Ingrown Toenail

An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. Sometimes referred to as a nail spike. The big toe is often affected, either on one or both sides but it can happen on any toe.

in grown toe nail

Symptoms:

  • pain
  • redness
  • swollen
  • inflammation of the skin at the end of the toe
  • a build-up of fluid in the area surrounding the toe
  • an overgrowth of skin around the affected toe (hypertrophy)
  • bleeding
  • white or yellow pus coming from the affected area
  • if infected it may throb and may need antibiotics from GP

Common Causes:

  • poor cutting technique – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin. Not filing them after cutting can also contribute
  • wearing tight-fitting shoes, socks or tights – excessive pressure can force the nail to pierce the skin on either side
  • sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and as it grows it pierces even further
  • injury – stubbing your toe or drooping an object on it can sometimes cause an ingrown toenail to develop
  • natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail. In some cases the size or shape of the nail may increase the risk
  • Fungal nails – due to increased thickness of fungal nails this can also increase the risk

Treatment options:

Initially it is vital that the offending nail spike be removed. Until this is removed the wound cannot begin to heal. Left untreated, an ingrown toenail can become infected and may need antibiotics from your GP to get rid of the infection. At David Brown Podiatry we use specialist ingrown toenail clippers to remove offending spike. A water spraying drill may then be used to clear out the area and ensure no sharp edges are left behind. In some cases this process can be too painful and so a Local Anaesthetic may be administered in to the affected toe before the nail spike is removed. Podiatric advice will then be given to reduce the risk of re occurrence. In some situations nail surgery may be required to prevent re occurrence. This may be suitable if the nail problem has existed for some time or if it is felt that surgery would be the best option. There are two main surgical procedures:

  • Partial Nail Avulsion (PNA)- where only a part/side of the nail is removed
  • Total Nail Avulsion (TNA)- where the whole nail is removed

In both cases a Local Anaesthetic will be administered and allowed to take effect. As soon as the anaesthetic has worked a tourniquet (small rubber band) will be applied to reduce the blood flow to the toe and the toe nail (PNA or TNA) will be removed and in most cases a phenol (chemical) will be applied to the nail bed to prevent the nail from re growing (98% effective). The toe will then be dressed in strerile dressings and advice will be given in order to allow the healing process to begin. Dressing appointments over the following weeks will be arranged depending on the individual circumstances. Approximate healing time is between 4-6 weeks. At David Brown Podiatry we will work with you through the whole process which will include consultation, eligibility checks, surgical procedure and a number of dressing appointments. *Not all patients will be eligible for nail surgery, this will be determined through a thorough pre surgical check. On our What is Podiatry? page there is a video about nail surgery if you want any further information or contact us with any questions.

Prevention:

  • Wear well fitted footwear
  • Avoid cutting too short
  • File all edges with a nail file
  • Good foot hygiene
  • Wearing good quality socks
  • DON’T PICK AT YOUR NAILS!!

 

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