Ingrowing Nails
Description
An ingrown toenail is a usually a painful condition characterized by the nail digging into the surrounding skin, leading to inflammation and possible infection of the toe.
This is a serious condition for people with impaired circulation, diabetes or diseases causing immune suppression
Let us split ingrown nails into 2 broad groups.
Firstly those where a spike of nail is penetrating the flesh.
It can be an acute problem which comes usually due to trauma or poor nail cutting or picking at the nails where a spike of nail is left which then grows forwards aggravating the skin at the edge of the nail. If left it can often develop a mass of red jelly like tissue called hypergranulation tissue which bleeds very easily. Healing is often complicated by infection which takes advantage of the moist environment. We often see people who have had several courses of antibiotics in a bid to solve the problem. However, that is not enough and the spike of nail needs to be removed. Usually this can be done without the need for local anaesthetic but sometimes it may be necessary and can be administered by a suitably qualified Podiatrist.
And secondly where the nail has curled over a period of time into the skin at the edges.
We call this involuted and is generally a chronic long term change in the nail profile that leads to it curling in at the edges. It usually occurs as a result of pressure which could be due to poor fitting shoes or a poor foot structure leading to pressure in that area. Obviously it can be a combination of them both. Although this forms gradually and may cause discomfort just from the pressure it can also be harder to cut leading to an increased likelihood of a spike being left which then penetrates the flesh.
What we can do
First line treatment is always to assess. Sometimes all that is needed is to simply remove a piece of nail but if it becomes a recurrent problem you will be advised to have some nail surgery which can involve removal of either a part of the nail or the whole nail. This can either be done with the root of the nail left intact to grow again or with either the whole or part of the root destroyed to leave you with either no nail or a narrower one. If you suspect an ingrown nail is starting it is always advisable to get it assessed quickly as even 24 hours of walking around with it can make it worse and therefore the treatment more involved and costly.