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Ingrown Toenails
Ingrown toenails are due to the penetration
of the edges of the nail plate into the soft tissue of the toe. It
begins with a painful irritation that often becomes infected. With
bacterial invasion, the nail margin becomes red and swollen often
demonstrating drainage or pus. In people who have diabetes or poor
circulation, this relatively minor problem can be become quite severe.
In this instance, a simple ingrown toenail can result in gangrene
of the toe. Patients with joint replacements or pace makers are at risk
of bacterial spread through the blood stream resulting in the spread of
infection to these sites. These patients should seek medical attention
at the earliest sign of an ingrown toenail. There are several causes of
ingrown toenails: a hereditary tendency to form ingrown toenails,
improperly cutting the toenails either too short or cutting into the
side of the nail, and ill-fitting shoes can cause them. Children will
often develop ingrown toenails as a result of pealing or tearing their
toenails off instead of trimming them with a nail clipper. Once an
ingrown toenail starts, they will often reoccur. Many people perform
"bathroom" surgery to cut the nail margin out only to have it reoccur
months later as the nail grows out. Treatment Treatment
for ingrown toenails is relatively painless. The injection to numb the
toe may hurt some, but a skilled doctor has techniques to minimize this
discomfort. Once the toe is numb, the nail margin is removed and the
nail root in this area is destroyed. Most commonly, the doctor will use
an acid to kill the root of the nail, but other techniques are also
available. It may take a few weeks for the nail margin to completely
heal, but there are generally no restrictions in activity, bathing, or
wearing shoes. Once the numbness wears off, there may be some very mild
discomfort but rarely does this require pain medicine. A resumption of
sports activities and exercise is generally permitted the following day. There
are very few complications associated with this procedure. Reoccurrence
of the ingrown toenail can occur a small percentage of the time.
Continuation of the infection is possible which can be controlled
easily with oral antibiotics. On occasion, the remaining nail may
become loose from the nail bed and fall off. A new nail will grow out
to replace it over several months. With removal of the nail margin, the
nail will be narrower and this should be expected. To
prevent ingrown toenails it is recommended to wear properly fitting
shoes and to trim the toenails straight across and not too short.
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