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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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
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 ! Nikki Jackson
- 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
A great practice. Have been using for the past 5 years and always have excellent service. Very friendly and helpful staff. My feet are in great shape
Emily Harris
- Knowing Jonathan as a fellow podiatrist. He has a special gift in delivering information and motivating people, which is amazing. I have attended a number of his courses and talks, where he shares his knowledge and skills. An inspirational podiatrist!
Lynda Cowan
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
- 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
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
- 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
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
- 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
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
- 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
I wouldn't trust anyone else with my foot-care. With severe circulation issues, my feet are comprised - Health First have treated me for 15 years and I highly recommend them.
Angela Navarro
- Highly recommend this practice. Jonathan and his team are extremely professional and friendly. As a cancer patient I was anxious to find a podiatrist whom I could trust completely. Jonathan took time to fully understand my medical situation and on-going difficulty with my toes. He was proactive in communicating with my Oncologist and the required nail surgery took place 2 days after my initial appointment. Everything was carefully explained and skilfully carried out. I am one very satisfied customer!
Angela Terry
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
- 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
Jonathan is great - passionate, knowledgeable and dedicated to getting people’s foot problems sorted.
I had the pleasure of helping him recently with promotion material for a podshealheels and he delivered a superb lecture to a group of patients and professionals. Dave James
- After knee surgery I experienced ankle problems, a couple of visits to Jonathan has sorted the problem out. Thank you.
Judith Mary
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