Ingrown Toenails

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Sometimes there are multiple reasons that an edge of a nail grows into the skin ( or that the skin is pushed onto or over part of the nail ). The result is often the same, and often this can be a very painful situation, which can then sometimes lead to surrounding infection or Abscess, or Localized Cellulitis. Possible causes can include single reasons or combinations of the following examples ( there are other reasons too ):

a/ The shape and the growth of the root of the nail may be effected by heredity , aging, or the shape as defined at birth.

b/ Direct trauma to the toe and nail bed may damage the nail growth region, or embed the nail , or damage surrounding tissues

c/ Incorrect cutting techniques, improper instruments used to cut the nails and patients poor judgement

d/ Other foot structure issues ( pressure from a bending hammertoe, hallux valgus bunion adjacent toe pressure , bone spurs under the nail plate )

e/ Shoe fit / shoe sizing / poor fashion shoe choices / pressure from sports activities and sport gear

f/ Other nail diseases ( fungus nails , psoriasis , aging nails, nail dystrophy )

The following are some photos of various mishapened nails, and ingrown nails.

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In my office, there are a variety of ways to help patients with ingrown nail problems, including possible prevention of improper care. For example, if someone cannot see well, or reach well, a podiatrist can offer periodic trimming of the nails, so that the patient does not get into trouble by injuring themselves and causing an ingrown nail . Cutting a " V" in the nail does not work, and trying to dig out a corner, might lead to more problems. In an acute ( sudden, painful, first time situation ) we can use local anesthetic , in the office, to simply remove an ingrown nail or border. In recurrent situations ( it keeps coming back after it is removed by the patient, or even by a professional ), there are ways to " kill" just a portion of the nail that wants to ingrow ( sometimes cosmetically hard to see that it was done after it heals, although sometimes there is a visible change in nail width or appearance ) . In some instances, the entire nail needs to be removed. Of course, if nail disease, or shoe selection, or other factors beside the nail is a problem, in some, ( but not all cases ) correcting those issues can go a long way in easing the ingrown nail tendency.

In any regard, if you make an appointment in our office, we will review the options, and allow you to help determine what is in your best short term, and long term interest. Most often, people call to make appointments for ingrown nails because they experiencing significant pain, and / or the nail has become infected. At your first visit, we would include the time to do the procedure necessary to remove the ingrown nail ( and deal with the infection ) at that same visit time. There are no stitches, and the next day you can get a bath or shower, but you will need to following cleaning and dressing instructions. Oral antibiotics may be needed ( but we prefer not to over utilize oral antibiotics ) ; topical antibiotics will normally be required temporarily. We have a screen that we can position in front of you, so that you do not need to watch any of this if you do not want to. Note: the "killing procedure" [ ablation, matrixectomy etc ] is not done the first time we meet and is scheduled separately. See file attachment for history of this procedure and safety including in diabetics See example of toes where nails have been removed partially, or totally in some more exceptional circumstances.

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