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 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
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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!
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- 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.
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Jonathan is great - passionate, knowledgeable and dedicated to getting people’s foot problems sorted.
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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
I have been seeing Jonathan for over 20 years. He did a wonderful job to get me from hobbling around a golf course, barely able to finish a round, to fully engaging in a range of sports and activities I thought were beyond me for good. I continue to use his services when worn-out orthotics need replacing. He is a consummate professional and a very friendly, decent guy to boot. He is well supported by his excellent reception team. I thoroughly recommend Health First to anyone looking for a top quality foot care service and am happy to vouch in person if anyone cares to get in touch.
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