How can we treat ingrown toenails?

Ingrown toenails (onychocryptosis) are  caused by downward pressure on the nail which is mainly caused by ill-fitting footwear and/or inappropriate nail care. Trauma to the nail plate or the surrounding tissues can also alter the way that the nail plate grows. Some patients may be pre-disposed to abnormally shaped nail beds which causes the nail plate to grow irregularly. This is known as involuted nails.

When the nail breaks through the skin it causes inflammation, severe pain and swelling. Other causes of onychocryptosis include abnormal sized nail plates, incorrect cutting of nails, trauma, tight footwear, high heels or advanced age. Treatment involves trimming the nail where possible, antibacterial ointment and sometimes removing the nail from the side of the skin.

Possible complications of onychcryptosis

Stage 1

This depends on the degree of invasion into the nail or surrounding soft tissue.

The main complaint is pain and if left without treatment the infection will spread further into the nail and surrounding areas. The patient will have swelling, redness and warmth and may find it difficult to walk.

Stage 2

This is when the nail is left to penetrate the soft tissues. It is increasingly red, swollen and painful. White or yellow pus may form. Granulation tissue is formed – this has to be surgically removed.

Stage 3

This is similar to Stage 2 but with further granulation of the surrounding skin. The overgrown skin may thicken meaning that the nail penetrates deeper. This makes removal harder. The infection may also occur with a fever and may lead to a bone infection, ulceration, gangrene and possibly amputation. It is especially severe for those with poor blood flow or nerve damage.

Treatment

Where ingrowing toenails are not infected, here at Total Foot Repair we can perform a Partial Nail Removal removing the spike which is ingrown providing immediate relief to the patient. We would then apply an anti-bacterial dressing as a precaution to protect the area and prevent bacteria from entering the wound. The dressing would need to be kept on for at least 48 hours and kept dry. Once removed, if the wound appeared worse or the same I would recommend visiting a GP for possible antibiotics.