It can be very painful condition and because of fear of surgery many people put off seeking treatment until the nail has deteriorated to a chronic state. Many ingrown toe nails can be treated without the need for surgery, although conservative measures may mean that you have to visit a podiatrist at regular intervals. If surgery is required, it is very likely that it can be done without the need for admission to hospital. Many ingrown nails can be treated surgically in a podiatrist’s rooms with the procedure taking an hour or less.
Causes of Ingrown Nails
- Footwear that crowds the toes and toenails can increase the risk of ingrown toenails. This may include shoes which are too tight, short, narrow at the end, or flat at the end. Not cutting the toenails straight across.
- If you cut toenails too short, or cut the edges of the toenail this encourages the surrounding skin to fold over the nail, and the nail to push into that skin and pierce it.
- Toenail injury such as dropping something on your toe or kicking something hard.
- Toenails with an unusual curve. The way you walk or stand can effect the toenails and the risk of developing ingrown toenails.
- Poor foot hygiene or excessive sweating can create a higher risk of developing an ingrown toenail because of the excess moisture.
- Flat Feet can lead to feet turning outwards when walking causing the weight of the body to “roll over the side of the big toe instead of propulsing straight over the top. This can lead to compression of the toes and can lead to an ingrown toe nail. The force that leads to these ingrown nails are often seen in conjunction with callus on the side of the big toe
There are a range of treatment option including conservative nail trimming, loose footwear and antibiotics but surgical partial nail avulsion with phenol matrixectomy remains the definitive treatment for ingrown nails.
Partial Nail Avulsion
The procedure carried out by podiatrists is to remove the ingrown part of the nail under a local anaesthetic. To stop the offending part from regrowing, a chemical is applied to the tissue from which the nail grows. This method leaves no scar on the skin and leaves most of the nail in place resulting in a good cosmetic appearance. Healing is slightly slower by this method, but there is usually less post-operative pain than with other procedures.
Re-dressings at home and a few consultations with your podiatrist may be required over the two to three weeks following the procedure. For the first few days after the procedure pain relief, the use of open toed shoes and activity modification may be necessary, however interference with day to day activities is generally minimal.
In more severe cases, where the nail is severely deformed and causing pain on both edges of the toe, we may recommend a Total Nail Avulsion (TNA) removing the entire toenail to achieve the best result. If you have pain in your toe nails see your podiatrist, the treatment may not be as bad as you might imagine. All surgical procedures have some risk of complication; however this procedure is associated with a low rate of complications, again you should discuss this with your Podiatrist.
All surgical procedures have some risk of complication; however this procedure is associated with a low rate of complications, again you should discuss this with your Podiatrist.