Ingrown Toenail...the who, the what and the nasty!

Many of us have been there, that little bit of roughness to the side of the nail that you just can't help but pick at, then a couple of days later you feel a niggle, tenderness beside the nail and pain when you're wearing shoes. Before you know it, you're in agony...middle of the night waking up in the night considering cutting off your own toe type agony...yep, you've got an Ingrown Toenail!

So what is an Ingrown Toenail?:

A true ingrowing toenail (onychocryptosis) occurs when a splinter or spike of nail pierces the skin due to one of or a combination of the following; your natural nail shape, poor nail-cutting and/or trauma resulting in a very painful condition. Trauma can be a single incident e.g dropping a jar from the fridge onto your nail, falling and stubbing the toe and nail or ongoing trauma such as inappropriate footwear. If not treated quickly and effectively, ingrowing toenails may become infected possibly leading to the need for antibiotics (take a look at yesterdays Wednesday Wisdom video that you can find here: http://bit.ly/CanAntibioticsCureAnIGTN).

Conservative Treatment:

A podiatrist after assessing the nail will gently remove the offending spike of nail. On occasion this may require either a topical or injected local anaesthetic. After the nail splinter is cleared the side edge of the nail plate is gently smoothed to ensure there is no further splintering or roughness, sometimes a drill with a very fine burr will be used but this is not a painful process. Appropriate preventative and care advice regarding footwear and care of the nail will be given. In some instances this treatment will resolve the problem but as the nail will always continue growing some may require subsequent conservative treatment or sometimes the long term solution of minor nail surgery.

Nail Surgery:

This minor procedure is performed under local anaesthetic, with the problematic section or in rarer cases, the whole nail being removed. Usually chemical ablation of the nail bed is recommended to prevent any further regrowth of the treated area. This procedure is called a partial or total nail avulsion and takes about 45-60 minutes with a very high success rate.

We advise that you take the day off work or school. Healing usually takes a few weeks and the end result is in most cases aesthetically pleasing and pain free.

Your Podiatrist will be able to advise you fully.

Between Appts:

Where appropriate, your podiatrist can teach you how to dry file the nail to help ensure it doesn't happen again and to keep the nail shorter between appointments.

For more information on good nail care you can watch the following video: LINK

SOS Procedure:

First call your Podiatrist practice to have the nail checked and professionally treated. In most cases you will be offered an appointment with 24-48 hours, however, whilst you are waiting, footwear should be chosen carefully to avoid any pressure across the toes and the foot can be bathed 2-3 times a day in warm salty water.

Other things it may be (Differential Diagnosis):

Onychophosis - debris, corns or callus that gets trapped down the side of the nail.

Involuted Nail (also known as Pincer Nails) - either an inherited, familial shape, caused by trauma or associated with some diseases. The nail plate shape curves down into the toe.