Ingrown toe nail

What are ingrown toenails?

Ingrown toenails occur when the edges or corners of your nails grow into the skin next to the nail. Your big toe is most likely to get an ingrown toenail.

What causes ingrown toenails?

Many things can cause an ingrown toenail, including:

• cutting toenails incorrectly

• irregular, curved toenails

• footwear that places a lot of pressure on the big toes, such as socks and stockings that are too tight or shoes that are too tight, narrow, or flat for your feet

• toenail injury, including stubbing your toe, dropping something heavy on your foot, or kicking a ball repeatedly

• poor posture

• improper foot hygiene, such as not keeping your feet clean or dry

• genetic predisposition

What are the symptoms of ingrown toenails?

Ingrown toenails can be painful, and they usually worsen in stages.
Early-stage symptoms include:

• skin next to the nail becoming tender, swollen, or hard

• pain when pressure is placed on the toe

• fluid building up around the toe

If your toe becomes infected, symptoms may include:

• red, swollen skin

• pain

• bleeding

• oozing pus

• overgrowth of skin around the toe

Treat your ingrown toenail as soon as possible to avoid worsening symptoms.

Treatment options:

1. Phenol matricectomy: It is the most commonly used chemical agent for matricectomy, with good results and a low recurrence rate; however, because of the extensive tissue damage it causes, drainage and delayed wound healing may occur.

2. Chemical matricectomy with 10% sodium hydroxide: This is as effective as phenol. It acts through liquefactive necrosis by alkali burning, resulting in less postoperative drainage and a shorter healing time.

3. The Winograd procedure (wedge resection): This involves local anesthesia and digital tourniquet application followed by a longitudinal incision along the eponychium followed by removal of the lateral nail border, hypertrophied tissue, and germinal matrix.

Postoperative care:

 

• The patient is allowed to walk after the operation.

• Rest at home with feet elevation is recommended, with intake of analgesics when needed.

• Normal ambulation and activity can be resumed as soon as 24 hours after the operation.

• First follow up is done after 48hrs.

• The patient is instructed to use topical antibiotic cream over the suture line twice a day.

• Sutures are usually removed after 2 weeks.

• Always keep the wound dry and clean.

Complications of ingrown toenails:

If left untreated, an ingrown toenail infection can cause an infection in the bone in your toe. A toenail infection can also lead to foot ulcers, or open sores, and a loss of blood flow to the infected area. Tissue decay and tissue death at the site of infection are possible.

Preventing ingrown toenails:

Ingrown toenails can be prevented by making several lifestyle changes:

• Trim your toenails straight across and make sure that the edges do not curve in.

• Avoid cutting toenails too short.

• Wear proper fitting shoes, socks, and tights.

• If your toenails are abnormally curved or thick, surgery may be necessary to prevent ingrown nails.