In-growing toe nails


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In – growing toe nails can be conservatory managed by your Chiropodist or Podiatrist by appropriately cutting and shaping the nail. If the problem persists the nail can be corrected permanently with a minor procedure. Nail surgery is a long term solution when in grown toe nails re-occur. Commonly you may experience pain in the big toe nail, pus can develop or bleeding occurs. During the nail surgery procedure a portion of the offending nail or the whole nail can be permanently removed under local anesthetic and using a chemical called phenol. There is a 95% success rate with this procedure and is the only option for long term management of curved nails, infected toe nails or in growing toe nails.

Ingrowing toe nails are very common and also in contact sports such as football or hockey and athletics. They can be very painful and may limit walking, running or sports. Signs and Symptoms of ingrowing toe nails:

  • Hard skin near the nail
  • The toe is painful.
  • Tenderness in the skin around the nail.
  • Redness in the skin next to the nail.
  • Swelling around the skin and nail.
  • The toe may be hot.
  • The skin may be bleeding.
  • Pus or infection may be present near the toe nail.
  • Causes of ingrowing toe nails:
  • Footwear – ill fitting shoes and footwear which are too tight.
  • Inappropriate cutting – leaving spikes in the nail which pierce the skin.
  • Injury – Dropping an object on the nail or sports such as running causing pressure on the nail.
  • Hereditary nail conditions – Abnormal curves in the nail.
  • Posture or foot abnormality – Foot deformity, the way you walk or foot conditions such as
  • bunions may influence the development of an in growing toe nail.
  • Infection.
  • Treatment options:
  • Deep/wide footwear giving you more space around the toes.
  • Soaking the feet in salt water and using antiseptic cream such as savlon.
  • Conservative cutting of the nail completed regularly by podiatrists.
  • Nail surgery - Removal of part of the nail or the whole nail.

Nail Surgery – How will the toe nail be removed?

    1. After an assessment for suitability for this procedure, two local anaesthetic injections (mepivacaine 3% plain) will be injected into the offending toe/toe’s.
    2. After 5 minutes the toe/toe’s will be numb and either a portion of the nail or the whole nail will be removed. This makes the procedure pain free.
    3. A chemical (phenol) will be applied to destroy the exposed nail bed so the part of the removed nail never grows back again (95% success).
    4. The toe is then dressed with a large bandage.
    5. After the procedure you are required to rest and take pain relief (if required).
    6. This procedure takes around one hour, you can walk normally afterwards but are required to bring flip flops and cannot drive for 24 hours. The wound takes between 6-10 weeks to heal.

How painful is it afterwards?

Most patients do not need pain relief medication following this procedure however some patients may experience mild symptoms. If the toe is painful it is advisable to take over the counter pain relief such as Paracetamol and nothing which contains anti-coagulant medication such as Asprin.

Are there any risks involved?

This procedure is considered a safe and effective way to treat in growing toe nails. Like any procedure there are minor risks involved which your podiatrist will discuss with you during the assessment and when gaining formal consent prior to booking this procedure.

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Thu 2nd Jan 2020 am31 10:50 @thephysiogroup