An ingrown toenail is a condition in which the side or top of the toenail grows into the surrounding skin. An ingrown toenail without infection is simply a painful toenail edge, but with infection, it is essentially a foreign body lodged in the nail groove of the toe.
An ingrown toenail can arise on its own, from cutting the edges improperly, tight-fitting shoes or from trauma and fungal infections. Ingrown toenail pain ranges from dull to sharp depending upon the level of irritation and compression of the nail edge(s).
Depending on the severity of pain and discomfort, we provide the option of either conservative ingrown toenail treatment or surgical toenail treatment.
When it comes to the question of opting for conservative treatment — such as lifestyle changes, shoe alterations, and pain medications — or instead choosing ingrown toenail surgery, it really depends on the age, particular issue, and health of the individual.
While conservative treatment may alleviate some of the discomfort associated with ingrown toenails, it can’t be considered an actual cure for the overgrowth.
We have found that patients want both a permanent procedure where the painful nail edge does not return, and a more aesthetically pleasing cosmetic outcome as well. Moore Foot and Ankle Specialists use a technique that spares the rest of the toenail, and only removes a smaller portion, thus preserving normal appearance and width.
A number of conservative treatment options are available for those suffering from an ingrown toenail, including the following:
A larger, softer shoe can relieve the direct or indirect pressure from ingrown toenails. Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely.
Nail-softening products, such as topical creams, gels, and solutions, can ease the pain and pressure of a painful ingrown toenail. Antibiotic medication may be necessary for acute infections.
Over-the-counter padding can be worn in between the toes or behind the nail edge to help ease discomfort associated with an ingrown toenail.
Cutting the nail edges straight across without cutting the corners will prevent the skin at the edges from growing over the nail (becoming an ingrown toenail). Once the nail is ingrown, the painful edge(s) can be angled at the end by a professional to temporarily relieve the pressure and/or infection.
Surgical treatment for ingrown toenails takes place in the office, quickly and painlessly with a local anesthetic.
Over the years we have developed a technique where removing a large piece of the toenail is not necessary, rather we are able to remove only the piece that disappears down into the nail fold. The edge is removed to relieve the pressure, and a topical chemical agent can be applied (depending on the status of infection) to prevent the ingrown edge from returning permanently.
Full weight-bearing is allowed immediately following the procedure, without restrictions.
Technically, an ingrown toenail is where either edge of the toenail is causing pain or growing too deep into the nail groove. Over time, the pressure can build up calluses that create more pain if not removed, or even cause an infection if it pierces the skin. Tight shoe gear is a common cause for ingrown toenails, as well as improper trimming of the nail corners, and genetic trending.
Most patients wait until the nail edge is infected, but it is best to have your ingrown toenail treated or removed if there is any chronic pain or discomfort. If the infection is moderate to severe, the permanent procedure cannot be performed.
The nail edge or foreign body is removed to relieve the pain and treat the infection with antibiotics. Then the patient can return to have the nail edge removed permanently in two to three weeks, when the nail edge is healed.
X-rays are a standard of care and necessary to rule out a bone infection — the most severe stage of this problem. The toenail is only two to three millimeters away from the terminal phalanx and bone infections can result in a digital amputation.
Ingrown toenails can be very painful due to the fact that the extremities (fingers and toes) have very sensitive nerve endings. The nail edge is also sharp and combined with increased pressure from a shoe, an infection can add to the level of pain.
The simplest procedure that a podiatrist can perform for an ingrown toenail is to trim the edge to relieve the pain and rule out deeper, more serious problems (bone infection) with an X-ray. If there is no infection, or minimal infection, the permanent procedure (Matrixectomy) can be performed, where the nail edge is removed and the root of the nail is treated to prevent the edge from growing back.
There are several ways to stop an ingrown toenail from coming back. “Killing the root,” or Matrixectomy, can remove the ingrown toenail surgically, chemically, or even with cautery and laser techniques. The most common chemical solution is a weak acid called Phenol. This chemical cautery or burn prevents the nail edge from returning with only an average 5-10% failure rate.
Beyond satisfied with the ingrown toenail removal that was done on my left toe, I recommend to make appointments and stop suffering like I did for about 10 years of having ingrown issues going to urgent care that really did not know what to do they would only remove part of the ingrown and leave the rest still in the root growing back to hurt me. At Moore Foot and Ankle Specialist they really know what they are doing and make sure it is a permanent fix by burning the roots. If I could I would give 10 gold stars you can also see how the process gets done on their YouTube channel, all I search for permanent ingrown toe removal in Houston TX. And you will see Dr. Moore’s video.
One of our patients was gracious enough to show her nail edge 2 weeks after her ingrown toenail removal surgery. With so many ways to remove this painful problem, a cosmetic and permanent outcome is what we have perfected over the years in accordance of patient requests.
Are you suffering from painful ingrown toenails? Contact Moore Foot and Ankle Specialists today to discuss the method of treatment best for you.
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