Ingrown Toenail Solutions in Canberra
When a toenail edge presses against and irritates the nail fold or adjacent skin. Ingrown toenails can have associated pain, infection, corns, calluses and hypergranulation. Hypergranuation is a red growth made up of tiny blood vessels, scar tissue and connective tissue.
An ingrown toenail may be caused or contributed by one or more of these conditions:
Involuted (excessively curved) toenails
Trauma to the toenail
Toenails that are too wide and flat for the nail bed
A nail spike or sharp edge that has been left in the corner when trimming
Toe deformities (claw toes, bunions)
Faulty foot posture and biomechanics
Shoes that are too tight around the toes
Genetic predisposition to an abnormal nail shape
The medication Isotretinoin (Roaccutane©)
Follow the nature contour of the toenail when trimming
Check that a nail spike hasn’t been left in the corner after trimming. This can be done with the pointed end found on some files
Use a file to smooth rough edges
Avoid trauma that can cause ingrown toenails, although, this can be hard to avoid in certain sports and around young children
Avoid wearing shoes that are tightly fitted around the toenails
Treat excessive foot perspiration
Ingrown toenails caused by faulty foot biomechanics should be addressed by a podiatrist
Skilful trimming of the nail edge to remove the offending nail spike, sharp edge or involution edge
Removal of nail edge calluses and dry skin
Silver nitrate application to associated hypergranulation
Packing of the edge with material to prevent nail and skin fold contact
Topical antiseptics to reduce bacterial and fungal populations
Referral for oral antibiotics therapy in moderate-severe bacterial infections
Dressings to protect the toe from environmental bacteria, fungi and trauma
Discussion regarding ingrown toenail prevention
A consultation with a podiatrist trained in both surgery and nail bracing will help you decide the best treatment option for your circumstances.
Treatment options for ongoing, reoccurring ingrown toenails
A smooth wire or plastic device is glued to the toenail like braces are applied to teeth. A gentle force within the brace encourages the nail to reposition. 4-6 weekly appointments are required until the desired nail shape is achieved. This can take 4-18 months depending on severity. Our podiatrists have seen patients from Belconnen, Canberra and surrounding suburbs, to offer accurate and in-depth advice on dealing with these issues.
Under local anesthesia the offending section of the toenail is removed. When it’s just the side/s of the toenail, the surgery is called a ‘partial nail avulsion’. When an entire toenail is removed it’s called a ‘total nail avulsion’.
The cells that create the nail are chemically destroyed with phenol meaning this section of the nail shouldn’t grow back. Only in very rare circumstances is the whole toenail removed. The surgery is performed in the clinic in a sterile environment. No stitches are required.
The procedure has the specific risks and limitations which are discussed with by your podiatrist.
Drug free, safe procedure
Instant reduction in toenail edge pressure
Minimal restriction on activities
Immediate return to work and sport
No chance of nail spikes growing back
No wound to heal
Normal nail aesthetic
Nail polish can be applied after application
If the nail edge is ingrowing because the nail plate is too wide and flat only surgery will reduce the width
For severe ingrown toenails with hypergranulation
Fewer appointments required
Faster treatment duration
The toe is injected with local anaesthetic, which is tested before the procedure begins.
An elastic ring called a tourniquet is placed around the base of the toe to control bleeding.
A narrow sliver of the affected nail edge is cut and removed (no skin incisions are needed).
In cases where phenolisation is needed – a strong chemical (phenol) is applied to the nail root to prevent the re-growth of nail. It is then flushed with saline.
The tourniquet is removed, a sterile dressing is applied to the toe once the bleeding has ceased.
Your podiatrist will give written and verbal instructions on how to best look after your toe post-operatively.
The toe is re-dressed at two redressing appointments, 2-3 days and 1 week post-surgery.
Your Podiatrist can immediately help to reduce pain associated with an ingrown toenail or involuted toenail with proper trimming to alleviate pressure on the adjacent skin. Often improved nail shape or nail edge lifting is noticed in the first 4 weeks. Treatment duration should be 6 to 12 months given total nail replacement takes 12 to 18 months.
4-8 weekly appointments are required until the desired nail shape is achieved, this may only take a few months, thereafter, a retainer brace is applied to hold this position until it grows out or falls off. Nail polish may be applied to this retainer brace. A podiatrist can provide personalised treatment duration based on the characteristics of your toenail.
Remove all nail polish from the nail to be treated.
Plan to avoid swimming for 2 days following brace application. Swimming in the hours before application is allowed.
Otherwise continue with all normal daily living activities.
Always avoid tight, narrow shoes and kicking balls with the foot being treated.
Avoid scrubbing the area or wearing shoes that could rub on the brace
Within 1 to 2 days, the initial tension will disappear. If the tension is severe, call the clinic and avoid tight fitting shoes and socks. Placing a Band-Aid over the nail and toe (non-stick part on the brace) may relieve some pressure.
Check that the brace isn’t loose once a week. If the brace becomes loose or detached or if a wire becomes exposed, your Podiatrist must be immediately notified. If the brace detaches, do not throw out the brace, bring it to the next podiatry appointment.
As the nail grows, the brace will move towards the free edge of the nail. Avoid trimming the nail too short; leave it at a comfortable length.