Article by Dr. Misako McLeod, DPM
One of the most common problems I see in my office is ingrown toenails. They are painful, annoying, and recurrent. Many people suffer needlessly with pain when the treatment and cure is simple.
An ingrown toenail is where the edge or the side of the nail is incurvated, digging into the skin and causing pain. Sometimes, the nail has penetrated the skin and a subsequent infection may occur causing worsening pain and discomfort.
Many people revert to “bathroom surgery” where they attempt to pull the curved nail edge out with nail cutters. This is unwise as the environment is unsterile and you may leave behind a small spicule or nail edge which can cause worsening pain and infection.
Diabetics need to be especially careful in preventing ingrown toenails as they are especially susceptible to infections.
So what are the treatments?
If the nail’s edge is mildly incurvated, sometimes one may get relief from simply soaking the toe in warm water and epsom salt. This will dry out the nail and sometimes will alleviate the inflammation. However, when the ingrown toenail is severe, it’s best to seek medical attention from a podiatrist.
I usually recommend temporary removal of the side of the toenail (partial nail avulsion) or whole toenail (total nail avulsion). This is an office based procedure and it involves numbing up the toe and removing a small portion of the incurvated nail. After the procedure, the area is covered with a dressing and the patient is given Post-Operative Instructions to soak the nail.
Once the local anesthesia wears off, most patients experience little or no pain. They usually feel better now that the nail been removed. However, occasionally one may experience a bit of soreness and this is usually relieved with some Tylenol. With a simple, non-permanent toenail avulsion, the toenail edge will grow back within 6-8 months.
On the other hand, if the patient complains of recurrent ingrown toenails or a history of ingrown toenails, then I may recommend a partial permanent toenail procedure. This involves numbing up the toe, removing the side of the nail and then applying chemical to the nail root to kill the cells that grow on the nail’s side. The purpose of the permanent nail procedure is simply to prevent the side of the nail from coming back and becoming ingrown again.
For both procedures, patients are advised to soak the nail in epsom salt and water for 11 days. Patients are to see me in 11 days for a re-check.
Most patients are happy that they underwent this simple, office based procedure and be relieved from a life time of recurrent toenails and pain.
For more advanced cases of ingrown toenails or recurrent infections and abnormal contour of the nail skin, other, surgical procedures may be recommended.
If you suffer from Ingrown toenails (Onychocryptosis), call 1-844-442-3668 for a consultation.