Thursday, July 31, 2014

Ingrown Toenails

Definition

Ingrown toenail occurs when one or both of the lateral edges of the nail penetrates the skin and cuts into the soft flesh of the toe.

Description

Uncorrected, an ingrown toenail can result in severe complications, progressing to simple inflammation, serious infection, ulceration and gangrene.

Ingrown toenails are frequently at the inflammation or infection stage when treated by physicians or podiatrists. That is chiefly because anyone who suffers from it is seldom able to endure the pain and usually seeks aid before a more serious complication develops.

Although an ingrown toenail can affect anyone, it occurs most often in persons between the ages of 10 and 30, perhaps because they do more walking than older folks, or disregard the early warnings that adults will heed.

Causes

Any toe might suffer from an ingrown nail, but the big toe, because of its prominence and length, is involved most often.

The agents responsible are improper cutting of the nails, hereditary effects, and tight shoes and stockings. Short footwear can exert pressure upon the big toe, press directly on the toenail grooves, and force the outside edge of the nail into the flabby nail fold.

In small children, an ingrown toenail might be traced to tight clothing, leotards, sleepers, or other bedclothes. The subtle but prolonged pressure that those articles of clothing exert on the toenails as the child thrusts his feet forward can lead to serious problems in adulthood.

If a person has an inherited tendency towards nails with extreme curvature, the soft tissue of the fleshy folds might grow over the nail plate - and then the nail would grow inward. An overweight person who has chubby toes might also suffer from an ingrown nail that results from the fleshy folds covering the nail plate.

The most frequent cause of ingrown nails, however, is injudicious cutting of the toenail using scissors or, worse, treating of the nail corner with one's fingers. A few days after such self-administered "surgery," inflammation can appear at the offended corner of the nail. At first, there is some discoloration, a mild swelling, and the escape of a little fluid.

If these signs are disregarded, inflammation sets in. Pus forms and redness increases. Then, as the toe balloons, the pain starts.

Sometimes, a bloody mass of material known as proud flesh appears at the lateral edge of the toenail between the nail plate and the nail groove. Proud flesh is acutely painful and, when irritated or injured, bleeds readily. At this point, most sufferers seek medical aid.

If it goes untreated, a dangerous infection can spread and the infection can enter the bloodstream and proceed further up the leg.

Treatment

Treatment of the ingrown toenail involves removing the offending portions of the toenail, reducing the inflammation, and controlling the infection. In severe cases, a foot doctor might administer or prescribe antibiotics.

Various surgical procedures are used to eliminate ingrown toenails. The doctor can remove a portion of the nail, a portion of the underlying nail bed, some of the adjacent soft tissues and even a part of the growth center.

Minimal-incision surgery is effective for permanently eliminating the corners of the matrix so that the nail edge growing inward do not cut into the fleshy folds as the toenail grows forward.

Electrical cauterization, chemical cauterization, or surgical excision help the health professional remove the corners of the patient's nail growth permanently.

Questions

What is causing the problem?

Is there a serious infection present?

What treatment do you recommend?

Are antibiotics needed?

Will a painkiller help?

Will you treat it surgically?

Are there measures that can be taken to prevent a recurrence?

Self-Care

Self-care can be very effective if you are experiencing the very beginnings of a toenail's digging laterally into the toe's soft tissues. Take some drugstore collodion liquid, and coat a wisp of cotton with it. Then, slip the resulting moistened material into the space between the nail and the fleshy fold.

As the collodion dries, the cotton forms and acts as a wedge between the toenail and the fleshy fold. So, as the sharp edge of the toenail grows, it will move past the toe's protruding flesh and thus avoid cutting into the soft parts.

To avoid the problem completely, file the nail margins thin with an emery board to reduce the pressure on them and trim the nails straight across with toenail clippers.