The team at Footmed Foot and Ankle Clinics in Adelaide and Murray Bridge provide quality care for ingrown toenails. We assist in helping you understand how to treat an ingrown toenail and prevent further issues.
What is an ingrown toenail?
An ingrown toenail, also known as onychocryptosis or unguis incarnates, is a painful condition of the toe. It occurs when a sharp corner of the toenail digs into the skin at the end of or side of the toe. Pain and inflammation at the spot where the nail curls into the skin occurs first. Later, the inflamed area can begin to grow extra tissue or drain yellowish fluid. If left untreated, an ingrown toenail can progress to an infection or even an abscess that requires surgical treatment. They are more common in men than in women. Young adults in their 20s or 30s are most at risk. Any toenail can become ingrown, but the condition is usually found in the big toes.
Ingrown toenails most commonly occurs for four main reasons:
- Poor cutting technique: Cutting the nail too far down the side & leaving behind a sharp edge or spicule, or cutting the skin.
- Fungal infection can distort the nail
- Injury to the nail: Dropping a heavy object on the toe or stubbing the toe can damage the nail root so that the nail grows incorrectly. Tight shoes can push the flesh up hard against the nail.
- Inherited poor nail growth: The nail instead of growing flat has a curvature (involution) which can either irritate the surrounding skin or make it difficult to cut. Nail growth is genetically determined. If a parent or grandparent had a problem a child or grandchild is more likely to develop the same thing.
Treating recurring issues
If you have a recurrent problem with ingrown toenails despite attempts at ‘growing them out’ by your podiatrist, then surgery will often offer a cure. Nails that get infected and do not respond with antibiotics often require a permanent procedure.
The correct nail cutting procedure is to avoid digging into the corners of the toe and making sure you cut the nail straight across. This is easy with normal nails but if you have a hereditary incurvated nail then cutting them straight across does very little to help the pain.
If a permanent solution is required a minor surgical procedure, which involves removing the offending piece of nail, will be recommended. It takes about 20 minutes to perform and is carried out using a local anaesthetic. A nail splitter is used to remove a small section of nail up to the nail fold. A beaver blade is then used to release the nail underneath the nail fold without having to cut the flesh. This frees the offending nail edge. Once it removed from the nail groove it exposes the nail root from which the nail grows. A chemical (phenol) is then used to burn or cauterise the nail root to prevent the nail from regrowing.
This procedure can also be used for the permanent removal of a whole toenail. If there is an infection present it will need to be resolved before any surgical procedure can be done. Oral antibiotics may be prescribed for you for 1-2 weeks before the surgery.