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.
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.
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.
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.
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.
November 14, 2019
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.
October 16, 2019
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)
September 5, 2019
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.
April 2, 2020
Specialist podiatry advice from a highly skilled professional - bridging the gap between podiatry and physio.
January 23, 2019
I made an appointment with Jonathan at the Health First Clinic in Southam, as recommended by Vicki Cooper. It sounded like I had too many issues for Vicki to deal with. I turned up asking for help with removing verrucas that had been there for years and help with an ingrown toenail, that although had been removed and treated, had grown back. I was astounded at Jonathan’s knowledge, and it turns out I was given completely the wrong advice, and treatment, by two other Podiatrists🤬😞. He gave me all instructions and options I didn’t know about, on how to remove the Verrucas, and it turns out my ingrown toenail wasn’t ingrown at all and so was removed and treated for no reason🤦♀️. Note to self, DON’T trust just anyone, trust THE BEST. Thanks to Jonathan and his team at Health First, I now look very differently at my feet. 👍😊
June 29, 2022
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!
September 29, 2017
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.
February 7, 2020
As an owner of 3 dogs I’m pretty much on my feet the whole time. However, walking became very painful because of my feet. The culprits were seed corns and awful cracked heels on both feet. Jonathan was excellent at carrying out very effective treatment and advising on an aftercare/maintenance routine. My feet now look and feel so much better and I’m pain free!
November 16, 2021
Had a fantastic day observing in clinic yesterday! Jonathan AMAZED me with his extensive knowledge, he was very supportive & I learnt so much just in 1 day! I admire Jonathans determination & drive to help his patients resolve any issues they may have & I hope to follow in his footsteps once I graduate from university. Thanks again for the opportunity your useful and excellent advice will always remain with me. Faye 🙂
June 12, 2021
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.
June 24, 2021
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.
October 28, 2019
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.👣
July 16, 2019
- Liam Alexander Willson
December 6, 2018