Home Care: Keep It Simple
If your symptoms are minor and you dont have a complicating medical condition such as diabetes, you can start at home with conservative measures.
Soak the foot in lukewarm water two or three times a day for 15 minutes . You can add Epsom salts if you wish, although theres no scientific evidence that this will improve pain relief or healing. Massage the skin at the side of the toenail , gently pushing it away from the nail. After each soak, dry your foot thoroughly. Wear sandals or other low-heeled open-toed shoes whenever possible. When you wear close-toed shoes, make sure the toe box allows room for the toes to move freely. When the toenail grows out, cut it across in a line that mimics the curving line of the toe tip do not round the corners down.
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What Are Ingrown Toenail Symptoms And Signs
Ingrown toenail symptoms and signs include:
- Sometimes there may be a clear yellowish drainage, or if it becomes infected, pus drainage.
- Young children may show signs of limping to avoid putting pressure on the ingrown toenail site.
Occasionally, ingrown toenails resolve without treatment. A podiatrist should treat painful, persistent, and recurring ingrown toenails. If the ingrown toenail has been present for a long time, a very vascular tissue called granulation tissue may form that easily bleeds.
Dont Suffer Let A Professional Podiatrist Help You
If youre in Los Angeles, California and want a professional podiatrist to help with your condition then contact Wound Institute of America, one of the top wound care clinics in California. If youre not in Los Angeles and want a recommendation on treatment in your area, contact us and we will provide the best recommended clinic in your area for treatment. Ingrown toenails are treatable and may be prevented with proper care.
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Ingrown Toenail Infection Symptoms And Treatment
Ingrown toenail infection occurs when the corner or edge of your nail grows right into the skin close to the overgrown nail. If there is no infection in the ingrown toenail, you can easily treat it at home. However, you should seek medical attention if the affected skin is pierced already.
Those suffering from certain health conditions, like poor blood circulation or diabetes are at higher risk of developing complications.
In most instances, the culprit toe most of the time is your big toe. The National Health Services stated that the problem affects both the male and the female.
However, the condition is commoner in individuals having sweaty feet, especially teenagers. Toenail thickens with age and this predisposes older people to the condition.
Additionally, Cutting nail incorrectly, irregularly curved toenails, improper footwear, toenail injury, poor posture, improper foot hygiene and genetics are some of the most common conditions leading to the infection.
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What Causes An Ingrown Toenail
There are many causes for ingrown nails, but the two most common causes are poorly fitting shoes and improperly trimmed nails. Tight shoes compress the side of the nail and alter the fit of the nail in the groove. When nails are peeled off or torn, the edge of the nail can extend down into the corner of the nail groove. A torn nail can irritate the skin next to the nail, producing inflammation and sometimes infection.
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Care Advice For Ingrown Toenail
Treatment Of Ingrown Toenail Infection
There are several methods for treatment of an infected ingrown toenail. If the toe is still not too infected then one of the first methods which should be used is soaking of the toe. The foot can be soaked in warm water for ten minutes and repeated several times per day. It will soften the skin on the side of the toe in where the toenail is ingrown. That will allow the patient to retract the skin and expose the side of the toenail. You can also add Epsom salt or antibacterial solutions into the water. This method can be helpful for treatment of the first stage of an ingrown toenail. Cotton can be used to elevate the ingrown part of the nail.
If there are signs of infection then local antibiotic therapy can be started. This can be helpful in some milder cases of infection. The most commonly used topical antibiotic is Neosporin.In the case of more severe infection, oral antibiotic therapy is indicated. Oral broad spectrum antibiotics should be prescribed to try to reduce the infection. Swab culture can be helpful in determining which antibiotic should be prescribed.
In case any of the conservative measures do not show progress in the treatment of ingrown toenail infection then surgery is the only solution. There are a variety of different surgical techniques which can be used to treat an infected ingrown toenail.
Infected ingrown toenail after unsuccessful oral and topical antibiotic therapy
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What Is The Recommended Surgical Procedure For Ingrown Nails
Surgical removal of an ingrown nail involves removing a small portion of the side of the nail and destroying the nail bed beneath. The toe is injected with a numbing medicine, and the toenail is cut to create a new, straight nail edge. The cells underneath the nail will try to grow a new nail, so they must be destroyed, thereby creating a permanently thinner nail. If there is heaped up tissue on the side of the toe, it must be removed. The toe is then bandaged until it completely heals .
What Are The Signs And Symptoms Of An Ingrown Toenail
Ingrown toenails can be classified into three stages according to severity.
- End of the toe becomes reddened with mild swelling
- May feel warm and be painful to touch
- No pus or drainage
- Toe becomes increasingly red, swollen and painful
- May be white or yellow coloured pus or drainage from the area
- Infection may have developed
- Symptoms of redness, swelling and pain are increased
- Granulation tissue forms and adds to the swelling and discharge of pus
- Lateral nail-fold hypertrophy
- More severe infection with fever may follow
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Apple Cider Vinegar Soak
Apple cider vinegar is considered a folk remedy for a majority of ailments these days. And this includes ingrown nails. Apple cider vinegar is known to have anti-inflammatory, antiseptic and pain-relieving properties.
However, scientific evidence for apple cider vinegar as a remedy to common ailments is limited at best.
You can try to treat an ingrown nail by soaking your affected foot in a bucket or basin of warm water mixed with a ¼ cup of apple cider vinegar. Do this for up to 20 minutes daily.
Remember to always dry your foot thoroughly once you are done with the soaking.
Wear Comfortable Shoes And Socks
Shoes and socks that are too tight can crowd your toes. Improper footwear is a leading cause of ingrown toenails. To help prevent an ingrown toenail from developing or worsening, wear shoes and socks or hosiery that fit but still leave ample space in the toe bed. During the healing process, avoid shoes or wear sandals as much as possible to limit pressure on your toenails.
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Epsom Salt For Ingrown Toenails
One of the most common self-treatments for ingrown toenails involves Epsom salt. How does Epsom salt help an ingrown toenail? As long as thereâs no discharge, pus or other sign of infection on your toe, you can create a warm water and Epsom salt bath for your foot. You can soak it for 20 minutes a few times a day, these baths paired with a soft massage near the infected area to reduce inflammation and improve circulation.
After you soak your foot, dry it thoroughly and use an antibacterial cream on the toe.
Can Thick Toenails Be Prevented
You can reduce the risk of thick toenails or the recurrence of toenail fungus in several ways:
- Keep your feet clean by washing them with soap and water regularly. Dry them off with a towel afterward.
- Keep your feet as dry as possible: Change your socks a few times a day, wear cotton socks that remove moisture from your feet, rotate your shoes so they can dry out, and purchase shoes that breathe and dont constrict your feet.
- Try a foot powder that keeps your feet dry.
- Wear flip-flops or other shower shoes when you are in locker rooms or at the pool.
- Groom your feet properly.
- Make sure to use disinfected tools when trimming your nails.
- Purchase new footwear if your nail fungus has recently been cured.
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Have Part Of The Toenail Removed
Learning how to cut your toenails the right way and avoiding tight-fitting shoes usually prevents ingrown toenails in the future. Some people, however, cant fix the problem on their own.
Unfortunately, their toenails grow in a such a way that they will eventually cause pain.
If this describes your situation, then Dr. Rambacher may want to remove a part of your toenail. After removing part of the toenail, the nail cant grow into your skin.
Dr. Rambacher can even use laser therapy to target highly specific parts of your toenail. If necessary, he can use laser therapy to remove recurring ingrown toenails at their roots.
What Does The Recovery From Toenail Surgery Entail
The operated foot should be elevated for the remainder of the day. Typically, the dressings are removed the day following the procedure.
- Cleansing of the wound or soaking in Epsom salts and/or antimicrobial soap followed by application of antibacterial cream and small bandage twice a day for one to two weeks can help to prevent infection.
- Open toe or loose-fitting, wide-toe box shoes are recommended to avoid pressure on the toe while healing.
Your doctor may want to see you return in a few weeks to ensure appropriate healing of the procedure site.
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Aftercare For Ingrown Toenail Treatment
After your ingrown toenail treatment, your podiatrist will apply the first dressing on the toe/s, and youll be given the following instructions:
- Keep the dressing clean and dry for 48 hours
- After removing the dressing, flush the toe with saline or saltwater and carefully pat it dry
- Apply an antiseptic ointment and use a clean, light dressing over the affected toe
- To manage normal levels of pain, take appropriate doses of an over-the-counter painkiller like paracetamol
Causes Of Ingrown Toenails
There are a number of ways your toenail can get infected. Causes of ingrown toenails include:
- Cutting a toenail too short or leaving it too long
- Receiving a toenail injury
- Having a genetic predisposition for curved toenails
- Wearing footwear that is too narrow, too tight, or puts too much pressure on your toes
- Cutting your toenail at an angle on the sides instead of straight across
- Taking part in activities like soccer, skiing, or dancing
- Not keeping your toes dry and clean
- Inheriting the tendency for ingrown toenails from one or both of your parents
- Getting pedicures from nail technicians that overcut your toenail
Pretty much anyone can get ingrown toenails, but some groups are more susceptible than others. If you have diabetes or another condition that causes circulation issues, you may experience ingrown toenails more often than normal. If this is the case, you should check your toes often and see a podiatrist regularly â poor blood flow can prevent toenail infections from healing quickly.
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What Are The Potential Complications Of Surgery
Complications from ingrown toenail surgeries are rare but can occur and may include:
- infection after the procedure,
Arch Dis ChildJournal of the American Podiatric Medical AssociationClinics in Podiatric Medicine and SurgeryJournal of the American Podiatric Medical AssociationAmerican Family PhysicianArch Fam MedDermatol Ther
Destruction Of The Matrix
Although phenol has antiseptic and anesthetic properties, it may cause tissue damage and possibly infection, delaying postoperative healing.20 The best evidence demonstrates that partial nail avulsion followed by phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toenails.16 Another study found that partial nail avulsion with phenolization yielded better results than partial avulsion with nail matrix excision.21 In the latter study, local antibiotics did not reduce the risk of infection or recurrence of the ingrown toenail, and phenolization did not increase the risk of infection more than matrix excision.21 A Cochrane systematic review found that partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence than surgical excision without phenolization, but has a slightly increased risk of postoperative infection.8 Trials evaluating different treatment methodologies have not adequately assessed patient satisfaction because follow-up time in each trial was less than six months, which is not an adequate time period to measure symptomatic recurrence. Although phenolization may be the most appropriate and beneficial treatment for most patients, risks and benefits should be discussed with each patient.
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How To Diagnose Ingrown Toenails
The diagnosis of an ingrown toenail is typically straightforward and does not require diagnostic labs or images. However, the signs and symptoms of ingrown toenails can vary quite dramatically, particularly if an infection develops. There may simply be some tenderness at the nail border when pressure is applied. There is typically an incurvation of the nail or a spike of the nail pressing into the skin of the nail border. Associated redness and swelling localized to the nail also suggest the diagnosis of an ingrown toenail. When an infection is involved, there may be severe redness and swelling, drainage, pus, and malodor.
Making the proper diagnosis requires taking into account the medical history and all possible causative factors. If one is unsure, seek professional help. Some conditions such as tumors, foreign bodies, trauma, and fungal infection may appear to be an ingrown toenail to the untrained eye.
Infections Caused By An Ingrown Toenail
ParonychiaDepending on the spread of microorganisms in the human body there are several forms of infection which can be caused by an ingrown toenail. Local infection of the soft tissue of the side of the toe is called paronychia. The mechanism of paronychia infection caused by the ingrown toenail is described above in the text. Shortly, microorganisms enter the soft tissue on the side of the toe through a wound which was created by an ingrown toenail. There they will multiply and fight with the immune cells which will lead to infection and pus formation. There are also other causes of paronychia: nail biting, sucking thumbs by infants and manicures/pedicures.In the acute form of paronychia, ingrown toenail infection will spread in a few hours and it will lead to abscess formation. If the infected ingrown toenail is more severe it can cause fever and enlargement of lymph nodes. The most common causes are Staphylococcus. In the chronic form, the process will go more slowly. It will eventually lead to inflammation of the toe and may eventually lead to the destruction of the nail plate. In this case, fungal infection is more common.
Paronychia, Hardin Library for the Health Sciences, 2010, available from http://hardinmd.lib.uiowa.edu/dermnet/paronychia2.html
Cellulitis, available from http://www.redefiningthefaceofbeauty.com/2013/05/skin-disorders-cellulitis.html
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What Causes An Infected Ingrown Toenail
The warm, moist environment of the feet can be a breeding ground for bacteria and fungi. These commonly include Staphylococcus, Pseudomonas, dermatophytes, Candida, and Trichophyton. When there is a break in the skin from the offending nail border, these organisms can invade the area and cause an infection. Treatment for these infections is essential to maintain healthy toenails and feet. The medical term for an infected ingrown toenail is called paronychia. If not treated, the infected toenail can cause serious problems such as chronic pain and disfigurement, cellulitis, and bone infection.
Stages Of Ingrown Toenail Infection
In the first stage of an infected ingrown nail, the microorganism which entered the toe will start multiplying and destroying the surrounding tissue. It will cause the migration of the inflammatory cells from the blood to the site of infection. In this stage, the human immune system will battle the microorganism to prevent further development of infection. That will lead to swelling, redness and tenderness of the toe.
If the patient is immune-compromised, if the infection is not treated properly, if the microorganism is resistant to treatment methods or if the microorganism is multiplying faster than it is being destroyed then the infection will last for a longer period of time. This will cause the accumulation of the human immune cells from the blood and bacteria from the skin. As the battle between them lasts longer it leads to an accumulation of dead matter in the toe. The dead matter are destroyed bacteria, immune cells, and tissue which was destroyed by bacteria. They form a clear/yellow liquid called pus which will start draining from the infected ingrown toenail.
Samples of infected ingrown toenails
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