Ingrown Toenail Solutions
What is an ingrown toenail?
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.
Ingrown toenail causes
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©)
How can ingrown toenails be prevented?
-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
Treatment options for once-off ingrown toenails
A podiatrist may implement one or more of the following:
-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
Treatment options for ongoing, reoccurring ingrown toenails
A consultation with a podiatrist trained in both surgery and nail bracing will help you decide the best treatment option for your circumstances.
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.
Under local anesthesia the offending section of the toenail is removed. 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.
Gentles forces from the nail brace improve the toenail alignment
What are the benefits of using nail bracing over surgery?
-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
What are the benefits of surgery over nail bracing?
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
A range of bracing styles available at New Step Podiatry