Symptoms
An ingrown nail occurs when any part of the nail grows into the surrounding skin.
This can happen slowly or seemingly "over night" and may cause irritation, pain, redness or swelling. Over time, ingrown nails may cause a deep abscess or infection and can be associated with small spurs under the nail and pierces the skin due to a combination of your natural nail shape, poor nail-cutting and/or trauma which causes extreme pain. If not treated quickly and effectively, ingrowing toenails often become infected leading to the need for antibiotics. Thickened or fungal nails tend to aggravate an ingrown nail. Potential causes of ingrown nails include: previous injury to the toe, improper shoe gear, contributing factors due to other toe or foot deformities and certain athletic activity.
Evaluation
We will discuss your symptoms as it relates to your condition. We will then examine, palpate, probe and trim or thin down the nail or unhealthy tissue to determine the cause of the nail symptoms. A bone abnormality such as a curled toe, long toe, hammertoe or bunion should also be examined to determine if it is a contributing factor to the nail ingrowth.
Treatment
Conservative treatment consists of addressing any predisposing toe and /or foot condition, shoe gear factors and proper hygiene habits including foot soaks at home. We can also routinely cut and debride the nail and /or any debris that accumulates around the nail. There are several nonprescription and prescription antibiotic creams that may cure the very new and mild cases. More significant nail infections may require an oral prescription antibiotic.
The most definitive way to treat an ingrown nail is to remove the offending nail border causing the symptoms. Surgical treatment includes avulsion (temporary removal) of part of the nail or matrixectomy (permanent removal) of part of the nail under a local anesthetic. In this case, the nail root is removed or a chemical is applied so no nail corner grows back. Both procedures are performed in the clinic, the toe is numbed with a local anesthetic and the procedure is completed. The patient is allowed to ambulate to tolerance and instruction for home care is given.
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