Ingrown Toenails

What is an ingrown toenail?

Dr. Campitelli No Comments


An ingrown toenail is when the border or side of your toenail breaks through the skin next to it which eventually leads to a skin infection or cellulitis. The skin becomes swollen, red and painful. Sometimes you will see pus draining from underneath the nail. 

Treatment at home consists of soaking the foot or toe in warm water and a tablespoon of Epsom salts or antibacterial soap twice a day for fifteen minutes. The area should be covered with a bandaid and antibiotic ointment at all times. 

If home therapy doesn’t resolve the infection the border will need to be removed surgically. This is a simple procedure performed in the office with local anesthesia to numb the toe. Recovery involves soaking for 7-10 days and wearing a bandaid and antibiotic ointment. 

More serious cases may require taking oral antibiotics and sometimes the entire nail needs to be removed temporarily. 

If it is a recurrent situation where the nail continues to become ingrown every six months or more, then a permanent procedure is performed to prevent regrowth of the nail border. 

Here’s a video of Dr. Campitelli performing the procedure in the office. 

SUBUNGUAL HEMATOMAS (RUNNER’S NAIL)

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Subungual hematomas frequently occur in distance runners and I tend to see a lot of them in my practice. While it can be a controversial topic in regard to either draining or removing the entire nail, I learned early in my career that it is best to remove the entire nail.
Read one of my posts on Dr. Nicks Running Blog that gives a detailed approach on the benefits of removing a painful toenail to relieve the pressure from bleeding. 

Surgical removal of ingrown toenail. 

Dr. Campitelli 2 comments

Suffering from an infected ingrown toenail?

There are two possible solutions for your problem. If this is the first time you are experiencing an ingrown toenail, then a nail avulsion would be indicated. This is a surgical procedure performed in the office where the ingrown border of the nail plate is surgically excised. Antibiotics are typically not needed and the condition resolves by simply removing the ingrown nail border. The recovery period is usually 7-10 days and heavy activity such as running can be performed within 24-48 hours.

CAUTION:  THE FOLLOWING VIDEO CONTAINS REAL SURGICAL FOOTAGE

For recurrent cases of ingrown toenails, a permanent procedure is typically chosen. This involves the same technique as a nail avulsion, but a chemical is introduced into the nail groove and the nail matrix (cells that form the nail) is ablated to prevent the border of the nail from growing back.  The recovery period is slightly extended for this procedure as drainage usually occurs for 14 days. Regular activity, as well as exercise,  can again take place in 24-48 hours.

Questions?  Post in the comments section below!

 

Ingrown Toenails: Example of the infamous “hidden” nail.

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If you ever had an ingrown toenail that never responded to your “bathroom” surgery then you may want to read this to see why.

Typically when the nail plate irritates the surrounding nail fold, it breaks the king and gets covered by the inflamed nail fold.  When one tries to “cut the corner” out, they typically miss the entire side and cut a portion of the nail and apply pressure to pull it out.  A spike of nail is left behind and continues to grow and eventually is stuck into the nail fold which complicates the situation even further.  Now bacteria is enabled to enter the skin and an infection occurs.  When this occurs, the only way to remove the nail is through surgical excision and excising the entire side of the nail.

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Topical Nail Solution to soften and clear discolored toenails.
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