Ingrowing Toenails

INGROWING TOENAILS

 The nails of the toes and fingers act as shields, protecting the tender skin lying underneath, they also will add strength and increase sensation.

 

 

About Ingrowing toenails

Most commonly affecting the big toe nail which grows into the skin becoming embedded as the nail grows causing pain, irritation and  infection, the toe nail having a tendancy to weep or bleed when aggravated by any external pressure, flesh adjacent to the ingrowing nail as seen below becomes organised into hypergranulation tissue.

Most usually young men, and those in the 15-40 age group are affected, and is common amongst athletes.

What Causes Ingrowing toenails ?

Poor foot, toe, or nail structure, or a particular style of walking, excessive sweating, or direct injury, the most common cause being incorrect nail cutting, nails cut too short, or down the sides may leave a sharp piece of nail which pierces the nail groove as it grows, tight footwear or hosiery can make problems worse.

Always cut nails correctly with proper nail clippers, you should always cut your nails following the shape of the end of the toe.

What to do ?

In the early stages, if your toe is inflamed, bathe in a warm saline solution to help prevent infection and cover with a dry dressing, if the problem persists and especially if you are elderly,diabetic, have poor circulation, or have a long term medical condition that requires special care.

Treatment

If there is no infection, the edge of the nail is usually smoothed and any offending splinters removed, but if the ingrowing nail remains, the surrounding flesh becomes infected you may require antibiotics to reduce the infection and inflammation, this does NOT cure your ingrowing nail, the nail may require surgical removal, the procedure undertaken at The Lawrence Clinic by your Podiatrist is to remove only the affected nail leaving a good cosmetic result and prevent recurrence, too many nails are removed in their entirety without consideration!

Podiatrists at The Lawrence Clinic specialise in a technique called a partial nail avulsion, this routine procedure is carried out under local anaesthesia which involves the surgical removal of the offending nail section only, and any hypergranulation tissue that may have formed, whilst maintaining the rest of your nail plate.

 

                                              

In order to stop the nail regrowing once it has been removed, the nail bed is cauterised with a caustic called phenol, the toe dressed and patients are seen weekly until healing is complete, generally these procedures completely heal within 2 - 4 weeks.

Only in certain cases are whole nails removed e.g very thickened, painful nails, fungal nails.