What exactly is an ingrown toenail? It is when the sides of the toenail grow into the toenail borders and break the skin and create an infection. This can occur from chronic tight fitting shoes, picking or tearing at your toenails, or simply genetic predisposition.
The number one surgical procedure that I perform (everyday) in the office is surgical removal of an ingrown toenail. If you think you have an ingrown toenail, it is crucial to have this treated to prevent a more severe infection from occurring.
Is it a good idea to keep having your ingrown toenail fixed while getting your pedicure done? Probably not. The risk of developing a toenail fungus or even a severely infected ingrown toenail greatly increases by having someone pick at the side of your toenail.
Toenail trauma is very common and can create panic to many people. The biggest question is “what do you do to the toenail?”. Here are some guidelines on what to do if you injure your toenail.
If you have every had an ingrown toenail removed and developed a reoccurent small portion of nail in the corner, it is called spicule. This small sliver of nail will grow at the same rate of the full sized nail plate but will be a small detached portion of nail. While it is nothing to worry about, it can be irritable and bleed if pulled out. Many patients also describe that it catches on their socks and clothes and is painful.
Suffering from a severely painful toenail that is constantly irritated with shoes and impossible to cut? Surgical removal is most likely the best option. Toenail deformities can be the result of trauma to the nail plate which can occur from dropping something on your toe, or simply through years of irritation of the nail plate on a shoe. Nail fungus can also be the cause of a deformed toenail, so it is imperative to first have the nail tested for fungus before making any decisions to permanently remove the toenail.
An ingrown toenail is typically the result of the nail plate growing into the adjacent nail fold or skin next to the toenail. The break in the skin allows bacteria to enter and an infection occurs.
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.
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.
There are two possible solutions for you to fix your ingrown toenail. 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.
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