SCHOLL Ingrowing Toenails

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For any bleeding or discharge from an infection, or even excessive healing flesh (hypergranulation tissue) around the nail, antibiotics will be prescribed to manage the infection as well as having the offending spike removed An ingrowing toenail typically affects teenagers and young adults the most. A number of things can cause an ingrowing toenail to develop and if left untreated, could pierce the skin. For involuted nails, part of the nail that is curling into the flesh is removed and then the edges of the nail are filed to a smooth surface You should see a podiatrist urgently if you have symptoms of infection, and also have diabetes, poor circulation or a reduced immune system. You should also visit a podiatrist if you experience any persistent pain in your toe from the ingrowing nail or have a condition that affects the nerves and/or feeling in your foot.

However, not everyone identifies an ingrowing toenail correctly. Sometimes, they have a curly nail which has a lot of debris (dirt or fluff) underneath it or a corn or callus down the side of the nail, which can be just as painful. However, if it’s a corn, you tend to experience a throbbing pain as opposed to the sharp pain you get with an ingrowing toenail. If this is the case, your podiatrist will remove the debris, and, if necessary, thin the nail. Is it serious? Cutting toenails incorrectly, too short, especially around the edges which can encourage the nail to grow into the skin. Bostanci S, Ekmekçi P, Gürgey E. Chemical matricectomy with phenol for the treatment of ingrowing toenail. Acta Derm Venereol. 2001;81(3):181-183.Romero-Pérez D, Betlloch-Mas I, Encabo-Durán B. Onychocryptosis. Int J Dermatol. 2017;56(2):221-224.

If you have diabetes, are taking steroids or are on anti-coagulants, don’t attempt to cut your nails or remove an ingrowing spikes of nail yourself. When should I see a podiatrist? Taping the nail. With this method, your health care provider pulls the skin away from the ingrown nail with tape.

Treatment

There are many genetic factors that can make you prone to ingrowing toenails, including your posture (the way you stand), your gait (the way you walk) and any foot deformity such as a bunion, hammer toes or excessive pronation of the feet (when your foot rolls inward excessively). Your nails may also have a natural tendency to splay or curl out instead of growing straight, encouraging your nail to grow outwards or inwards into the flesh. Andreassi A, Grimaldi L, D'Aniello C, et al. Segmental phenolization for the treatment of ingrowing toenails. J Dermatolog Treat. 2004;15(3):179-181. Ensure the lateral horn of the matrix is ablated by moving the electrode laterally beneath the proximal nail fold; a properly treated nail bed appears white after thermal ablation. According to Dr. Cary Zinkin, a podiatrist and spokesperson for the American Podiatric Medical Association, there are four main causes of ingrown toenails: footwear that’s too tight, trauma to the toe (like badly stubbing it), improper trimming, and heredity. The first three can be prevented, but there are some people who are just prone to ingrowns “because of the shape of the nail root and the way the skin goes around it,” Zinkin says. In those cases, he recommends seeing a podiatrist for a simple procedure in which part of the nail is removed to prevent further ingrowns. Provide informed surgical consent and place the patient in the supine position, with the knees flexed and the foot flat on the table or the leg extended and the foot hanging off the end of the table.

If you experience any foot care issues that do not resolve themselves naturally or through routine foot care within three weeks, you should seek the help of a healthcare professional.

Frequently Asked Questions

Dinulos JGH. Nail diseases. In Habif's Clinical Dermatology. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Oct. 12, 2021. Place the electrode over the lateral nail bed with the Teflon-coated portion upward. Lift the electrode about 1 mm, creating a small gap ( Figure 5 23). For toes too painful to touch, a local anaesthetic will be injected before removing the offending portion of nail Gutiérrez-Mendoza D, De Anda Juárez M, Ávalos VF, et al. “Cotton nail cast”: a simple solution for mild and painful lateral and distal nail embedding. Dermatol Surg. 2015;41(3):411-414.

Yang KC, Li YT. Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser. Dermatol Surg. 2002;28(5):419-421. Arai H, Arai T, Nakajima H, et al. Formable acrylic treatment for ingrowing nail with gutter splint and sculptured nail. Int J Dermatol. 2004;43(10):759-765.Nishioka K, Katayama I, Kobayashi Y, et al. Taping for embedded toenails. Br J Dermatol. 1985;113(2):246-247. Serour F. Recurrent ingrown big toenails are efficiently treated by CO2 laser. Dermatol Surg. 2002;28(6):509-512.