Ingrown Toenail

Ingrown Toenail showing infection tissue granulation
Ingrown Toenail showing infection and tissue granulation
What is an ingrown toenail?
Ingrown toenails are a common problem that can cause pain and discomfort. All toes can become ingrown but most commonly the big toenails are more frequently seen. An ingrown toenail occurs when one side of the nail curls down and grows into the nail sulci (side of the nail bed). This can often happen from poor nail cutting technique, trauma to the toe, tight fitting footwear, picking the toenails, sweaty feet making it easier for nails to dig in and also very involuted (curled over) and fan shaped nails. Ingrown toenails if left untreated, often become infected and can produce hypergranulation tissue (overgrowth of blood vessels/ proud flesh), causing them to take longer to heal. If infection is left untreated, it can spread to underlying bone and become much more serious.

What can I do to treat and prevent my ingrown toenails?
Routine nail cutting every 6-8 weeks is recommended by a podiatrist to cut the nails correctly. Other preventative advice includes cutting the nails straight across and using an emery board to file the nails.
Changing socks when they become sweaty and avoiding tight footwear. If ingrown toenails become frequent and annoying, nail surgery is recommended.

What does nail surgery involve?
Nail surgery is a common procedure carried out by a podiatrist to remove part, or all of a problem toenail. If the whole nail is removed it is call a Total Nail Avulsion, often abbreviated to TNA. If only part of the nail is removed, which is the most common operation, then it is termed a Partial Nail Avulsion (PNA). Problem nails include infected, ingrowing toenails or damaged, distorted thick nails that are causing pain and have not responded to conservative treatment. Local anaesthetic is injected into the toe so it is completely numb. A tornicot is applied to stop the bleeding and then the problem section of nail is removed. Phenol is then applied to the underlying nail matrix to help stop regrowth of the nail. This procedure is known as Phenol Matricectomy and has a success rate of around 95% in preventing re-growth.