A021

Ingrown toenails

A021

Ingrown Toenails.

Ingrown toenails or Onychocryptosis is a condition whereby the nail pushes into the surrounding tissue causing pressure and pain. In some cases this nail edge or spike pierces the surrounding skin of the nail causing severe irritation and can lead to acute localised infection. The condition is often seen in the adolescent population but can be seen at any age and in any demographic.

Causes of Ingrowing Nails

There are a number of factors that may cause an ingrown toenail. We are often asked at Peninsula Foot Clinic just what causes an ingrown toenail. The following are some common causes of ingrowing nails:

  • Poor cutting technique. This may leave a simple nail spike or hard shoulder in the nail edge that can cause lasting pressure or tissue damage. Often cutting the nails too short
  • Abnormalities in the nail width and growth can predispose some people to higher pressures or chances of ingrowing. It is not uncommon to see nails change shape in the older population due to trauma or hereditary influences. Involuted or excessively curved nails increases the risk of ingrown toenails and can become extremely difficult to tend to properly without specialist care.
  • Hyperhidrosis or excessive sweating can increase the risk of acute infection in an ingrown nail. As the moisture is held against the skin it softens and becomes less resistant to pressure from the surrounding nail increasing the chances of piercing the skin.
  • Fungal nails or any condition of the nail that may cause it to become brittle and thickened has the chance of causing more pressure or nail spikes in a nail edge.
  • Poor foot mechanics and over pronation (flattening of the foot) can assist in causing ingrown nails. If a foot functions poorly causing increased pressure on the inside of a big toe, the surrounding soft tissue is commonly forced against the nail during activity. This can cause an increased chance of reoccurring ingrown nails.
  • Poor fitting footwear, socks and hosiery can also increase the risk of developing an ingrown nail.

Signs and Symptoms of an Ingrowing Nail

An ingrowing toenail is almost always painful. Any pressure from footwear or walking can elicit acute pain at the site. In cases where the nail may not have broken the skin pain can be the only presenting symptom. When infection is also present you are likely to feel pain accompanied by any number signs of infection, redness and swelling. In acute cases the affected toe(s) are likely to throb on rest and any slight pressure will elicit significant pain. If left untreated excess tissue can develop in the surrounding skin overhanging the nail edge.

 

Treatment and Removal of Ingrowing Nails and Cost of Surgery

Your podiatrist sees cases of ingrown nails on a regular basis and is able to assess your circumstances and develop a treatment plan that works best for you. In doing so they will discuss the appropriate remedies for your circumstances considering work or sporting commitments, severity and cost.

Ingrown toenail treatment is heavily dependant on the severity of the site, whether infection is involved and whether it has occurred previously. Initially your podiatrist may look to remove the nail edge or spike and can often cure the associated pain with little discomfort.

If the edge remains persistent your podiatrist may choose to address the precipitating factors directly such as improving foot function with foot orthotics or making a wedge for between the toes to alleviate pressure.

If simple conservative measures fails to resolve your ingrown nail a surgical procedure may be recommended to provide a long term solution. This minor surgery performed in the clinic involves a local anaesthetic to the area, removal of a portion of the nail and the application of a chemical or laser to the area the nail grows from to ensure that aspect of the nail does not grow back. The area is then dressed up and monitored closely over the coming weeks to ensure no complications occur. At Peninsula Foot Clinic we offer nail surgery for a cost of $410, which includes follow up appointments to monitor the site. This should however be discussed with your podiatrist on a separate consult to ensure that surgery is appropriate and discuss any other considerations.

Care and recovery following nail surgery consists of dressing and monitoring the site. In most cases a return to activity or work can be achieved within 1 to 2 days and with minimal disruption.

Prevention and Cure of Ingrown Toenails

We are often asked how to stop an ingrown toenail or the best way to avoid ingrowing toenails. Prevention and cure of ingrowing nails is relatively different from case to case. For this reason we would encourage you to speak to your podiatrist about the best ways for you to remedy your condition. They may offer advice or treatments tailored to your situation to best help and care for your toe(s).

If you are experiencing any pain or symptoms of an ingrown nail contact the team at Peninsula Foot Clinic on 03 5982 0000 for an appointment or further information.