. Improper care of the toes:
  2. if the corners of the nail are cut too deep, this will lead to improper growth of the nail plate and ingrowth into the soft tissues of the periungual fold;
  3. Wearing tight shoes with a narrow toe mechanically presses the skin roll into the nail plate.This provokes inflammation, which further develops into onychocryptosis. At a young and working age, tight shoes are the main reason for the appearance of an ingrown toenail;
  4. Prolonged squeezing of the toes with a plaster cast or other immobilizing or corrective dressing can also lead to ingrowth of the nail.
  5. Anatomical features of the foot and toes [1] :
  6. congenital and acquired bone deformities – flat feet, wide foot, hallux valgus;
  7. Physiologically large, fleshy periungual ridges.
  8. Factors leading to the secondary development of an ingrown nail:
  9. fungal infection of the toes (onychomycosis): the nail plate thickens, deforms and grows into the periungual roller;
  10. foot injury;
  11. diabetes mellitus, gout, etc.

Onychocryptosis can affect both children and the elderly. However, this disease is most typical for young people: according to statistics, 8-10% of the working population [2] face it.

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms of an ingrown toenail

Complaints when visiting a doctor are most often the same: pain in the area of ​​the big toe, which appeared either for no apparent reason, or after an injury or wearing uncomfortable shoes. The disease is characterized by increased pain intensity, edema and hyperemia of the periungual ridge, the appearance of pus and the growth of granulations called “wild meat” (due to the similarity in color to raw meat).

Clinically, there are three stages of development of the disease [3] :

  1. Moderate or insignificant edema and infiltration of the nail fold without changing the nail plate, pus and “wild meat”. Pain most often occurs when moving and wearing shoes.
  2. Pronounced edema of the periungual ridge, its enlargement and deformation, “influx” of tissues on the nail plate, the appearance of pus, compaction of the nail plate, its dullness;
  3. Sharp edema and hyperemia of the periungual ridges, pronounced hypergranulation, “wild meat”, pus.The nail plate becomes thinner, becomes brittle and mobile.

All stages of the development of the disease can be complicated by the inflammatory process.

Pathogenesis of an ingrown nail

When analyzing the pathogenesis (mechanism of the appearance and development of the disease) of onychocryptosis, it is important to take into account the peculiarities of the structure and growth of the nail [4] .

Growth of the nail occurs constantly, throughout a person’s life. The growth rate is about 0.1 mm per day, the nail is completely renewed after 100 days.

The nail plate is formed in the germinal zone (matrix) and further moves along the nail bed. When a part of the nail plate is removed and the matrix is ​​preserved, the nail will grow back and cause the same problems, and the disease recurs.

The nail plate does not grow in width, and ingrowth of the nail occurs exclusively due to inflammation of the periungual fold. In the process of the development of the disease, the soft tissues of the periungual roller are injured by the sharp edge of the nail plate.An inflammatory process begins with edema of the soft tissues, due to which they are even more pressed into the nail. As a result of constant trauma, granulation tissue begins to grow (rather soft and porous, perceived by an unaware person as “extra skin”). Gradually, swelling and inflammation build up, causing more and more discomfort. The fungal and bacterial environment joins, there is a change in the color of the affected periungual roller, a local increase in temperature and the release of pus.It becomes almost impossible to wear the usual shoes; attempts to lean on a sore finger cause acute pain. Further, the inflammatory process becomes chronic, the granulation tissue becomes denser, the nail plate is deformed, and inflammation can spread to the bone tissue [5] .

Classification and developmental stages of an ingrown nail

Classification D.I. Muratova (1972) most fully reflects the causes and pathogenesis of the disease. The author divides the course of the disease into four degrees of severity [6] :

First degree : normal nail shape, complaints of pain in the nail phalanx of the toe, moderate swelling and redness of the lateral ridge on the first toe.

Second degree : the shape of the nail is convex, its thickness ranges from 0.5 to 1 mm, the growing edge is visible. The ingrowth angle of the nail varies from 15 to 30 degrees.

Third degree : the nail takes a tower-like shape, the edges grow deep into the surrounding tissue. The thickness of the nail plate is 2.5 mm, and the angle of the growing edge reaches 30-45 degrees.

Fourth degree : the shape of the nail takes the form of a horn or claw, its thickness is more than 2.5 mm, the angle of curvature of the growing edge is more than 45 degrees, clinical symptoms of trophic changes in the matrix, tissues of the nail bed and nail are observed.

Complications of an ingrown toenail

Complications of untimely treatment of an ingrown nail are associated with the development of an infectious and inflammatory process, which manifests itself in the following pathological conditions [7] :

  1. Toe abscess – formation of a cavity with purulent and purulent contents redness of the entire nail phalanx. Requires surgical intervention.
  2. Osteomyelitis of the nail phalanx of the finger – the infectious process spreads to the bone, medical and surgical treatment is necessary.With late treatment, phalanx amputation may be required.
  3. Gangrene of the toe – irreversible damage (necrosis) of the soft tissues of the foot. The only way to treat this condition is to amputate the nail phalanx or the entire toe.
  4. Lymphangitis or lymphadenitis – spread of infection through the lymphatic system with damage to the lymphatic vessels or lymph nodes. Requires complex treatment with the appointment of anti-inflammatory and antibacterial therapy.

Diabetes mellitus, obliterating atherosclerosis of the vessels of the lower extremities and immunodeficiency increase the likelihood of complications. Also, risk factors include smoking, obesity, old age. A decrease in local defense reactions leads to a more frequent detection of mycoses. In addition, a long-term ingrown nail can cause fibroids and malignant neoplasms.

Diagnosis of an ingrown nail

Diagnosis of an ingrown nail begins with identifying typical complaints, causes of the development of the disease and predisposing factors.During the examination, the doctor determines the presence of anatomical features, the stage of development of the disease, the presence of complications, conducts a comparative examination of the other limb.

The characteristic appearance of the finger, the presence of predisposing factors and anatomical features, signs of inflammation, purulent discharge and granulation allow you to easily diagnose and determine the severity of the process [8] .

If you suspect the possibility of complications, as well as to clarify the causes of the development of the disease, the doctor uses additional diagnostic methods:

  1. Complete blood count – to exclude signs of a general inflammatory process.
  2. X-ray examination of feet . The X-ray is intended to detect the spread of purulent inflammation, the transition of the pathological process to the phalanx bones, as well as to clarify the anatomical features of the foot (the degree of deviation of the first toe, assessing the degree of flat feet).
  3. Sowing of purulent discharge to study the type of pathogen. This is necessary in order to determine the sensitivity of bacteria to antibiotics in case of prolonged recurrent course of the disease and ineffectiveness of therapy.

Treatment of an ingrown nail

At the initial stage of the development of the disease, conservative treatment is prescribed with the elimination of the predisposing factors of the disease. It is recommended to reduce the load on the toe, restrict walking, wearing loose shoes (if possible, walking without shoes), applying cold to the site of inflammation, hygiene of the feet, avoiding trauma, compresses with antiseptic solutions. The use of ointments such as ichthyol ointment or Vishnevsky’s ointment is not recommended.If the inflammation disappears, then the patient is advised to be careful and, if the inflammation recurs, go to the surgeon again.

In case of ineffectiveness of the therapy, a later stage of the disease or recurrent course, surgical intervention is indicated.

More than 150 methods of surgical and conservative treatment of an ingrown nail are currently known [2] [9] . However, only a few of them give the desired result (minimal risk of recurrence, high cosmetic effect, high recovery rate).

The most effective and frequently used surgical operations:

  1. Marginal resection of the nail plate without resection of the periungual ridge – includes the removal of 1-2 mm of the ingrown edge of the nail plate with the destruction of the growth zone of the removed fragment to prevent recurrence. The operation of choice with a slightly and moderately altered periungual ridge without pronounced granulations and “wild meat”.
  2. Marginal resection of the nail plate with resection of the periungual ridge (surgery according to Bartlett, according to Schmiden) – supplemented with one of the options for resection of the periungual ridge.It is indicated with a pronounced change in the periungual roller, abundant granulations and the presence of “wild meat”. In this case, the resected periungual ridge is sutured with single-row interrupted sutures. This type of operation is more traumatic, however, during the operation, the risk of recurrence is significantly reduced.
  3. Complete removal of the nail plate (Dupuytren’s operation) is used less and less due to the high risk of relapse, high pain intensity after surgery and low cosmetic effect.The operation of choice for severe damage to the nail plate, for example, with onychomycosis.
  4. Radio wave and laser methods. They are rarely used in their pure form, but they can complement the marginal resection. After removing the ingrown part of the nail by the radio wave method, the doctor acts on a fragment of the growth zone in order to destroy it and prevent relapse. The surgeon can do the same procedure with a laser.

Any operation can be performed in a small operating room, does not require lengthy preoperative preparation and is performed under local anesthesia.Anesthetic solution (novocaine, lidocaine) is injected into the base of the thumb. The full anesthetic effect is achieved within 7-10 minutes after the injection of the anesthetic.

With proper anesthesia, the operation to remove an ingrown nail is absolutely painless and takes from 10 minutes, depending on the complexity and prevalence of the process. Before anesthesia, the doctor must check with the patient if he is allergic to the anesthetic and other medications. After the operation, a tight aseptic bandage with an antiseptic is applied.Dressings in the postoperative period are sufficient to carry out once a day under the supervision of a physician. The stitches are removed in 7-14 days, depending on the volume of the operation and the body’s ability to recover.

The above methods require extremely qualified treatment. If the exposure is insufficient, the likelihood of a relapse of the disease is high. In case of excessive exposure, areas of the growth zone can be damaged, which will cause permanent deformation of the nail for life.

There is a large number of scientific works investigating methods of combined treatment of an ingrown toenail.Methods of cryodestruction, dynamic destruction by phenol, ozone therapy, ultrasound, EHF-irradiation, etc., are considered, however, these methods are not widely used [10] [11] [12] .

I will answer the most frequent questions of patients:

  1. After the operation, you can go home on your own feet, you can drive a car and lead a normal life.
  2. The effect of anesthesia lasts up to 2 hours, after which pain appears in the area of ​​the postoperative wound.For the postoperative period, anesthetic therapy is prescribed in advance, taking into account the patient’s allergies and concomitant diseases.
  3. After surgery, the dressing may be slightly soaked with blood, but if signs of bleeding persist, you should urgently consult your doctor.

Forecast. Prevention

With timely access to a doctor, correct operation and adherence to the necessary recommendations, the risk of recurrence remains quite low.

Surgical treatment is the most effective way to treat this disease. Conservative methods are able to eliminate the problem only at the very initial stages [2] and are used with the operation in combination.

The operation to remove an ingrown toenail usually does not require special preparation and can be carried out in a private medical center. With the right choice of anesthesia, it is absolutely painless, takes from 10 minutes and has a low relapse rate. The operation eliminates the disease, improves the cosmetic effect and improves the patient’s quality of life without restricting his daily activities.

To prevent an ingrown toenail, it is necessary to eliminate the causes of its occurrence:

  • Wear comfortable shoes;
  • observe hygiene in nail care;
  • To trim nails correctly: in a straight line not below the tip of the toe;
  • File the edges of the nail with a file in the corners so that they are smooth and do not injure the skin.

In addition, it is recommended to correct concomitant diseases: normalize blood sugar in diabetes mellitus, control body weight in obesity, cure onychomycosis (foot fungus), wear orthopedic shoes for flat feet and silicone liners for hallux valgus.

Ingrown toenail: causes and prevention

Most often, an ingrown toenail appears almost exclusively on the thumb. Too tight, improperly fitted shoes and improper nail clipping are the most common causes of an ingrown toenail. More often than not, when cutting nails, a mistake is made arising from excessive diligence – the nails are cut too short.

To avoid the ingrown toenail problem, trim your toenails and especially your big toes so that they protrude 1–2 millimeters beyond the edge of your toe.When the foot is in the shoe, the slightly flattened ball of the toe will be covered with a nail, which, as it were, protects it. But at the same time, the nail in the shoe will not protrude too much from the edge of the toe and tear stockings or socks.

In addition, to prevent the appearance of an ingrown nail, one more rule should be observed: in no case round off the lateral parts of the nail and, moreover, do not cut off the lateral triangles from it! It is the rounding of the free edge that is the surest way to grow in the nail.

What to do if you nevertheless find an ingrown toenail, or notice the first signs of ingrown nails? First, change your shoes to looser ones right away. Be sure to soak your feet with a warm solution of potassium permanganate or purified soda twice a day (one tablespoon per basin).

After such a foot bath, try slipping a cotton swab a few millimeters thick under the sides of the nail to lift the nail above the nail roller.If this works out, hold the nail in this position for several hours, and lubricate the nail roller with iodine.

Try to push strips of gauze soaked in petroleum jelly or vegetable oil between your skin and your nail along the sides. The gauze should be changed every day until the ingrown part is loose from the skin. Then cut it off.

If the ingrown toenail is very strong and thick, the middle part should be scraped off. Due to the fact that the nail, growing together along the scraping line, is compressed, its ingrown corners are pushed back.

If your efforts to treat an ingrown toenail have not been successful, do not tempt fate and consult a surgeon!

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90,000 causes, symptoms, diagnosis, treatment, prevention

Pathology of the nail plate, characterized by changes in the matrix and surrounding soft tissues.Refers to inflammatory and purulent diseases, ingrowth of the nail plate in the tissue of the lateral nail ridges, painful sensations.

Causes of ingrown toenail

Transverse flat feet, curvature of the toes, improper processing of nails with cutting corners during manicure, congenital deformity of the feet, wide toes, foot hyperhidrosis, psoriasis, fungal lesions, nail dysplasia, crossing fingers; heavy loads, heavy weight, frostbite, injuries; narrow, high-heeled, non-ventilated shoes; hereditary factor; cardiovascular diseases, diabetes mellitus, varicose veins; exposure to aggressive chemical substances.

Symptoms of an ingrown nail

Pain while walking, redness and swelling of the skin on the finger, fever, the onset of a purulent-inflammatory process, the acute angle of the nail plate increases and grows into the roller, bleeding appears; the nail plate is dull and thickened.

Diagnosis of an ingrown toenail

Podiatrist examines symptoms and medical history, conducts a visual examination. To clarify the diagnosis, laboratory tests are prescribed: a general blood test, a blood sugar test, an X-ray of the bones of the foot; examination by a dermatologist.

Treatment of an ingrown toenail

Treatment is carried out in a comprehensive manner and depends on the degree and causes of the disease. Antibacterial and emollient ointments are used – Ichthyol, Vishnevsky’s ointment; trays with manganese; Burnt alum, Levomikol, Baniocin.

Surgical intervention with a scalpel, laser correction, radio wave removal method; orthopedic treatment is carried out individually: plates, braces, corrections.

Prevention of ingrown toenail

Choose and wear comfortable shoes correctly; regularly take care of nails, trim without cutting corners, not too short and in a straight line; use orthoses, corrective feet and relieve pressure on the toes; timely treat fungal diseases; when visiting the pool and sauna, have removable shoes, protect your fingers from injury; do not use someone else’s shoes.

90,000 Ingrown toenail: causes, treatment, symptoms, removal, surgery

An ingrown nail or onychocryptosis is an ingrowth of a part of the nail plate into the lateral edge of the tissue of the nail fold. The outer edge of the big toe is most commonly affected. When the nail grows in, the nail fold turns red, swells, an inflammatory process occurs, which is accompanied by severe pain.

Not everyone notices that the nail has grown into the skin, and they go to the doctor already at the stage of suppuration and unbearable pain.An ingrown toenail in half of the cases becomes a chronic phenomenon.

Why does the nail grow in?

The nail grows into the finger due to a number of external causes:

  • Incorrectly performed pedicure (in 95% of cases) – cutting off the corner of the nail, leaving a sharp edge, burrs, cleaning the free part of the nail with the tips of scissors. After cutting the nail, there should be no rounded edge, you should not cut the nail too short.
  • narrow, disproportionate footwear, with narrow toes (see.ballet shoes are the cause of an ingrown nail), with constant pressure on the nail, it changes the direction of its growth.
  • increased load on the legs

and some diseases:

  • nail plate fungus – nail fungus leads to its deformation and thickening, growing into the periungual roller
  • flat feet, valgus feet – both deformity of the foot and curvature of the big toe occur, since the second toe is pressing on it
  • Congenital excess amount of soft tissue in the subungual cushion
  • pregnancy – an ingrown toenail often occurs in women shortly after childbirth (after 1.5-2 months) during breastfeeding or late pregnancy
  • finger injury or frostbite
  • diseases that disrupt nail nutrition – endocrine pathologies, diabetes mellitus, obesity, cardiovascular diseases
  • skin diseases – psoriasis, warts, lichen, etc., which contribute to deformation of nails
  • treatment of oncological diseases – chemotherapy, radiation therapy negatively affect constantly actively growing cells

Symptoms and signs of an ingrown toenail

Signs of an ingrown toenail:

  • Pain in the area of ​​the nail fold from the ingrowing side of the nail, constant, aggravated by walking and wearing shoes.
  • The sore at the site of ingrowth of the nail appears as a result of injury.
  • The roller swells, turns red, pulsating pain appears – this is the addition of an infection, while purulent discharge appears.
  • Excessive tissue growth (granulation) of the color of raw meat on the toe.
  • With a long course – irreversible changes in the nail, deformation, thickening and shortening of the plate. Coarsening of soft tissues. Suppuration.

Survey

To exclude the development of complications and quickly cure an ingrown nail, you should contact a surgeon or podiatrist (foot diseases).He will direct to:

If you suspect a toenail fungus, you should contact a dermatologist for complex treatment, since in this case the ingrown nail is only a consequence of a fungal infection, and treating the consequences, and not the disease itself, is futile.

In the presence of complications, the surgeon will send an X-ray of the foot to determine the presence or absence of a purulent process on the bone, and also to exclude such a pathology as osteophyte (bony outgrowth on the finger), the symptoms of which are similar to onychocryptosis.

Conservative treatment

It is effective in the initial stage of the disease, so do not delay visiting a doctor, it is carried out at home:

Baths and compresses

  • Disinfectant baths with solutions of potassium permanganate, baking soda, sea salt (every day, alternately) 2-4 times a day. The softening of the tissues leads to the natural release of the ingrown part of the nail. After such procedures, try to gently remove the nail and treat the area with iodine.Do the baths until the signs of onychocryptosis disappear.
  • Applying a piece of sterile bandage soaked in Chlorhexidine solution between the nail and the skin fold. As it dries, the bandage is moistened in an antiseptic. Each day, the bandage is pushed forward a little, freeing up even more of the nail. When done diligently, this home treatment is very effective.
  • Compress: it is done at night for 3-4 days, if the inflammation does not relieve, then you should contact the surgeon. Composition: dilute 10 ml of Dimexide with 20 ml of water, 1 amp.analgin, 1 ml. dexamethasone. A gauze swab is moistened with such a solution, applied to the finger, cellophane on top, bandaged, put on a sock for the night.
  • You can use this method: with a nail file, cut a vertical groove on the ingrown nail (only on the stratum corneum). This groove will tighten, thus raising the edge of the ingrown toenail.
  • When inflammation begins (throbbing pain, redness, swelling), this method is suitable only at the very beginning of the inflammatory process to stop it, if an abscess of a finger has begun, this cannot be done and you should consult a doctor.Dip the inflamed finger into a container of very hot water (boiling water) for 1-2 seconds (as much as you can tolerate) and so on several times (20-30 times in 10-20 minutes), then repeat the procedure until the pain and inflammation disappear.
  • For severe pain, possibly oral NSAIDs (porracetamol, nimesulide, ibuprofen, etc.)

Observe the following rules during treatment:

  • Wearing loose shoes
  • Perfect foot hygiene
  • Change of socks 2 times a day
  • Correct nail trimming (see below).

Ointments and solutions for ingrown nail

Noctinorm

This is a balm that softens the nail plate, facilitates circumcision, relieves pain and inflammation.
Ingredients: extracts of licorice, macklea, St. John’s wort, palm oil and petroleum jelly.
Application: 1-2 p / day, before use, you should steam your feet so that the corners of the nail come out from under the nail rollers, then apply the balm to the roller and the entire nail plate.

Uroderm


Composition: The main active ingredient of the ointment is urea (carbamide), which softens the tissues and the nail, making it easier to cut the ingrown nail.
Application: Before cutting the nail, apply the ointment for 3-4 days. It is applied to a dry finger, with a special spatula, fill the cream between the periungual roller and the edge of the nail, put on socks and leave for a while. After 3 days, you can trim your nail.

Levomekol


For use only after surgery.
Ingredients: antibiotic chloramphenicol and methyluracil, which improves tissue regeneration.
Application: After the operation, a bandage with levomekol is applied until the wound is completely cleansed.

Vishnevsky ointment

It is used when an infection is attached.
Ingredients: castor oil, birch tar, xeroform powder.
Application: Apply the ointment at night under the bandage, remove it in the morning, if the nail comes out from under the roller, you can cut it off.

Ichthyol ointment


Composition: petroleum jelly, ichtammol.
Reduces pain, inflammation, irritation, destroys bacteria, softens the nail plate.
Application: A bandage with ichthyol ointment is applied at night, in the morning it is removed and the nail can be cut.

Staples and Plates

They raise the edge of the nail without causing any discomfort, you can wear shoes. The braces look a bit like dental braces. Installed on the nail only by a doctor.

  • Wearing special plates on the thumb: Podofix, Oniklip.
  • Wearing staples: Osthold, Ora, Fraser.

Surgical treatment includes a range of methods

Resection of the edge of the growing nail or the entire nail plate

Ingrown toenail removal is an operation performed under local anesthesia. If the nail festers, most often the entire nail plate is removed. A new nail will grow back within 3 months. Unfortunately, after surgery, relapses of the disease occur with a high frequency in 3-4 months.Therefore, relapse prevention is carried out, which consists in the plastic of the nail roller: removal of granulations and part of the skin along the lateral surface of the finger. The nail roller stops contacting the nail plate.

Laser moxibustion

Laser of ingrown nail and nail plate growth cells after ingrown nail removal. It is indicated for ingrown nails at the cuticle level. High-tech method leading to permanent remission. The laser beam burns out the growth cells and part of the ingrown nail, while simultaneously removing the inflamed tissue and granulation.Laser correction is the best treatment for an ingrown toenail.

Radio wave removal of ingrown nail

Gentle technique, no suture remains after the operation, and the likelihood of complications and recurrence is minimal. During the operation, the ingrown part of the nail is eliminated, and the matrix and growth zone is processed.

What to do after ingrown toenail surgery?

  • After resection, the nail bed is exposed and causes pain for some time.Healing takes place for a long time for a month, and during this period it is important to protect tissues from infection.
  • Every day for 3-5 days, the nail bed is treated with antiseptics (Chlorhexidine, hydrogen peroxide) and antibacterial ointment (Levomekol, Gentaksan, Oflokain), and the finger is bandaged with sterile materials. Subsequently, the dressing is done every other day.
  • Ensure complete rest of the limb in the first few days and then protect the leg from overload and injury.
  • If necessary, take painkillers is prescribed.
  • It is recommended to wear wide shoes with minimal contact with the operated toe.

What to do if a child has an ingrown nail?

In this case, you should immediately go to the doctor – the pain threshold in children is very high, so independent actions can only aggravate the situation. How to treat an ingrown toenail in a child, the doctor will decide after examination.

Complications

  • Lymphangitis and lymphadenitis – spread of infection through the lymphatic vessels to nearby lymph nodes.
  • Abscess of a finger is a purulent lesion of soft tissues with swelling and redness.
  • Osteomyelitis is a neglected case of an abscess, with a short period of time the inflammation spreads to the bone (more about osteomyelitis).
  • Gangrene of the finger – tissue necrosis of an irreversible nature, the tissues become black.

Prevention of nail ingrowth

  • Correct pedicure:
    • softening nails in a warm bath before pedicure;
    • Cutting the nail in a straight line, without rounding the edges, as is done on the hands;
    • Neat processing of the edge of the nail and tips with a soft nail file;
    • the free edge of the nail after clipping should be 2-3 mm, do not cut too short;
    • Removing excess skin and dirt with a piece of bandage or cotton wool, not with scissors.
  • Application of liquid to prevent ingrown nails (GiGi No Bump Topical Solution, Genwol med) – softens the skin, reduces keratinization and prevents ingrown nails.
  • Wearing well-proportioned shoes with small heels (3-4 cm for women, 2 cm for men).
  • Wearing orthopedic shoes and insoles in the presence of a corresponding pathology.
  • Foot hygiene, regular change of socks.
  • Fighting excess weight.
  • Timely treatment of fungal infections.

90,000 Ingrown toenail problem in children

Main / About the hospital / Articles / The problem of an ingrown nail in children

Attention!

Registration for surgery on the problem of an ingrown nail by phone +7 (812) 670 25 15 during working days from 09.00-17.00

Leading pediatric surgeon of St. Mary Magdalene Children’s hospital No.2 Sigunov Viktor Sergeevich answers the readers’ questions

My son began to complain of pain in the big toe when walking, he cannot put on his old shoes.What could it be?

– By all indications, your child has an ingrown nail, but you need to make sure of this by examining the patient. An ingrown toenail is very common, starting from childhood.

Doctor, what is an ingrown toenail and how dangerous is this disease in childhood?

– An ingrown nail is a combined pathology of the nail plate and the tissues surrounding the nail. In this case, there is a pathological expansion of the growth zone of the nail, its growth in the lateral direction, deformation and penetration into the soft tissues of the nail fold.This, in turn, leads to the proliferation of pathological unhealthy tissue and the development of chronic inflammation.

My friends say that my child’s nails are called “in me.” Is this disease really so inherited?

– In part, heredity factors contribute to the occurrence of an ingrown toenail. But it all starts with the wrong choice of shoes for a child, excessive abuse of flat-soled shoes, especially with regard to seemingly harmless house slippers.Of course, wearing tight and uncomfortable shoes, inflammatory diseases, injuries.

What are the first symptoms of the disease?

– It is worth paying attention to the fact that an ingrown toenail is most often formed on the big toes. The first symptoms of ingrowth of the nail plate are pain, redness and swelling of the periungual fold. All this makes it difficult to wear shoes for a long time. In the end, the infection is attached and pus begins to stand out from under the nail.

We treated the ingrown toenail ourselves for a long, long time, then went to the doctor and he said that the situation can be radically changed only with a surgical method, but my child is very afraid of this. Is it really that scary?

– Indeed, treatment at the initial stage is conservative, but experience shows that the gradual progression of the disease forces the patient to seek surgical help. The only method to get rid of an ingrown toenail is surgery.The procedure is painless, as it is performed under local anesthesia and your child will not feel anything, after which a bandage is applied. After the procedure, patients are advised to keep the operated limb at rest for a while. To prevent the development of the inflammatory process, antibacterial agents are prescribed. This intervention practically does not disrupt the patient’s usual rhythm of life.

Does the child need to go to the hospital for such an operation or can it be done on an outpatient basis?

– A method of gentle surgical correction of an ingrown nail has long been developed in our hospital.For children, it is preferable to stay in a hospital during the postoperative period (about 5 days), but an outpatient treatment option is also possible.

The most experienced doctors of the department of purulent surgery operate in our hospital: the head of the department, a surgeon of the highest qualification category Viktor Sergeevich Sigunov and a surgeon of the highest qualification category Natalya Alexandrovna Mushkina.

The department has superior rooms. You can use them if you wish.

No wonder they say that our body is one. And if even a small organ is sick in it, the whole organism is sick. If it so happens that your child has an ingrown toenail disease, do not worry or despair. By now you already know where your child can be best served.

Attention!

Registration for surgery on the problem of an ingrown nail by phone +7 (812) 670 25 15 on working days from 09.00-17.00

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