Ingrown Toenail

Aquilon_IngrownToenails.jpg
 

Ingrown Toenail

Onychocryptosis (Ingrown toenails) are one of the more common foot problems treated by a Chiropodist. They can be very painful, sometimes even impeding on daily activities.

Ingrown toenails are caused by a nail spike that penetrates the skin along the margins of the nail, causing pain. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Pain can be present without infection. If there is an infection, the usual signs include redness, swelling, increased warmth and pain. Drainage of pus or a watery discharge tinged with blood may also be seen.

Ingrown toenails are a result of :

  • Improper cutting of the toenails, leaving a sharp spike of the nail to penetrate the skin.

  • Tight-fitting shoes which "squish" the toes together.

  • Socks that are too tight.

  • Abnormal shape of the nail plate.

  • Other toenail deformities (e.g. excessively thick nail plate).

  • Trauma to the nail plate or toe.

Complications

  • Infection, if present, may spread to the foot and leg, or into the bloodstream.

  • Loss of the nail plate due to infection.

  • Inflammation of the nail bed.

  • Chronic ingrowing toenails can cause deformity of the nail plate and/or surrounding soft tissues.

  • A small benign tumor called a granuloma can form along the nail margin.

  • Diabetic patients and those with poor circulation to the feet must never attempt to treat an ingrown toenail at home. Consult your Chiropodist.

  • If a patient suffers from a chronic ingrown toenail on one of the borders of the toe, a procedure called a Partial Nail Avulsion may be required. This would permanently remove a narrow piece of the toenail from the side of the nail.

Toenail Surgery

  1. The toe is anaesthetized and prepped with an antiseptic solution.

  2. A tourniquet is applied and the medial border of the nail is removed.

  3. Liquefied phenol is applied to cauterize the nail matrix (growth area) and the nail bed.

  4. The chemical cautery is complete.

  5. The procedure is painless as the toe is anaesthetized with a local anaesthetic agent. There is minimal post-operative discomfort. The wound heals in about four to six weeks. During this time period, it is simply dressed with a topical antibiotic and band-aids. After healing, the nail is normal in appearance and somewhat narrower than before.

Reducing the Risks

  • Cut the toenails straight across and leave them slightly longer at the end of the toe.

  • Avoid tight-fitting footwear.

  • Never use scissors to cut your toenails.

  • An infected ingrown nail requires prompt professional attention. Contact your Chiropodist immediately.

  • If you are a diabetic or have poor circulation the water for soaking should never be more than 95 degrees Fahrenheit.

Permanent, Partial or total nail Avulsion

Some ingrown toenails only require a local anaesthetic and a simple procedure that removes the offending piece of nail. Often these will never reoccur again; however, chronic ingrown toenails that are causing repeated irritation and infection require corrective surgery to eliminate this reoccurring problem. This procedure involves removal of either part of the nail (partial) or the whole nail (total).