Ingrown toenail
By Dr. Sergio Mazzei, General Surgeon
An ingrown toenail happens when your toenail grows into the skin around it. The skin can get damaged, causing infection and pain, usually to the big toe. The most common cause of an ingrowing toenail is not cutting your toenails properly, by cutting them too short or down the sides of your toenail, and wearing shoes which are not wide enough to fit your toes in their natural position.
Ingrown toenails irritate the skin. As a result, they can make it easier for bacteria and other microbes to get in, which increases the risk of infection. Some signs of infection include:
- Swelling
- Pus
- Redness
- Extreme pain
Reportedly about 20% of people who visit a doctor for advice regarding a foot problem have an ingrown toenail. The treatment methods may vary depending on how advanced the problem is and the individual needs of the patient. In severe cases, especially when the nail has become infected, people may need to see a doctor for advice, antibiotics, and sometimes for a surgical procedure.
For patients with long-term and recurring ingrown toenail issues, ingrown toenail surgery is probably the best option. To avoid continual discomfort and pain when non-invasive treatments are unsuccessful, surgically removing the nail edge can be a better permanent solution.
Ingrown toenail surgery usually involves the use of local anesthesia which means that the person remains awake, but the doctor numbs the area so the patient cannot feel their toe.
- Wedge resection: A part of the toenail is removed to prevent it from digging deep into the skin. This is also called a partial nail avulsion.
- Toenail removal: It is necessary to remove the entire toenail. It can take up to several months for the nail to fully regrow, and it depend of different reasons. This procedure is also called complete nail plate avulsion.
- Surgery on the tip of the toe. If a previous procedures have failed, a doctor may remove and reshape the soft tissue at the tip of the toe.
- Matrixectomy: This procedure may be necessary if nail removal or wedge resection fails. It involves the removal of the nail bed in addition to the nail.
The wound should heal within several weeks. The pain will steadily lessen in the next days following surgery and should stop by the time the wound heals. It can take several months for the nail to regrow, but the length of time will vary from person to person.
People with ingrown toenails should discuss their treatment options with a skilled, experienced surgeon. Excellent medical care can reduce the risk of complications following surgery and increase the chances of a full recovery with the regrowth of a healthy nail.
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