Have you ever felt a sharp pain at the tip of your great toe, noticed it was a bit swollen, red, and angry looking? And then you'd chalk it up to tight shoes and move on, ignore it, and hope it would go away. But it didn't. The pain gradually worsened, the redness increased and slowly spread along the edge of the toe, and the skin along the nail started to swell. The next day you push on it and some white stuff comes out and you finally think it's time to seek professional help: your Podiatrist.
The ingrown nail can be caused by many things, ranging from tight shoes worn during a long hike or at an event to an aggressive pedicurist trying their best to clean along the inside of you nail or your own attempt at cutting your nails that you've neglected for months. The cause is important because this can be changed in an attempt to stop the ingrown nail from happening again. Unless it is a congenital deformity of the toe and toenail, born with a recurring ingrown toenail which can cause pain in children of all ages.
Many patients will go to their primary care physician who will prescribe antibiotics and send you to a Podiatrist. Antibiotics are rarely necessary to treat this problem, which is caused by the nail growing into the skin, breaking the skin, and allowing bacteria to grow and cause the infection.
The pain of the ingrown nail cutting into the skin is compounded by the infection and resulting attempt of your body to defend itself. But the war in your toe can be resolved by simply removing the ingrown nail.
Removing the ingrown portion of the toenail is a minor surgical procedure that requires anesthesia most of the time. Sometimes all that is needed is a small snip of a portion of the nail, but the most effective treatment is completely removing the ingrown side of the nail. If the entire toe is involved or the infection has progressed to affect both sides of the toe, then the entire nail may need to be removed.
This is only the first part of the treatment. The next phase is just as important, which requires the patient to perform diligent soaks in warm water and Epsom salt. This salt solution will allow for proper drainage of the infection. The patient should then clean the wound and apply the proper antibiotic cream and cover with gauze twice a day. A follow up appointment is necessary one week after the procedure to make sure that the wound is being treated properly by the patient, to stem any residual infection, and clean any remaining tissue that may be causing some pain or discomfort.
There are times when a second procedure is necessary to clean out the wound again under local anesthesia. The wound usually heals well in several weeks time, which is mostly dependent on the care taken to soak and clean the wound by the patient at home.
If the patient presents with a history of multiple recurrences of ingrown nails, then it may be prudent to perform a permanent removal of the nail border. This is performed in a similar manner with the addition of application of a strong base or acid that will destroy the nail at its root and hinder its ability to grow back. Sometimes this permanent procedure is performed surgically with a sharp blade to cut out the nail root.