Next in our series about how to cure foot problems is the all too common ingrowing toenail. This is an often misused term by patients and health care professionals alike, including other foot colleagues. Just because you have pain around your toenail does not mean that it is ingrown. There are lots of nail pathologies that can cause pain including most commonly:
- Thickened toenail (onychauxis, onychogryphosis)
- Fungal toenail (onychomycosis)
- Sub-ungual ulceration (tissue breakdown beneath the nail)
- Sub-ungual exostosis (lump on the bone beneath the nail)
- Peri-ungual hyperkeratosis (hard skin / corns) at the sides of the nails (onychophosis)
- Nail involution (curvature of the nail)
- Nail convolution (completely curved toenail)
- True ingrowing toenail (onychocryptosis)
You will notice that the terms “onycho” and “ungual” both appear. This is because the English language has origins in both ancient Greek and Latin, and both terms mean “nail” or associated with that structure.
Therefore in order to be able to cure nail problems, we first need to get the diagnosis correct. This is where seeing someone who knows lots about feet comes in. The first 5 on the list above require very different treatment plans to the last 3, and it is those latter ones that are frequently described as ingrowing. Sometimes they can be alleviated with appropriate nail care (which doesn’t include cutting a ‘V’ in them despite what the old wives tale says!), correctly fitting footwear, and/or antibiotics if infection develops. However to achieve the most relief from the problem, we have to somehow alter how the nail grows. This can either be done temporarily with nail bracing, or more permanently with nail surgery. Generally the preferred option in the UK due to its high rates of success is nail surgery, which can be performed either using a scalpel to cut out the nail matrix (the tissue that generates nail growth) or using chemicals such as phenol or sodium hydroxide to destroy the nail matrix.
Nail surgery is performed following a pre-operative assessment to help ensure that there will be no complications during the procedure and that healing will take place satisfactorily. At my clinic this means a thorough medical history is taken together with indepth assessments for local anaesthetic, nail surgery, and peripheral vasculature (blood supply) involving doppler ultrasonography. The procedure of choice at my clinic is phenolisation of the nail matrix as we have over 99% success rate with this, and it is suitable for involuted nails, convoluted nails, and true ingrown nails. It can even be performed on infected toenails and troublesome finger nails as well.
When performing nail surgery, there is the option of removing a small part of the nail to resolve the problem, or the complete nail. However it is only occasionally necessary to have to lose the whole nail even though this may be the only option offered by others who perform nail surgery. The vast majority of nail surgery cases only require what we call partial nail avulsion with phenolisation of the nail matrix. If done carefully by a skilled Podiatrist (Foot Specialist) then you won’t even notice any of the nail is missing, but you will be pain-free most likely for the rest of your life. You can learn more about this surgery and even watch it being performed on our YouTube channel.
Here are just a few of the many reviews we receive regarding nail surgery:
“After months of suffering with ingrown toenails, I went to see Jonathan Small who was kind, professional and gentle. He performed the nail surgery on the same day as assessment so I could begin the road to recovery. I would recommend Health First to anyone with foot problems.” Natasha R.
“I’ve been putting off toe nail surgery for years as I hate having my feet messed about with, but finally took the plunge. The healing time has been significantly reduced from previous toe nail surgeries, all healed within 3 weeks instead of the usual 6 weeks.
Really pleased with the service , I would definitely recommend Jon for toe nail surgery especially if you hate having your feet messed about with or are a little nervous! He’s really calm and competent.” Susan T.
“Jonathan Small and his team have been excellent. A person centred, straight forward approach and really genuine team. I had been told by NHS and other podiatrists that the healing after ingrowing toe nail would take up to 12 weeks yet after the surgery at Health First Foot, it has completely healed in just over 3 weeks. Going privately was one of the best investments I’ve made. Thank you Health First!” Nicola J.
“Referred by my usual Chiropodist to Johnathan as she was hesitant of doing surgery on my ingrown toe nail, as I am on medication following a kidney transplant and heart attack. So off I trotted to Southam, circa 15 mins from Leamington. Found it straight away car park and pub 😉 right on the corner!
Nice chap , 30 years experience, didn’t feel a thing.
Beg or borrow the money, you will be pleased you did my friends. Highly recommend.” Gerard T.
Remember if you require a Podiatry or Physiotherapy appointment, please call 01926 811272 or alternatively, you can book an appointment online.