Are your toenails causing you pain?
Ingrown toenails (IGTN) are a common
feature in our clinical practice. Sometimes they may look like the picture
above, if things have got bad, but other times the nail can look relatively
normal.
The condition commonly affects the big
toe but can affect the smaller toes. Adolescents present most frequently with
an IGTN due to sports and poor nail cutting however, all age groups can be
affected.
What causes an Ingrowing toenail?
Nail shape, poor fitting footwear, trauma,
inability to manage own nail care, overlong big toe, impaired vision, biomechanical/foot
posture issues, nail thickening, and excess weight are all contributing factors
most associated with IGTN’s.
Patients tend to present with sharp pain
on the affected toe, there may be weeping /pus present, the toe may be red and
swollen, pain during walking and even the weight of the duvet may cause pain.
Treatment options range from
conservative nail care to nail surgery.
So, what is Nail Surgery?
Nail Surgery is the removal of all or part
of the nail, that has been causing your pain and discomfort. The area can be
treated to prevent regrowth of the offending nail to resolve the problem
permanently.
Why won’t my nail regrow?
During nail surgery, once the offending
piece of nail has been removed, a chemical called phenol is applied to kill the
nail growth cells this prevents the nail from growing again.
What would be involved on the day?
- On arrival assessment and consent forms will be
checked/completed
- Local Anaesthetic will be used to numb the toe – no
driving will be allowed for approx. 6 hours after, as your toe will still be
numb
- Once numb, you will feel no pain or sharp sensations, but
you will still have some perception of touch
- A torniquet/tight bandage is applied to the toe to
allow a blood free field for the surgery
- Part or all of the nail will be removed and the nail
bed cleaned of all debris
- The chemical ‘phenol’ is applied for a controlled period
to kill the growth cells
- The torniquet will be removed so normal blood flow
returns
- A sterile dressing will be applied
What happens after Nail Surgery?
A redressing appointment will be
scheduled for 2 days’ time. At this first redressing we will teach you how to
care for your toe and explain the redressing procedure. Healing of the wound
can take up to 6-8 weeks. Restriction on sporting activities from two to four
weeks following surgery is recommended, however this will be reviewed at each
redressing appointment.
Will my nail look funny after?
If just a side piece is nail is removed
once it has healed the fleshy skin usually moves over a little to meet the new
straight edge of the nail. So, unless someone was studying your toe hard they
would not know that anything had occurred.
If the whole nail is removed, the area
where the nail used to be does firm up to give the bone underneath protection. Again,
on a quick glance no one might notice the nail is missing, as it would just
look like you have very short nails. For ladies who have had the whole nail
removed it is possible to have a false nail added which can be made to look
like your others.
What should I do if I think I have an
ingrowing toenail?
If you are concerned about a nail,
please give us a call on 01242 673507 to book an appointment with one of our
Podiatry team.
Also keep an eye out for our “top tips
on managing your toenails” due out shortly.
