Ingrowing Toenails

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An ingrown toenail is one that pierces the skin of the toe. It can often be a splinter of nail digging into the flesh, and can be extremely painful. In more severe cases, it can become infected and bleed. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too. A nail that is curling (involuted or convoluted) into the flesh, but isn?t actually piercing the skin can be a painful.

Who Gets In-growing Toenails?

Active, sporty people are particularly prone as they break their nails. Younger people are also more likely to get them (they often pick their nails. People often develop them as a result of cutting nails too low at the corners

Are In-growing Toenails Serious?

If left untreated, and they become infected. The infection can spread to the rest of the toe and foot. The quicker you treat them, the easier it is to cure them. Infections on toes can be particularly serious and spread up the foot and lg in the elderly or people with reduced resistance to infection such as Diabetics or patients whose immune systems are suppressed.

What Causes The Problem?

There are many factors that can make you prone to in growing toenails. These may include things such as your posture and gait (the way you walk), a foot deformity such as a bunion, hammer toes or excessive pronation (inrolling) of the feet, tight footwear or socks. They can be inherited causing your nails to be unnaturally wide and fan shaped, or curl inwards instead of growing straight.

What Can I Do To Prevent In-growing Toenails?

Firstly, learn to cut your nails properly. Nail cutters aren?t a good idea because the curved cutting edge can cut the flesh and nail scissors can slip. It?s best to use nail nippers (available from chemist or Podiatrist) because they have a smaller cutting blade but a longer handle. Cut your nails straight across and don?t cut too low at the edge or down the side. The corner of the nail should be visible above the skin. Also, cut them after a bath or shower when they?re soft. Good hygiene can go a long way to preventing ingrown toenails. Avoid moist, soggy feet where possible.

What Is The Treatment For An In-growing Toenail?

It depends on the severity of your condition. For the basic ingrowing toenail, our Podiatrist will carefully and painlessly remove the offending spike of nail and cover with an antiseptic dressing. Podiatrists as part of their training specialise in nail problems, their cause and treatment.

If your toe is too painful to touch, our podiatrist may use a local anaesthetic to numb the toe, before removing the offending portion of nail. If you have involuted nails, your podiatrist may remove the bit that?s curling into the flesh and smooth the edges of the nail with specialised fine equipment. If you have bleeding or discharge from an infection, or even excessive healing flesh (hypergranulation tissue) around the nail, they?ll prescribe antibiotics to beat the infection, after having the offending spike removed.

If you are particularly prone to ingrown toenails from underlying problems such as poor gait, your podiatrist may recommend correction of the underlying cause as well as a more permanent solution to the nail itself, (see biomechanics and Orthoses)

If it is more an inherited problem of a wide nail plate, then a minor surgical procedure can be performed called a Partial Nail Avulsion (PNA) to remove the ingrowing edge of the nail and a small piece of the root of the nail edge so it does not regrow on that side. This is done under a local anaesthetic, where a few millimetres of the offending nail edge is removed (including the root) permanently, so the nail becomes very slightly narrower. This procedure was developed by Podiatrists in whose hands it is shown to have an over 97% success rate. After surgery, the overall appearance of the nail looks normal.

 High Risk Patients

If you have diabetes, are taking steroids or are on anti-coagulants, don?t attempt any form of self-treatment by trying to cut your nails or remove the ingrown spike of nail yourself; see your Podiatrist as soon as you can.

What To Do Before Seeing A Podiatrist

If you?ve booked an appointment with us, you may relieve the discomfort in the meantime by bathing your foot in a warm salty footbath. This prevents infection and reduces inflammation. Then apply a clean sterile dressing, especially if you have a discharge. Rest your foot as much as possible until we can sort out the problem for you.