In growing toenails

IN GROWING TOENAILS

An ingrowing toenail is where a piece of nail pierces the flesh of the toe. It can feel as if you have a splinter, and be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. In growing toenails most commonly affect the big toenail, but can affect the other toes too.

A nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin, isn't an ingrowing toenail but can feel very painful and can also appear red and inflamed.

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What causes an in growing toenail?

There are a range of factors that contribute to an ingrown toenail;

Poor toenail cutting- – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin
Ill-fitting footwear -wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail; the skin may be pierced if it's pressed on to your toenail
Sweaty feet – if the skin around your toenails is soft, it's easier for your nail to pierce it and embed itself within it
Trauma to the nail – for example, stubbing your toe can sometimes cause an ingrown toenail to develop
Hereditary factors such as the natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail

How can we help?

Often basic conservative treatment can manage this problem. We can help by cutting back the nail and removing the offending spike, as well as providing:

Advice on the correct footwear to prevent any discomfort
Advice on the correct nail cutting techniques
Treatment of thickened fungal nails using a nail file or podiatry drill

If however you have had the ingrowing toenail a while, it keeps coming back despite conservative treatment or it keeps getting infected then nail surgery may be the solution, which we offer here at The Foot Centre.

Nail Surgery

Nail surgery is the surgical removal of severe or returning ingrown and fungal toenails under local anaesthetic.

It involves partial or total removal of the toe nail.

Partial nail avulsion

Partial nail avulsion removes part of your toenail and is the most commonly used operation for treating ingrown toenails. It's about 98% effective.

We use a local anaesthetic to numb your toe before cutting away the edges of your toenail. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future.

Total nail avulsion

Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, you’ll have an indentation where your nail used to be. However, it's perfectly safe for you not to have a toenail.

In both instances;

We undertake the procedure in a seated position, before disinfecting the toe to provide a clean site for injection
We inject local anaesthetic into the toe to make it numb
Once the toe is completely numb, we apply a tourniquet around the toe to prevent any bleeding during the procedure
Once the tourniquet is applied, the edge of the nail or the complete nail is removed
We then apply a special substance known as phenol over the nail bed to prevent regrowth
Finally, we remove the tourniquet and apply a dressing

Once the procedure is completed, we will provide you with post- surgery guidance, dressings to take home, as well as the date and time of a follow up appointment for us to assess and re- dress the wound.

Generally healing takes about 6 weeks

The Foot Centre

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