What is an Ingrown Toenail?
When the edge of the toenail incorrectly grows and irritates the adjacent skin or flesh of the toe. An ingrown toenail can be painful and lead to infection. Corns, calluses and dry skin in the edge of the nail can increase the pressure causing more pain. Sometimes a red growth called hypergranulation forms on the side of an ingrown toenail. Hypergranulation is made up of tiny blood vessels, scar tissue and connective tissue in response to trauma and infection.
- What are the most common causes of an ingrown toenail?
- Cutting toenails too short or cutting down the sides of a toenail
- Abnormal nail shape (excessively curved, wide) or toe deformities (bunions, claw toes)
- Previous trauma
- Poorly fitting shoes causes microtrauma on the nail plate
- Foot mechanics
- Genetic predisposition for an abnormal nail shape
- The medication isotretinoin (roaccutane) and sweaty skin can increase susceptibility to ingrown toenails
What Preventative Options are there?
- The nail should be cut along the contour of the toe or straight across
- Rough edges should be filed
- Reduce tight fitting shoes wear time
- Address foot mechanics that are contributing to ingrowing toenails
- Treatment for excessive foot perspiration
What are the Treatments Options for an Ingrown Toenail?
The first line of treatment that a podiatrist usually takes is to:
1. Skillfully remove the sharp edge or corner of the nail. This can be performed when the toe is numbed by an injection of local anesthetic.
2. Associated corns, calluses and dry skin are removed.
3. Packing the edge to further separate the skin from the nail.
4. Silver nitrate may be applied to hypergranulation.
5. Application of a topical antiseptic to decrease the bacterial population.
6. Application of a hypoallergic dressing to protect the area.
Oral or topical antibiotic therapy, warm saline baths and treatment for sweaty feet may be required.
If the ingrown toenail reoccurs, a long term solution is indicated, these include surgery and nail bracing.
What is a Surgical Partial Nail Avulsion?
This surgical procedure is performed in clinic in a sterile environment by a podiatrist. Local anesthesia is administered so there is no pain during the procedure. The offending section of the nail is removed and the growth cells (matrix) are chemically destroyed using phenol.
By deactivating the nail matrix with phenol, that section of the nail should not grow back. No stitches are required and there is little to no post-surgical pain. Depending on the occupation, most people can go to work the next day.
Healing times are varied but are usually rapid within a month of the surgery. Swimming and some sports are avoided in this time.