In severe cases, more intensive treatments are needed. Surgery involves simply cutting away the sharp portion of ingrown nail, removal of the nail bed, or removal of a wedge of the affected tissue. Three nonsurgical methods involve using chemicals (usually phenol), cauterization (heating), or lasers to remove the skin. A major review of studies reported that the use of phenol along with simple separation of the nail was more effect than surgery alone in preventing recurrence, although infections were more common after the chemical procedure.
Bunions
A bunion is a deformity that usually occurs at the head of one of the five long bones (the metatarsal bones) that extend from the arch and connect to the toes. A bunion typically develops in the following way:
- Most often it occurs in the first metatarsal bone (the one that attaches to the big toe). A bunion may also develop in the bone that joins the little toe to the foot (the fifth metatarsal bone), in which case it is known as a bunionette or tailor's bunion.
- A bunion begins to form when the big or little toe is forced in toward the rest of the toes, causing the head of the metatarsal bone to jut out and rub against the side of the shoe.
- The underlying tissue becomes inflamed, and a painful bump forms.
- As this bony growth develops, the bunion is formed as the big toe is forced to grow at an increasing angle towards the rest of the toes. One important bunion deformity, hallux valgus, causes the bone and joint of the big toe to shift and grow inward, so that the second toe crosses over it.
Bunions can be caused by several conditions:
- Narrow high-heeled shoes with pointed toes can put enormous pressure on the front of the foot.
- Injury in the joint may cause a bunion to develop over time.
- Genetics play a role in 10 - 15% of all bunions.
Flat feet, gout, arthritis, and occupations (such as ballet) that place undue stress on the feet can also increase the risk for bunions.
Shoes and Protective Pads. Pressure and pain from bunions and bunionettes can be relieved by wearing appropriate shoes, such as the following:
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