What is an ingrown toenail?
A true ingrown toenail is one where the edge or corner of the nail penetrates the surrounding flesh, thereby causing an open wound which can get infected. This is quite a common occurrence, especially affecting the big toenails.
However involuted or convoluted toenails can cause similar pain to ingrowing toenails, but without the open wound and therefore no infection. These types of toenails have too much curvature across the nail and can be dealt with in the same way as true ingrow toenails.
Pain, redness, swelling, and weepage from the side of a toenail suggests that it is ingrown. This can occur on more than one side or toe at the same time. If left untreated, hypergranulation tissue can form, basically excessive healing flesh. This often requires removal either by chemical cautery or sharp debridement, and a Podiatrist would be best placed to confirm the diagnosis and provide appropriate treatments.
How is an ingrown toenail diagnosed?
Treatments For An Ingrown Toenail In Southam, Warwickshire
There are a range of treatment options available, but once an ingrowing toenail occurs, it is best to get professional advice and treatment.
Simple remedies
Sometimes ingrowing toenails can be alleviated with appropriate nail care (which doesn’t include cutting a ‘V’ in them despite the old wives tale!), correctly fitting footwear, and/or antibiotics if infection develops. Digging an ingrowing toenail out yourself is not the safest option due to the lack of sterility of any tools used, and therefore infection can be introduced or exascerabated. Podiatrists or Chiropodists or Foot Health Practitioners may be able to cut away that part of the nail which is digging into the flesh, either on a one-off basis or by providing regular care to help avoid recurrence. However to achieve the most relief from the problem, we have to somehow alter how the nail grows.
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 fingernails as well.
When performing nail surgery, removing a small part of the nail to resolve the problem is usually the best option. 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.
Nail bracing
This seems to be more commonly carried out in other European countries as a method of managing ingrowing toenails, possibly due to regulatory restrictions regarding surgery or access to local anaesthetics.
This procedure involves applying a gel or plastic or metal brace across the nail in attempt to straighten out any curvature. It can resolve ingrowing or involuted nails but may not provide a permanent solution without ongoing bracing.
How to prevent ingrown toenails
Firstly, avoiding tight fitting or pointed footwear can help as its stops the toe flesh from being squashed against the nail. Secondly, maintaining good foot hygiene will help reduce the chance of infection occuring if a nail edge should press into the flesh. This involves washing and drying your feet thoroughly each day, wearing clean hosiery, and making sure shoes are completely dry inside before donning them.
Finally it is important to cut toenails properly. You will undoubtedly have heard advice on nail cutting that says you need to cut nails straight across to stop ingrowing toenails. This is not actually the case, especially if your nails are involuted or convoluted. Instead your nail shape should ideally follow the shape of the end of the toe i.e. with a gentle curve. However when cutting your nails you do have to be careful that you don’t leave a shoulder or spike of nail that can press into the surrounding flesh. If you are struggling with your nail care, then regular treatment by a Podiatrist or Chiropodist or Foot Health Practitioner may be required.
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Last night I attended a talk by Jonathan on diabetes. What an amazing resource of knowledge the local NHS has lost by no longer employing him. But thankfully we still have his private practice in Warwickshire and I will be referring all my diabetic patients to find out their level of risk. Thanks Jonathan for a very interesting evening you should do more talks to spread the word about diabetes to other FHPs. 
Chris Nock
I was recommended to go and see Jonathan from an excellent local pilates instructor who I trust implicitly, so I knew that the recommendation didn't come lightly. I was not disappointed. Jonathan has been attentive, professional, knowledgeable and provided a very considered solution to my plantar fasciitis. His team are always friendly and helpful - even when I got stuck in traffic and missed my appointment! Highly recommend!
Clare Price
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Very professional and friendly service - solved my foot problems where many others had failed -highly recomended.
John Newbold
A caring and professional service backed up by experience. I had tried every over the counter cure and a few dodgy ones from the internet for my persistent verucca with no luck. Jonathan brought all of his extensive knowledge to bear and now it is gone. I felt confident that my best interests were at the heart of any treatments and that I was in safe, professional hands at all times. Highly recommended. Evelyn Baxter
- hi everyone
I've been battling with planter fasciitis in my heel for 15 months, Jonathan small was highly recommended. I got no such luck from my doctor. I give these a ring and got me in straight away. Met Jonathan had a brief chat the knowledge and information given was very helpful put me on a 6 week course and my foot is the best its been in a long time.
From start to finish my experience was great. highly recommend Jonathan and his staff all very friendly.
Cheryl Higgins
I was suffering with quite a complicated situation, both plantar fasciitis and Achilles tendon insertion and they required different treatment. Johnathon expertly explained how he was going to deal with the problem and glad to say that after an intensive course of treatment things have improved. Di Griffin-Bloxham
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Mr Small and team provided a really excellent service for my elderly mother and kept her on her feet, mobile and active for the two years she lived near Southam, thank you very much!
Charlotte Gath
Jonathan is an inspirational Podiatrist.
Having attended several courses that have been run by Jonathan and having been lucky enough to have heard him speak at multiple professional events, my knowledge has increased dramatically, as has my love for Podiatry.
A true gentleman and a fabulous educator. Sarah Byrne
- They have been caring for my feet for 13 years. I have been very happy with the care I received and looked forwards to the walking on air feeling when treatment was completed. The only reason I will not be visiting them again is because I am shortly moving north to Yorkshire to be nearer my family. Thanks Jonathon for the years of excellent care!
Doreen Johnson
rapid appointment when I needed it and first class service. surgery went very well and recovery so far good with no pain. recommended without reservation.
Jenny Jenny Wootton
- After knee surgery I experienced ankle problems, a couple of visits to Jonathan has sorted the problem out. Thank you.
Judith Mary
I experienced a very accurate diagnosis. Treatment was good and the pain is easing very nicely. Greeted by a pleasant lady on reception and advised of the need to follow PPE. Met with Jonathan who is very friendly and professional just as you would expect. Highly recommend him to help solve your feet/foot problems. John Dewar
- Jonathan Small has been treating me for a range of foot and gait problems for a number of
Years including plantar fasciitis, Morton’s neuromas and joint hypermobility. As well as physical
Treatment he has supplied me with various orthotics which have really helped me keep
Mobile and reasonably fit. I am undergoing treatment at the moment and I fully expect that
Jonathan will be as successful as he has been in the past. All the staff at Health First are
Friendly and helpful.
Pam Alexander
Excellent service. I am so pleased with the help, advice and treatment recieved. Many thanks
Jackie Dewdney
- Thank you Jonathan for inviting me along to your Dynamic & Disasters of The Diabetic Foot seminar and thank you for sharing your wealth of knowledge. For anyone who has been diagnosed as diabetic I would urge you to visit Jonathan for a comprehensive diabetic foot assessment. You only have one pair of feet so treat them with respect and they will last a lifetime. I look forward to working with you on our quest to treat and educate on foot health. Kind regards - Debbie Hewitt, Foot Health Practitioner (Rugby)
Debbie Hewitt
Thank you to Jonathan for taking the time to share your knowledge and experience with me. Five stars! Thanks a bunch!
Hannah Krepski
- I have received first class treatment and my foot is feeling less painful especially after the
laser treatment I had on it.
Mary Richardson
It was nice to be greeted by pleasant and friendly reception/admin staff.
Johnathan (the podiatrist) was very professional and he was very willing to share his knowledge.
The pain in my foot was laser treated and on the last treatment it was manipulated which was amazing.
I would highly recommend Johnathan.
Ann Ann Maria
- Specialist podiatry advice from a highly skilled professional - bridging the gap between podiatry and physio.
Jo Webb
I visited Jonathan with terrible foot pain, he diagnosed it as plantar fasciitis after a full check and I was given sets of exercises to heal my foot, I have just left after my third visit and the pain has all but gone, I found Jonathan and Kate very friendly, would and have recommend to others, Thank you.👣 Paul Fogg