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Ingrowing Toenails

What are they?
A true ingrowing toenail is where a shoulder or splinter of nail pierces the skin at the side of the nail.
Where?
The most common nail affected is the big toenail. It is most commonly found in teenagers, especially boys.
Causes?
The main cause is poor nail cutting
- cutting the nail too short
- digging down the sides
Poor footwear - shallow, pointed shoes
What does it look like?
The toe will be tender and may throb. It will also become red, warm, swollen and, if severe, infected, some pus discharge may be seen.
Where the piece of nail enters the skin a hole is formed which provides a good source of infection which commonly accompanies this condition.
TREATMENT - Depends upon the severity of the case
It may simply involve the careful removal of the piece of nail which has penetrated the skin, followed a month or more later by a packing placed between the edge of the nail and the groove, which allows the nail to grow over the skin properly. Sometimes the part is so sensitive the toe needs to be numbed first, this can be done easily in the practice using a local anaesthetic which is always available providing you have no medical contra-indications.
Been there - But it is not better!
If the area has not significantly improved by about 4 days following treatment, you MUST return to the surgery, as probably there was more than one spike causing trouble, this too has to be removed. Often I see and cure patents who have been elsewhere without success.
Done that - Fed up now
If the nail keeps ingrowing, then a more permanent treatment is available where we remove the offending side of the nail (leaving the centre of the nail as it is), & permanently kill a bit of the nail root. See below.
What else?
Often pain in the nail groove is not due to the nail itself growing in, so ensure if you have any problems with a toe, make sure you consult a chiropodist.
But it feels better now!
The commonest mistake with ingrowing toenails is where treatment is postponed because the pain has gone. Unless the ‘spike’ has been removed the pain will return again, often worse. Taking antibiotics to clear any infection present is almost pointless without the cause being dealt with, and can needlessly allow delay in solving the problem.

A Permanent and Pleasant Cure!

WEDGE RESECTION + PARTIAL AVULSION + MATRIX PHENOLISATION.
This procedure was developed originally in America in the 1950’s and became the radical treatment of choice by the 1980’s by members of the Society of Chiropodists and the Podiatry Association (the only medical bodies trained in this advanced technique of skin surgery).
Preparation
A case history is made and any medical conditions are taken into consideration before the operation is performed. This is to ensure your absolute safety, if you have had dental anaesthetics before, are reasonably fit, and have no artificial implants there should not be any problems. Queries may need to be checked with your doctor. You cannot expect to have an operation without visiting here at least once beforehand.
Treatment
The operation is performed on an outpatient basis and is completely painless. The time taken varies with each case and depends upon how many sides of nails are requiring treatment, (usually between 45 and 90 minutes). A local anaesthetic is administered to the base of the toes to be treated, you will normally be lying down during the whole procedure. The numbness will last approximately two hours. You must be accompanied home after the operation. Do not consume alcohol for 24 hours before of after, or take any drugs without consultation with the chiropodist. The edges should not be sore after this time anyway, depending on what is intended you probably can continue afterwards with your normal daily routine. Elevation, rest, and an ordinary analgesic might be needed but only in rare cases that feel uncomfortable. This operation is carried out under proper sterile field conditions so needs to be booked at a mutually convenient time as I do need to arrange an assistant to be available.
Afterwards?
That night as the soonest, three days later at the latest, the dressing will need to be changed. You will be supplied everything you need apart from a pair of scissors. You bathe the toe, take the dressing off underwater, scrub the area well, dry with a clean towel, apply the antiseptic, non-stick gauze, and bandage as shown. Some days after the operation the groove discharges a sticky fluid, this is a healthy sign and needs to be encouraged. When this stops you no longer need to redress the part, this takes often two to nine weeks. It is sensible practice to ensure that the operation is carried out at least 3 weeks before a holiday is planned.

An Ingrowing Toenail

 

 

Cartoon of Ingrowing Toenail

 
J.L. performing surgery

 

Produced by: Jonathan D. Lees D.Pod.M., M.C.Pod., HPC Registration Number CH.07404
Telephone:
Stourbridge (01384) 390000
Surgery Address: 37 High Street, Amblecote, Stourbridge, West Midlands DY8 4DG

This page last edited 18.08.2020© Copyright J. Lees

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