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Ingrown Toenail Surgery

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What is a Ingrown Toenail?

An ingrowing toenail is one that pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too. Whereas a nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn't an ingrowing toenail but can feel very painful and also appear red and inflamed as well.

What causes Ingrown toenails ?

  • Trauma is the most common cause of ingrown toenails, such as stubbing your toe or repetitive stress.

  • Not Cutting toenails properly, or picking toenails can cause involuted or ingrown toenails to develop.

  • Certain medications eg. isotretinoin can cause secondary side effects which can make you prone to develop involuted or ingrown toenails 

  • 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.
  • Tight footwear, hosiery and socks can also push your toe flesh onto the nail so that it pierces the skin.
  • Sweat excessively or don’t rotate your footwear, this makes the skin moist and weak so that it is easily penetrated by the nail.
  • If you have brittle nails with sharp edges or are in the habit of breaking off bits of nail that are sticking out, you are also more likely to get an ingrowing toenail. In addition, the wearing of support hose that is ill-fitting and squeezes the toes or likewise, the wearing of shoes with tight toe boxes.

Is it serious?

If left untreated, the infection can spread to the rest of the toe and foot, if infection enters the blood stream it can lead to sepsis and could lead to surgery. The quicker you treat it, the less painful the treatment. At My Foot Doctor we offer a range of treatments for ingrown toenails.

Who gets it?

Anyone can get an ingrown toenail however active, sporty people are particularly prone, due to repetitive stress and because they sweat more. Younger people are more likely to get it (as they pick their nails more, compared to older people who may not reach their toes!).

How do I know I have it?

The most common symptom is pain followed by some form of inflammation or redness in the surrounding nail and skin area.

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 nearly as painful. However, if it’s a corn, the pain tends to be throbbing 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.

How do I prevent it?

Firstly, learn to cut your nails properly. Nail cutters aren’t a good idea because the curved cutting edge can cut the flesh and nail scissors can slip. It’s best to use nail nippers (available from chemists or podiatrist) because they have a smaller cutting blade but a longer handle. Cut your nails straight across and don’t cut too low at the edge or down the side. The corner of the nail should be visible above the skin. Also, cut them after a bath or shower when the nail is much softer.

Good hygiene can go a long way to preventing ingrowing toenails. Avoid moist, soggy feet by letting rotating your footwear so each pair has a chance to dry out thoroughly. Avoid man-made materials (synthetics) and choose socks and shoes of natural fibre and which fit properly. Keep your feet clean and dry and in the summer and wear open-toed sandals to let air get to your toes as much as possible.

If you have diabetes, are taking steroids or are on anti-coagulants, don’t attempt to cut your nails or remove the ingrowing spike of nail yourself.

When should I see a podiatrist about it?

Visit a podiatrist if you experience any:

  • Persistent pain in your toe from the ingrowing nail
  • Symptoms of infection (pus), especially if you have Diabetes or a poor immune system
  • Condition which affects the nerves and/or feeling in your foot (neuropathy).

If you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as Podiatrist who specialises in a wide variety of foot and lower limb problems, your GP may be able to refer you to the local NHS trust for free treatment, but if you do not qualify for this or need urgent attention, you should contact a private podiatrist.

To talk to a podiatrist (also known as a chiropodist) about the options available regarding treatment, you can contact a NHS podiatrist or a private practice podiatrist. In both cases, always ensure that any practitioners you visit are registered with the Health Professionals Council (HCPC) and describe themselves as a podiatrist (or chiropodist).

What are the treatments available?

Before you are seen by a podiatrist, you can relieve the discomfort by bathing your foot in a salty footbath which helps to prevent infection and reduces inflammation. Then apply a clean sterile dressing, especially if you have a discharge and rest your foot as much as possible.

How a podiatrist will treat you will depend largely on the severity of your condition:

  • Conservative treatment - 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. includes removal of the piece of nail that is digging into the skin, re-shaping of the nail plate to prevent involuted shape, application of medical grade nail softner, and antiseptic dressing applied, a sulci protector may also be applied at additional cost, this can help prevent infection and protect the side wall from swelling.

  • Toenail Brace - Can help alleviate ingrown toenails and reduce pain associated with this condition, this is a great alternative to nail surgery. click link for further information 
  • Toenail Surgery - For toes too painful to touch, a local anaesthetic will be injected before removing the offending portion of nail. For any bleeding or discharge from an infection, or even excessive healing flesh (hypergranulation tissue) around the nail, antibiotics will be prescribed to beat the infection as well as having the offending spike removed. full medical history and consultation will be required prior to treatment. Late evening appointment and Emergency weekend appointments available on request. click the link for further information 
  • For those particularly prone to ingrowing toenails from underlying problems such as poor gait, partial nail avulsion (PNA) may be recommended along with finding a more permanent solution to the underlying condition. This procedure is done under a local anaesthetic where 8-10% of the nail is removed (including the root) so that the nail permanently becomes slightly narrower. The chemical phenol cauterises the nail and prevents it regrowing in the corners. This is over 95% successful. You will, however, have to come back to our podiatrist for a number of re-dressings appointments, After Toenail surgery.
    Our Podiatrist offers some innovative treatments to help alleviate painful ingrown toenails, such as a ingrown toenail brace which can help straighten the offending ingrown toenail, similar to a teeth braces to straighten teeth.

We also offer Toenail Replacement, this is an innovative cosmetic treatment that mimics the natural toenail that was there prior to surgical removal. This treatment can also be used to treat damaged toenails, fungal toenails, and thickened toenails to give a more cosmetically pleasing appearance. This is a great treatment prior to holidays, do you get embarrased by your toenails, then Wilde-Pedique is the perfect treatment for you. Our Podiatrist is also qualified in Shellac, and Gel Nails, which can also be applied as part of this treatment.

At My Foot Doctor our chiropodist and podiatrist has over 9 years experience treating a wide variety of foot and lower limb conditions, our podiatrist has trained in some of the most innovative treatments available such as Steroid injections, Ostenil injections, PRP injections, which can be used to treat a number of painful arthritic conditions such as Gout, Osteoarthritis, Ankle pain, Knee Pain, Hallux Rigidus and can also be utilised to treat a wide variety of sports injuries, plantar fasciitis, metatarsalgia, morton's neuroma.

If you would like further information or wish to discuss any treatment our podiatrist offers for foot or lower limb conditions, you can text her direct on: 07985 687 770, any information or pictures sent with be keep confidential.

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