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Ingrown Toenail Surgery

An ingrown toenail occurs when the edge of the nail grows into the flesh instead of over it. This may occur when extra pressure is placed on the toe, usually as a result of ill-fitted shoes or improper grooming of the nails. Ingrown toenails (usually the big toe) can result to redness, swelling, pain, and in some cases, infection.

While the condition sometimes heals on its own without medical intervention, a visit to the doctor is necessary when severe or spreading pain is experienced.

Individuals suffering from diabetes or other conditions that might cause poor blood flow to the feet are at greater risk of developing complications from the condition.

Causes

Ingrown toenails are mainly caused by ill-fitting shoes and improper trimming of the nails. Shoes that are too tight add pressure to the toenail and cause the nail to cut into the skin. To avoid ingrown toenails, nails should be cut straight across.

If left undetected or untreated, this condition can infect the underlying bone. When that happens, a serious bone infection might develop.

Complications are especially severe for those who have diabetes as it can cause the condition to not heal properly and may even become infected.

Symptoms

  • Swelling of the toe around the nail
  • Tenderness and pain along one or both sides of the nail
  • Redness on the affected area
  • Tissue infection around the toenail
  • Pain (especially when pressure is put on the affected area)
  • Build up of oedema in the area that surrounds the toe
  • Hypertrophy or overgrowth of skin around the toe
  • Presence of yellow or white pus on the affected toe

If your ingrown toenail is bleeding, has pus, or is inflamed, a visit to the doctor or podiatrist is recommended. Seeking medical attention is especially crucial if you have diabetes as it can influence and affect the healing process.

Diagnosis

The doctor can easily diagnose the condition based on the symptoms manifested and upon physical examination of the affected nail as well as the surrounding skin.

If you need to visit a podiatrist, make sure you are able to make the most of your appointment by covering all the bases.

If you can, list down your key questions including the following:

  • What are the likely treatment options? What are the pros and cons of each?
  • What can I expect in terms of results?
  • Is my condition temporary or chronic?
  • Would it be advisable to just wait if it goes away on its own?
  • What are some of the recommended nail care routines while waiting for the toe to heal?

Aside from preparing key questions for your doctor to answer, you should also be prepared to address accurately possible queries your doctor will also ask including the following:

  • How long has it been since the symptoms first occurred?
  • What home remedies have you tried?
  • Do your symptoms manifest all the time?
  • Do you have diabetes or other medical conditions that might cause poor blood flow to your feet or legs?

Prevention

Keep ingrown toenail from developing by keeping in mind the following preventive measures:

  • Do not keep your nails too short. Make it a point to keep your toenails at moderate length. If the nails are too short, chances are the pressure from the shoes might cause the nail to grow into the tissue.
  • Trim toenails straight across. If you will have your nails done at the salon, inform your pedicurist to trim them straight across. If you are suffering from any condition that causes poor blood flow to both the feet and the legs, leave the trimming to the able hands of your podiatrist.
  • Do not wear ill-fitting shoes. Footwear that pinch or put too much pressure on your toes may result to the nail growing into the surrounding tissue. Preferably, purchase footwear from stores that specialize in fitting shoes for individuals with foot issues.
  • Check your feet regularly. Examine if there are telltale signs of ingrown toenails or other foot problems. This is especially vital if you have diabetes.
  • Wear protective shoes. If there is a possibility you will injure your toes while at work, it would be best to wear protective footwear as preventive measure.

Treatment

Mild cases of ingrown toenails often respond to home treatment.

Treat the condition at home by:

  • Soaking feet in warm water. Do this for at least 15 to 20 minutes, three or four times a day. Soaking can relieve tenderness and reduce swelling.
  • Place dental floss or cotton under the affected toenail. After soaking, put waxed dental floss or fresh cotton under the edge of the ingrown nail. This will help ensure the nail will grow above the edge of the skin.
  • Put antibiotic cream. Apply antibiotic on the affected area and bandage the toe right after.
  • Wear the right shoes. Consider wearing sandals or open-toed shoes at least for the time being while your toe heals.
  • Take pain relievers. Ibuprofen (Motrin IB, Advil), acetaminophen (Tylenol), and naproxen sodium (Aleve) are just some of the over-the-counter medications you can take to help alleviate the pain.

In severe cases and those that do not respond well to noninvasive treatments, ingrown toenail surgery might be recommended.

The surgery may entail removing only a part of the toenail or all of it, depending on the severity of the condition.

Partial Nail Avulsion

As the name implies, this surgery involves removing only a part of the toenail. This is the most common surgical approach used when treating ingrown nails.

Local anesthetic will be used to numb the toe prior to cutting the edges away. A chemical known as phenol will then be applied to the affected area to prevent the nail from growing back and prevent the condition from recurring.

For infected ingrown toenails, antibiotics will be prescribed and any pus on the affected area will be drained away.

Total Nail Avulsion

The surgery where the toenail is removed completely is called total nail avulsion. This is often the option when the nail is thick and it presses into the skin surrounding the toe.

After ingrown toenail surgery, the toe will be wrapped in sterile bandage to prevent infection and to stem any bleeding. Resting the foot and keeping it elevated at least a day or two after the surgery is recommended and painkillers will be prescribed to ease any post-surgery pains.

 

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