Ingrown Toenail

An ingrown toenail, aka “onychocryptosis”, is a condition where the toenail grows into the side skin of the toe. This can happen on any toenail, but most commonly, the big toenail is affected. Nail pressure on the skin causes pain and inflammation. Sometimes the nail breaks the skin, resulting in severe pain, pus discharge, and raised, beefy, red skin growth called “hypergranulation tissue” in the area of the ingrown nail.

Risk Factors

• Genetics – Often there is a family history of ingrown nails.
  
  
• Nail Shape – Curvy or wide toenails are particularly prone to ingrowing.
  
  
• Damaged Nail – Nails damaged by trauma or fungus, are at increased risk of ingrowing.
  
  
• Improper Trimming – When nails are cut into a curve, the corner of the nail can be left in a vulneralbe area pushing on the skin, which increases the chance of an ingrown nail.
  
  
• Stubbing Toe – A violent stub in the wrong place can cause your nail to pierce the skin.
  
  
• Footwear – Tighter fitting footwear increases pressure on the side of the toes/nails.
  
  
• Bunions – Bunions force the big toe over against the 2nd toe, which increases pressure on the side of the nail.

Treatment
Home treatments for an ingrown toenail are should not be performed without consulting a professional to first assess the problematic nail. Self-care often makes the condition worse. If your ingrown nail is draining fluid or infected, treatment is urgent.
Chiropodists are highly trained in treating ingrown nails. Treatment options are based on presentation, overall health and re-occurrence.

• Conservative – If the ingrown nail is not deformed and unlikely to re-occur, conservative care may be recommended. This would typically consist of a “wedge resection”, which is where the ingrown nail is cut back away from the skin. This releases pressure from the skin, allowing it to heal. Relief is often instant.
  
  
• Surgical – For deformed nails that have a higher risk of recurring, or for severe ingrown nails, an in-office surgical approach, called a “partial nail avulsion with matrixecomy” is often recommended. This minor procedure offers a permanent, one-treatment fix. The procedure performed with the toe numbed. The ingrown portion of the nail is removed, and the “root” of the nail is cauterized with a chemical agent so it never grows back in teh problematic area. Success rate is very high. After healing, it is usually hard to see that the nail had ever been altered.
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Prevention

• Cut nails straight across, avoiding digging in the corners
  
  
• Avoid tight or pointed footwear
  
  
• If you have a nail that is difficult to cut, seek a chiropodist for professional care