An ingrowing toenail is where a piece of nail pierces the skin of the toe. It is most common in big toes but can also affect the smaller toes. Ingrowing nails can be extremely painful and can become inflamed or infected. They may bleed, or there may be pus or hypergranulation tissue (excess of healing flesh).
Not all painful Toes are caused by ingrowing toenails. Pain may also be caused by thickened or curved nails, or even a corn under the nail.
Nails that are very curved (involuted) but do not pierce the skin, may not be ingrowing, but can be just as painful.
What Causes Ingrowing Toenails? There are a number of things that may make you more prone to ingrowing toenails, including:-
Incorrect toenail cutting
Nail shape (such as ones that are very curled or broad)
Foot deformities such as bunions, hammer toes
Injury (such as stubbing your toe)
Tight footwear or socks
Hot or sweaty feet (the skin next to the nail becomes soft, so the nail can pierce it more easily)
Posture (the way you stand)
Gait (the way you walk)
Excessive pronation (when your foot rolls inwards excessively)
Without treatment, an ingrowing toenail can become infected. Normally, the quicker you deal with it,the less uncomfortable or painful it is.
The first thing your podiatrist will do is examine the toe in order to accurately diagnose the problem. There are a number of different treatment options, depending on the severity of your problem. In some cases, it may be possible to cut away the part of the nail that is causing the problem. The nail will then be shaped to try and stop the problem occurring again as the nail grows forward. The toe may require a dressing, or you may be advised about what to wear between the toes, to reduce any pressure.
If your ingrowing toenail does not improve, or if you have recurring problems, it may be necessary to have nail surgery. This procedure is carried out in our clinic and the appointment normally lasts an hour.
The most common nail surgery is removal of part of the nail (partial nail avulsion (PNA)). A local anaesthetic is used to numb the toe. Part of the nail is then removed and a chemical is normally applied to permanently stop the nail forming from ‘the root’. This procedure is intended to leave a permanently narrower nail and has a 95% success rate.
In some cases, a total nail avulsion (TNA) may be performed, to remove the entire nail. A chemical may then be applied to prevent the entire nail from regrowing.
The chemical used in Nail Surgery is called phenol and it is used to cauterise and prevent the nail from regrowing.
After nail surgery, you will need to return to your podiatrist for a redressing appointment and a follow up appointment to check that the nail bed is healing properly.
Insured patients will need to check with their insurance provider to check whether this procedure is covered by their insurance.