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,
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.
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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I have had persistent pain with my toenails for years, but did not know the cause of the problem.
Previous visits to a different podiatrist left me with no answers! After researching local podiatrists I found that Health First came highly recommended.
Mr Small quickly found out the cause of my problem and recommended the best treatment options.
The staff were all very friendly and made me feel welcome. All very professional.
I cannot recommend them enough to anyone! Will be going back for my follow up treatment in the new year. 
Millie Hefferan
if you have any worries about your feet then this is the place to go. First class service.i was given Jonathan's details after a foot opperation went wrong he has really helped me and made it now that I can get back to my normal life. thank you guys !!!
Carolyn Clayton
- I have received first class treatment and my foot is feeling less painful especially after the
laser treatment I had on it.
Mary Richardson
Excellent service. The clinic was efficient enough that Jonathan was able to undertake toe surgery on the same day of my first appointment (just minutes after the problem was diagnosed!). The staff were very friendly and informative, and kept me very much at ease during the entire process. I was very appreciative and will be returning if I have any similar problems in the future. Highly recommended!
Joe Miller
- 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
100% recommendation. I walked in with significant foot pain and walked out strapped up and reasonably pain free. The initial consultation was delivered with expert knowledge, professionalism and clearly explained diagnosis and treatment plan.
I had attended another foot clinic for a diagnosis but my instinct told me to walk away and consider their treatment proposal and seek another opinion. I felt disappointed that I had no immediate temporary solution to reduce constant foot pain..
I was then recommended to contact Jonathan and the rest is history. His manner and professionalism exceeds, not only am I working towards pain free walking I know I have the confidence in approaching a clear expert. Thank you Jonathan and your team. I have already recommended. 
Helen Keast
- I can so recommend this company, their treatments and advice were exemplary and I was made to feel so relaxed and looked after from beginning to end
Jackie King
Jonathan is very helpful and knowledgeable, he has looked after my feet over the years and I trust him completely. He is always polite, kind and considerate 
Tracey Bianciardi
- 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
My 15 year old son had an ingrown toenail which was very painful. We were able to see Jonathan very quickly who explained everything really clearly, he advised minor surgery to remove part of the nail and said he could do the procedure there and then. The procedure was carried out professionally and with every care for my son. I would highly recommend Jonathan and his clinic. Excellent aftercare also. Thanks so much. 
Karen Grant
- Excellent well informed professional service. Treatment options discussed, and every effort made to deliver appropriate care promptly.
Thank you to Jonathan and the team.
Carol Brewer
Great service and an extremely friendly atmosphere. Lovely people work here. 
Liam Alexander
- Specialist podiatry advice from a highly skilled professional - bridging the gap between podiatry and physio.
Jo Webb
Couldn't be more thankful for the quick and friendly service. I needed help fast (I couldn't wait 2-3 months for nail surgery on the NHS) and Jonathan sorted me out just three days after I phoned to enquire. I felt very confident and relaxed in Health First. Thank you all!
Amy Duffin
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My problem was immediately identified and expertly treated. The follow up advice has been do-able and effective to undertake at home. Thanks Liz Bones
Liz Bones
I’ve known Jonathan for quite some time as we share the same passion for feet. Experienced, knowledgeable and motivated. I have no hesitation in recommending his services to anyone in his local area. 
Faye At
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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
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
- Have been suffering from plantar fasciitis for some time. After treatment and advice from the Foot and Gait Clinic my condition is manageable. Thank you I am now pain free.
Sue Ball
As a foot heath practitioner who has recently attended one of Jonathan’s talks I would refer my patients on to him without reservation should they need specialist input. His lectures are interesting, informative and motivating. I have crossed his path at numerous events where I have listened to him. He instills confidence. 
Liza Clarke