Ingrown Toenails Are A Common Condition
If youve ever had the corner or side of your toenail become red and inflamed, youve 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.
When To Make An Appointment With One Of Our Podiatrists
When home remedies dont work, or you have recurring ingrown toenails, its time to schedule an appointment with us. Your podiatrist at Arlington/Mansfield Foot & Ankle Centers can determine whats 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. Its especially important that you dont 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.
What Causes An Infected Toenail
Your toenail can become infected in a number of ways, including fungal infections or even calluses caused by your shoes. One of the most common types of toenail infections is an ingrown toenail. If your toenail is ingrown, it means the edges of your toenail start to grow into the skin next to your toenail. Ingrown toenails can be red and inflamed, sore, and may even be filled with pus.
The most common causes of an ingrown toenails include:
- Cutting your toenail too short or too long
- Toenail injury
- Curved toenails
- Improper footwear that puts pressure on your big toes
- Cutting your toenail improperly
- Certain sports and activities like dance, soccer, and skiing
- Poor foot hygiene
Infections on your toes may be common if you have diabetes or similar conditions that cause poor circulation or a weakened immune system. Diabetics should check their feet often and have regular appointments with a podiatrist because they may not feel the pain of a toe infection until the problem is severe.
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What Are The Potential Complications Of Surgery
Complications from ingrown toenail surgeries are rare but can occur. Complications include infection after the procedure, prolonged tenderness along the procedure site, a slow-healing wound , and recurrence. You are more prone to post-surgery complications if you do not follow proper instruction to care for the ingrown toenail. Fortunately, these complications are fairly easy to manage. If you are prone to infection, your doctor may prescribe oral antibiotics following the procedure.
How Do You Treat An Ingrown Toenail
The treatment for your ingrown toenail will depend on the severity, as well as whether or not it’s infected. If the ingrown toenail is not infected, there are some things you can do at home to remedy it.;
As soon as you notice an ingrown toenail, Zubek recommends soaking the foot in warm water with soap or Epsom salts for 15 minutes several times per day.;
“You can gently pull the skin away from the ingrown nail during the soaking. You may also apply a topical steroid cream afterward to reduce inflammation,” says Zubek.;
Poston advises drying the foot thoroughly and keeping it clean. In order to prevent an infection, she suggests applying antibiotic ointment to the nail and surrounding skin.;
Important: If you’re immunocompromised, have poor circulation, or have diabetes, it’s advisable to see your doctor or podiatrist about treating the ingrown toenail. You may have a higher risk of infection that can lead to more severe skin or bone conditions, such as cellulitis or osteomyelitis.
“Once the swelling begins to decrease, gently lift the corner of the nail and insert some cotton or waxed dental floss between the nail and your skin to prevent the nail from going back into the skin,” says Poston.
According to Zubek, a podiatrist may apply a special splint or brace to the nail, or tape the skin to pull it away from the ingrown nail edge.;
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Treatments For Ingrown Toenail
Due to the pain of ingrown toenail and the often extremely scary look and smell of an infected ingrown toenail, people often head to the emergency room. This is appropriate for diabetics, people with peripheral vascular disease and those who are suffering fever and chills or flu-like symptoms along with the ingrown toenail. This is especially true if the condition has been discovered late at night when their doctors offices or urgent care centers are closed. In most instances, the professional treatment of an ingrown nail can wait to the morning. The use of Epson salt soaks, application of triple antibiotic cream , taking some ibuprofen or acetaminophen along with using a slipper or roomy shoe can give the otherwise healthy ingrown toenail sufferer some relief until the morning.
How Are Ingrown Toenail Treated
If you have diabetes, nerve damage in your leg or foot, poor blood circulation to your foot or an infection around the nail, see your doctor or podiatrist immediately.
Otherwise, try this:
- Soak your feet in warm water for 15 to 20 minutes, 3 or 4 times a day.
- Then use a cotton bud to gently push away the skin from the nail.
- Repeat each day for a few weeks, allowing the nail to grow.
- As the end of the nail grows forward, push a tiny piece of cotton wool or dental floss under it to help the nail grow over the skin and not grow into it. Change the cotton wool or dental floss each time you soak your foot.
- Do not pick at the toenail or try to remove it yourself.
An infected toenail may be treated with antibiotics. Your doctor or podiatrist may need to drain the pus. In severe cases, part or all of nail may need to be removed.
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Management Of The Ingrown Toenail
JOEL J. HEIDELBAUGH, MD, and HOBART LEE, MD, University of Michigan, Ann Arbor, Michigan
Am Fam Physician.;2009;Feb;15;79:303-308.
;Patient information: See related handout on ingrown toenails, written by the authors of this article.
Ingrown toenail, or onychocryptosis, most commonly affects the great toenail. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. Conservative treatment approaches include soaking the foot in warm, soapy water; placing cotton wisps or dental floss under the ingrown nail edge; and gutter splinting with or without the placement of an acrylic nail. Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization. Electrocautery, radiofrequency, and carbon dioxide laser ablation of the nail matrix are also options. Oral antibiotics before or after phenolization do not improve outcomes. Partial nail avulsion followed by either phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toe-nails. Compared with surgical excision of the nail without phenolization, partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence of ingrowing toenails, but has a slightly increased risk of postoperative infection.
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Causes And Risk Factors
Based on clinical experience, ingrown toe-nails are thought to be caused by improper nail trimming or tearing nails off . Because of poor visualization or instrumentation, a barb is created that anchors itself in the soft periungual tissues and penetrates deeply as the nail plate grows distally. Force during ambulation, pressure from constricting footwear, and obesity drive the nail barb penetration and worsens its severity.2
Figure 1.
Examples of improper and proper toenail trimming. Toenails should be cut straight across, and the corners should not be rounded off.
Figure 1.
Examples of improper and proper toenail trimming. Toenails should be cut straight across, and the corners should not be rounded off.
Risk factors predisposing to development of ingrown toenails include anatomic and behavioral mechanisms. Some experts suggest that wider nail folds and thinner, flatter nails increase the risk of ingrown toenails,3 but this remains unproven. A case-control study with 46 patients found no difference in the anatomic shape of toenails in patients with and without ingrown toenails.4 Repetitive trauma or inadvertent trauma may be inciting factors.5
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How To Prevent And Treat Ingrown Toenails In Children
Ingrown toenails are common in children. Older children and teens often get an ingrown toenail either because they wear tight-fitting shoes that put pressure on their toenail or they trim their toenails too short, especially on the sides. These improperly trimmed toenails can then grow under the nailfold;instead of continuing to grow out like they are supposed to.
The most common symptoms of an ingrown toenail include:
- pain
- erythema
Identifying When Your Ingrown Toenail Requires Medical Attention
Pain and swelling around your toe and the inability to wear certain shoes might be signs of an ingrown toenail. Its 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, weve put together this guide to help you identify when your ingrown toenail requires medical attention.
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Surgery For Ingrown Toenail
Most surgery for ingrown toenail is a minor affair in the podiatrists office. Usually a local anesthetic is used and the ingrown nail section, any proud flesh and abscesses are removed or drained. If the nail is severely incurvated and the person has had multiple instances of ingrown nails, a matricectomy is recommended.
A matricectomy involves removing the incurvated section of nail followed by application of carbolic acid with a cotton stick and an alcohol rinse. After one to two weeks, the nail edge heals and the nail section usually never returns to cause problems again. The cosmetic result is usually very satisfactory with the nail having a normal, flat appearance. Insurance generally will cover the cost of this procedure following the terms of the individuals insurance contract. If you suffer from this condition we welcome you to come in for a consultation with our helpful, knowledgeable staff.
For more information on ingrown toenails or to schedule a consultation, contact Essex Union Podiatry today.
How Is An Ingrown Toenail Removed
Surgical treatments include the following: temporary resection and removal of the offending nail border or corner, avulsion of the nail or offending nail border, or permanent elimination of the nail or offending nail border . A matrixectomy is the destruction or removal of the cells where the nail grows from called the nail matrix. The nail matrix is at the base of the toenail under the skin. This procedure can be done surgically by dissection, chemically, or electrically by destroying part or all of the matrix cells. These procedures are commonly reserved for chronic or recurrent situations.
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How To Remove An Ingrown Toenail Painlessly
Removing an ingrown toenail painlessly is possible. An ingrown toenail is a common foot issue., it develops when the nail edge digs into the skin. This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe. For some people, an;ingrown toenail;was a one-and-done problem. For others ingrown toenails are a constant struggle. According to;statistics,;18%;of;US adults have experienced it;at;least once in;their lives. Its important to;know how to remove an ingrown toenail painlessly as;soon as;they start in;order to;prevent infection and to;keep it;from getting worse.
Improper shoe gear and toe injuries are frequently associated with ingrown toenails. Athletes also commonly suffer from ingrown toenails. Incorrect nail-cutting technique and trauma sustained by the foot can cause ingrown toenails.If you have sweaty feet, then the skin around your toenails can be soft making it easier for your nail to pierce it and embed itself within it. It is not unusual for an ingrown toenail to recur unless treated appropriately. It is not unusual for an ingrown toenail to recur unless treated appropriately.
There are a number of home remedies to remove an ingrown toenail painlessly. Keep in mind that not all remedies have the same effect on people.
Will Ingrown Toenails Heal Left Untreated
Ingrown toenails left untreated usually cause a lot of pain, can get infected and, in the worst situations, can actually lead to bone infections and loss of the toe. It is always surprising to those who have never suffered an ingrown toenail how much a small piece of nail stuck in the skin can hurt so much. Toes and fingers happen to be able to sense a great deal due to their dense distribution of nerve endings. If you can ever remember having something small like a sliver of fiberglass or a very small splinter in your finger, you can get a sense of how painful an ingrown nail can be.
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Caring For An Infected Or Ingrown Toenail
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An infected toenail is a slow pain thats easy to ignore. That is, until it isnt. Whether the infection is caused by an ingrown nail or because of an injury, its hard to ignore when your toenail is a red, infected, sore mess. If you feel that you have an infection in your toe, you should follow up with a podiatrist or visit your local InstaCare or urgent care clinic as soon as possible.
What Is An Ingrown Toenail
An ingrown toenail occurs when the side of the nail curls down and grows into the skin around the nail.
Any toe can be affected but it commonly occurs in the big toe.
An ingrown toenail can become painful and inflamed .
Sometimes, it can become infected, which, if left untreated, can spread and infect the underlying bone.
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Medical Treatment Of Ingrown Toenails
Once your ingrown toenail has progressed past the first stage, you may need to seek medical help. There are various surgical treatments of ingrown toenails your podiatrist may recommend. All of these are standard, according to the American Academy of Orthopaedic Surgeons .
Wedge Resection:;This involves the partial removal of the nail or a portion of it, after numbing your toe with a local anesthetic and draining any ingrown toenail infection. Your doctor can perform this procedure in the office and the recovery time is anywhere between two weeks to two months, depending on the size of the nail portion removed.
Matrixectomy:;The matrixectomy procedure is also referred to as permanent or full nail avulsion. Unlike typical avulsions, which arent often practiced anymore , a matrixectomy happens when the physician removes the entire nail from your nail bed and then covers the nail matrix with a chemical that stops it from ever growing back.
Vandenbos Procedure:;The Vandenbos procedure has been around since the late 1950s and involves removal of the skin directly underneath and on either side of the ingrown toenail. Recovery is longer with this procedure, but this is also the only procedure in which a doctor does not need to prescribe antibiotics for prevention of infections. It also seems to be the procedure most likely to prevent recurrences of ingrown nails.
Can I Walk After Ingrown Toenail Surgery
Can I walk after ingrown toenail surgery? Although your toe will be numb after the procedure, you can still walk out of the clinic. We recommend that you rest and avoid activity for the rest of that day to minimize pain and ensure good healing.
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What Does An Ingrown Toenail Look Like
The diagnosis of an ingrown toenail is typically straightforward and does not require diagnostic labs or images. However, the signs and symptoms of ingrown toenails can vary quite dramatically, particularly if an infection develops. There may simply be some tenderness at the nail border when pressure is applied. There is typically an incurvation of the nail or a spike of nail pressing into the skin of the nail border. Associated redness and swelling localized to the nail also suggest the diagnosis of an ingrown toenail. When an infection is involved, there may be severe redness and swelling, drainage, pus, and malodor.
Making the proper diagnosis requires taking into account the medical history and all possible causative factors. If one is unsure, seek professional help. Some conditions such as tumors, foreign bodies, trauma, and fungal infection may appear to be an ingrown toenail to the untrained eye.
Ingrown Toenail Surgery Recovery
- Nail avulsion surgery has a 98.5 per cent success rate, but in the rare case that the surgery is unsuccessful, we will organise to re-do the procedure at no extra cost to you.
- Depending on your medical history and whether there is an infection due to the ingrown toenail, healing can vary from person to person.
- Most patients can return to work after 48 hours of rest, especially if they take all the advised post-surgery steps.
- Full healing of the surgical site can take between two to six weeks, and in some cases longer. The most common post-surgery complication is infection, especially if there was an infection present before the procedure. We will help you treat any infection with oral antibiotics.
- We work to give our patients the best cosmetic outcome possible, particularly in the case of partial nail avulsion surgery . For larger toes, the change in size and shape is unlikely to be very noticeable, although smaller nail plates may be more affected. If you have concerns about how your toe will look post-operation, talk to your podiatrist about this during your pre-surgery assessment.
GUARANTEE
Nail Avulsion surgery has a 98.5 per cent success rate. For The Foot Hub patients who have had ingrown toenail surgery and in the rare case it grows back, we will redo the surgery at no charge.
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