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Ingrown Toenails

GENERAL INFORMATION

Ingrown toenails almost always occur in big toes and can be the result of poorly fitting footwear, improper nail cutting, injury and/or pure bad luck.  An ingrown nail consists of a distal nail edge that begins to grow down into the toe instead of growing out straight in a normal fashion.  If you attempt to dig or tear it out, it may become infected.  If an abscess forms, nature, in an effort to pad the area, starts producing granulation tissue ("proud flesh").  You now have a fat, red, ugly, painful toe with a growth.

 

TREATMENT:

  1. Check on your tetanus status, since these are basically puncture wounds.
  2. Try to avoid pressure.  Wear wide, flat, comfortable shoes.  You might try cotton or a sponge between proximal toes or a Dr. Sholls "corn" sponge donut around the infection.
  3. DO NOT ATTEMPT SELF-SURGERY!!!
  4. Soak two or three times a day in warm water with Epsom salt, Betadine (iodine soap) or soap.  Keep it clean.  Wear a band aid if draining, but preferably let it dry out as much as possible.  Both bacteria and granulation tissue like soggy atmospheres.
  5. Poking a small pledget (roll) of cotton into the nail trough is sometimes helpful.  Cutting a "V" or filing the distal nail thin so it can buckle generally have been beneficial.
  6. If your clinician prescribes an antibiotic, take it regularly to avoid infection in your bone (osteomyelitis).
  7. Removal of the ingrown part is a simple procedure done under local anesthesia.  The granulation tissue, if present, is also removed.  With simple removal you have a 70% chance of total cure.  This percentage can be increased with further treatment of the nail bed with chemicals, electrocautery, cryosurgery or laser, but you will also increase your chances of complications.  Your toenail will also be permanently narrower.

CALL IF:

  1. Your toe becomes red, swollen or more painful.
  2. Red streaks develop up your foot.
  3. Fever, chills, joint pains start.
  4. You are concerned about your toe or your medication.

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February 28, 2008