Normally there’s a recent pedicure at the store or at home, a new pair of shoes or a bit of trauma. Then there is a little bit of discomfort, a bit of redness and before you know it, it’s a full blown can’t-put-my-toe-in-my-shoe-dont-even-think-about-touching-it ingrown toenail.
A true ingrown nail or onychocryptosis is when the skin surrounding the nail is impacted by the nail plate itself . This can be due to a number of reasons as mentioned above including incorrect nail cutting, trauma from footwear or direct pressure or a genetic predisposition due to nail shape and bone structure to name a few.
The trauma at the skin causes a protective inflammatory response at the site from our body- it tries to remove the foreign body or in this case the part of the nail that is hitting the skin. Despite our body’s efforts, unfortunately until the spike or section of nail is removed this process does nothing but create more discomfort, swelling, redness and sometimes pus.
Ingrown toenails are a common presentation to us as podiatrists and they can easily be treated within our clinic. First line treatments are very conservative and involve assessing the toe, identifying the cause and intending to remove any spikes. At this consult we might discuss footwear, sporting activities or your general foot care regime. Depending on the assessment and the level of infection, you might be asked to see your general practitioner for a course of antibiotics.
If consecutive conservative management is unsuccessful or the ingrown is a recurring problem then a discussion is normally had about a partial nail avulsion- this a small procedure whereby the side of the nail that is impacting on the skin is removed and a chemical is used to stop that portion of nail from growing back. This is also known as a nail surgery. This procedure generally takes no more than 10 minutes and there are no stitches required. You are required to stay off your foot as much as possible for the rest of the day but generally you can return to normal low impact activities, such as work, shopping, etc the next day with return to sport normally discussed at your first review appointment.
Our advice:
If you suspect an ingrown toenail- don’t attempt to cut it back or treat it yourself. Bathe with warm water and salt, apply an antiseptic such as betadine to the side of the nail and keep it protected with a bandaid and make an appointment with your podiatrist so that they can actively and correctly rectify and treat the nail.