Ingrown Toenails

What is it?
Ingrown toe nails are caused by impingement of the skin along the margins of the nails. Most commonly occurs on the big toe. Pain can be present without infection, and occasionally infection is present without pain. It can be sensitive to any pressure even the weight of the bed sheets. There may be drainage of pus or watery discharge tinged with blood. Some ingrown toenails are chronic, with repeated episodes of pain and infection. The usual signs of infection include: redness, swelling, increased warmth, and pain. A small benign tumor called a granuloma can form along the nail margins.

How did I get it?
Mostly due to the shape of the nails: curved; thickened; or thin & broad nail plates. It can also be due to improper cutting of the nail: cutting too short; leaving sharp corners/edges. Also caused by trauma to the toes: one episode of macro-trauma e.g. kicking or dropping a heavy object; or repeated micro-trauma e.g.: toe hitting end of steel toe boots. Other causes: abnormal gait and toe deformity causing hyper extended and trigger toes (runners or post stroke).
• Improper trimming of toenails.
• Tight fitting shoes which compress the toes together.
• Hose or socks that are too tight.
• Abnormally shaped toenail plate.
• Other toenail deformities (e.g. excessively thick nail plate).
• Trauma to the nail.

How to get rid of it?
Home Advise: cut nails straight across and file the corner edges; warm salt water foot baths; over the counter antibiotic cream, and to avoid tight footwear.

An ingrown toenail requires prompt professional attention! Ingrown toenails are one of the more common foot problems treated by chiropodists.

A chiropodist can remove the ingrown nail spike (with or without freezing) providing immediate relief. A chiropodist may give you an oral and/or topical antibiotic to treat the infection as well.

If having ingrown toenails is a reoccurring problem, we can perform a simple in-office procedure in our surgical suite to kill the part of root (matrix cells that grow nails) so that the problem never occurs again!

The Ingrown Toenail Procedure

The toe is anaesthetized, prepped with antiseptic, and a tourniquet.
The offending border of the nail is cut back and removed.
Liquified phenol (90%) is applied to ‘kill the root” (nail matrix -growth area) and the nail bed. This will prevent re-growth of that side of the nail, as well as stop bleeding and numb temporarily the toe making the post-operative pain very minimal.
Then it’s all wrapped up and ready to go home!

This procedure is painless, as the toe is put “to sleep” with a local anaesthetic agent. There is minimal post-operative discomfort. The wound is usually fully healed in about three to four weeks. During this period it is simply dressed with topical antibiotics and bandages. After healing, the nail is normal in appearance, somewhat more narrow than before. The incarnated nail border is gone, leaving the toenail unlikely to ever ingrown again.

Complications of an improperly treated or neglected Ingrown Toenail

Infection, if present, may spread to the foot and leg, or into the blood stream.
Loss of the nail plate from the infection or inflammation of the nail bed.
Chronic ingrowing nails can cause deformity of the nail plate and/or surrounding soft tissues.
A small benign tumor called a granuloma can form along the nail margins.

*** Diabetes and those with poor circulation to the feet must NEVER attempt to treat an ingrown toenail at home. Consult with a chiropodist or physician immediately.

What the Chiropodist May Do
Ingrown toenail routine nail cutting treatment may need to be done on a routine basis. Your chiropodist may perform any one or combination of the following procedures.

Elevate the end of the nail plate to prevent impingement on the soft tissues by packing
Prescribe antibiotics
Advise you on special foot soaks
Drain the infection.
Permanently surgically correct a chronic ingrown toenail.

What you can do:

Warm salt water foot baths
Cut toenail straight across, and leave it slightly longer than the end of the toe, and file the corner edges.
Cover the counter antibiotic cream
Avoid tight fitting foot wear.
If discomfort develops try soaking the foot in a basin of warm water 2 or 3 times a day.