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Ingrown Toenails.

Eltham Foot Clinic > Ingrown Toenails.

Ingrown toenails are horribly painful, grossly unsightly and are notoriously repeat offenders. They are like the bad guys who never get locked up and serially offend. Unfortunately, many people live with the discomfort of an ingrown toenail but there is no need too.

As a podiatrist I note the following things with ingrown toenails: 

  1. Usually present in adolescents
  2. Can happen after a traumatic injury to the toe
  3. More common during the colder months 
  4. Often repeatedly occur even with the best foot care.
  5. Patients let them go too long before seeking attention for what could be a simple fix.

Ingrown toenails get worse the longer they remain problematic. It’s unfortunate that most patients present to a podiatrist as the last resort instead of the first point of call. Patients often present after they have been to the GP to get antibiotics, hacked at the nail to make the problem worse and then once all else has failed visit a podiatrist.

The order should be to visit a podiatrist from the first point and let them determine if antibiotics are required to clear any infection – antibiotics are heavily over prescribed. The reason for the infection is because the body’s number one defence against infection (the skin) has been compromised by the nail. When the ingrown toenail is removed, topical antimicrobials such as Betadine, and salt water footpaths, are more than sufficient for the majority of most infections.

Let’s say you leave an ingrown toenail untreated for weeks or months or some instances years, what happens to the toe? Often this presents in clinic with scar tissue formation in the nail bed, hypergranulation tissue formation which has herniated from the skin, pigmentation of the sulci and serous exudate/blood or puss emanating from the area. To put this description into an image the toe would look like the following image.

Chronic Ingrown Toenail

What causes of ingrown toenails do podiatrists find to be the causative factor?

Firstly, ingrown toenails have a strong hereditary link. Often, parents attending with children will tell of their experience of ingrown toenails during their childhood.

Further, as we transition from summer to winter our footwear changes from open toe exposed footwear to usually tighter occlusive footwear. We all forget that as time goes along our feet change. Your feet today aren’t the same feet in 2,5, or 10 years.

Tight footwear often causes the flesh around the nails to press into the nail causing what would be perceived to be an ingrown toenail. This is also a reason why adolescents seem to encounter ingrown toenails more often than other age groups. The key is to check footwear fitting approximately every six months despite the shoes looking like new (let’s face it, most children would shred through their shoes in 6 months anyway). Get their feet fitted in store each time a new shoes is purchased and also start the new school year off with a new pair of shoes. Feet can do a lot of growing during the summer break! 

What you also want to do is make sure that you’re not cutting down your nails too short down the sides of the nail, trim them across lightly and if the corners are bother some give the nail a file.

How to cut your toenails

What treatments exist for ingrown toenails?

First point of call is usually painlessly trimming the nail which is causing the problem and shaping the nail in such a way to avoid reoccurrence of an ingrown toenail. Sometimes, if this fails or the podiatrist feels the nail will become ingrown again they may recommend more invasive treatments.

Often, a podiatrist will also try and pack the nail to get the nail to grow out over the skin and avoid growing into the skin. ‘Packing’ the nail may not always be suitable and there are cases where this is certainly ideal. Packing the nail can be uncomfortable for some people but certainly a lot less pain is felt than an ingrown toenail.

Last, there are procedures that can be performed in chair for the permanent removal of the nail. This does not need hospital admission. These procedures are safe and highly effective.

We regularly audit and review our performance and have 98% success rate with these ingrown toenail procedures in pain reduction, cosmetic appearance, and nail regrowth.

The general concern with ‘ingrown toenail surgery’ is the post op pain and cosmetic appearance of the nail. We can confidently say that post ingrown toenail surgery, pain is minimal and the cosmetic appearance of the nail is always kept in mind with every procedure. It is rare to experience cosmetic complications with these procedures. We perform a minimally invasive procedure with no incisions, cuts or sutures to the surrounding skin leaving the resulting toenail looking natural.

To sum it up, ingrown toenails are a common problem which are often a source of pain and disability. Your first point of call should be a podiatrist as they are experts in ingrown toenail management. If you are struggling with ingrown toenails give us a call on 9431 1138 or book online. We are certain we can solve your toenail problem.

Want more information on nails? Have a look at Better Health Channel, they have fantastic little read about nails.