Ingrown Nail Treatment
Introduction:
The nail becomes ingrown when it extends into the adjacent skin, creating pain. Although it is more common to find this condition in the first toe, it can also happen to any toe that is crowded by the shoe or adjacent toes. This becomes a more serious problem when the toe becomes infected, appearing red and swollen and becoming more painful for the patient.
Causes:
Improper nail trimming, trauma, genetic factors, anatomic variations such as malformed nail plate or deformed toe, pregnancy, biomechanical dysfunction, subungual exostosis, improperly fitted shoes.
In athletes this condition occurs because of quick stops and starts, along with lateral movements of their individual sports and the unique designs and fit of their shoes, along with improper grooming of their nails as well as genetic makeup of their feet.
The elderly may have this condition because of thickened and diseased nails, poorly fitting shoes, peripheral neuropathy and a lack of grooming.
The way that people cut their nails can also encourage ingrown toenails – rounding off the corners and cutting them back too short can both create an environment that causes the skin to grow into the nail area. Combining this nail-cutting method with a too-tight shoe is a perfect scenario to develop ingrown nail.
Clinical Presentation:
The patient presents complaining of pain that is worse in shoes. The condition usually presents in the great toe and on the lateral border. There is redness, swelling, foul odor and drainage at the nail groove. There may be hypertrophic granulation tissue.
Treatment:
In mild cases treatments have usually been exhausted at home before the patient is seen by a medical professional and include warm water soaks, topical antibiotics and nail trimming (which can actuality worsen the condition).
Oral antibiotics are rarely needed but it is often difficult to reassure a concerned parent or patient of that fact and require educating the patient about current best practices.
In-Office Treatment Options for Ingrown Toenails: A slant-back or wedge resection is performed of the offending, painful border. Patient education is a key component as well. The patient should be educated on trimming nails straight across and, if tolerated, to place a small cotton bead or roll between nail and skin fold to encourage the nail to grow up and out away from the skin.
The chemical matrixectomy, or P&A is a procedure performed in the podiatric physician’s office. The chemicals used are phenol and alcohol or sodium hydroxide. After anesthesia has been accomplished and the digit has been prepped, the ingrown sites of the nail are removed and the chemical gets applied. Application of the chemical kills the nail matrix on the corners and prevents regrowth of ingrown nails (Literature shows that around 90% of the time, chemical matrixectomy is successful and prevents reoccurrence of ingrown nail).
Recommendation:
If you are suffering from ingrown nail, you may start soaking your foot in Epsom salt and warm water solution and come see one of our podiatrists at Empire Foot and Ankle center in Chino or Upland location. If you get your ingrown toenail treated fast, the chance of it getting infected is less and matrixectomy will have better outcome when the ingrown nail is not infected.