What is an ingrown toenail? An ingrown toenail occurs when one or both sides (borders) of the toenail grow into the surrounding skin (the nail folds). This can lead to pain and, potentially, an infection.
What are the symptoms of ingrown toenails? The most common symptom is pain, especially when pressure is applied to the area. If the ingrown toenail becomes infected, you might notice:
- Redness around the affected nail border.
- Warmth in the skin surrounding the toe.
- Swelling of the toe.
- Drainage, which can be clear or yellowish (serous fluid) or contain pus (purulent fluid).
- Granuloma: If the ingrown toenail is left untreated for a prolonged period, a small, inflamed, and often fleshy bump of tissue (granuloma) may form along the nail border.
What are the treatments for ingrown toenails?
There are several approaches to treating ingrown toenails, ranging from home care to minor surgical procedures:
- Slant back the Nail Edge
- What it is: Carefully cutting away the ingrown portion or sharp corner of the nail to relieve pressure.
- Who does it: This is sometimes attempted at home (with caution) or performed by a podiatrist.
- Pros & Cons: This method is relatively easy to perform and minimally invasive. However, because the nail root isn’t treated, recurrence is common as the nail continues to grow. Home attempts can sometimes worsen the condition if not done correctly or if an infection is present.
- Warm Water Soaks
- What it is: Soaking the affected foot in warm water for 15-20 minutes, 2-3 times a day. Epsom salt can be added to the water, which may help soothe the foot and reduce inflammation.
- How it helps: This method temporarily softens the nail and the surrounding skin, which can reduce pain and inflammation. The goal is to allow the nail to grow out with less irritation.
- Limitations: While helpful for mild cases or to manage symptoms, severe or deeply ingrown nails may not fully resolve with soaking alone.
- Partial Nail Avulsion (Removal of the Offending Nail Border)
- What it is: A minor surgical procedure performed by a podiatrist. After numbing the toe, a small vertical section of the ingrown nail border is carefully cut and removed from the base (nail matrix) to the tip.
- Effectiveness: This method is generally very effective at relieving symptoms and treating the immediate problem.
- Recurrence: The nail border can grow back, and recurrence of the ingrown toenail may happen, though it typically takes more than six months, if at all.
- Matrixectomy (Permanent Nail Border Removal)
- What it is: A definitive procedure performed by a podiatrist, usually for recurrent or severe ingrown toenails. It involves two main steps:
- Partial Nail Avulsion: The offending nail border is removed, as described above, to expose the nail matrix (the area at the base of the nail responsible for generating new nail cells).
- Matrix Destruction: The exposed nail matrix corresponding to the removed nail portion is then destroyed using a chemical (like phenol or sodium hydroxide), surgical excision (cutting it out), or laser.
- Outcome: The destroyed portion of the nail matrix will no longer produce a nail, resulting in a slightly narrower nail permanently.
- Effectiveness & Recurrence: This method is considered a permanent solution for ingrown toenails. However, there’s a small chance of recurrence (around 5-10% of cases) if any matrix cells survive the procedure.
- When it’s offered: This procedure is typically recommended for patients who experience repeated ingrown toenails despite other treatments.
- What it is: A definitive procedure performed by a podiatrist, usually for recurrent or severe ingrown toenails. It involves two main steps:
Important Note: If you suspect an ingrown toenail, especially if there are signs of infection (like pus, significant redness, or increasing pain), it’s best to consult a healthcare professional, such as a podiatrist, for proper diagnosis and treatment. Avoid attempting to cut deeply into the nail corners yourself, as this can sometimes worsen the condition or lead to infection.
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