What exactly is an ingrown toenail?
An ingrown toenail is a process that occurs when the lateral edges of the nail plate dig into the flesh of the toe. It usually occurs on the big toes, but can happen on any toe and is extremely painful. Technically called onychocryptosis.
What symptoms indicate a case of ingrown toenail?
The first symptom of an ingrown toenail is pain at the tip of the toe, many patients report that they cannot even bear the weight of the sheets on the toe in bed. If it is not treated, it will evolve increasing inflammation and generating infection, accumulating pus and hypertrophying the entire lateral edge of the finger so that the nail is even more buried.
Parents beware, the most acute cases usually occur in children and adolescents, when they begin to cut their nails by themselves without parental control and do not do it correctly, together with the fact that they have thinner and sharper nails, increased sweating and continued use of closed sports shoes, the pathology occurs. The problem is that many times they keep quiet about it for fear of having something done to them that could hurt them more, hoping that it will fix itself. Until the parents discover the cake.
What causes this pathology?
Our organism notices that it has a foreign body nailed so it generates a process of inflammation and infection to try to eliminate it, but as the nail is a tissue (keratin) that the body cannot destroy by itself, the pathology will not stop until the piece of nail that is being nailed is extracted. Sometimes the nail does not become nailed, but presses on the side of the finger generating a callus, in that case there will be no infection, but inflammation and pain as well.
The nail can be nailed for various reasons: a bad cut of it in which we have not gotten to cut the side of the nail leaving a sharp tip, trauma or a genetic component, certain types of nails have a curved shape or are too wide and have more tendency to become ingrown, also over the years by the continued microtrauma with the tip of the shoe nails tend to thicken and curve more and a nail that had never given problems begins to give them.
What is the treatment to be followed to cure it?
The first thing to do is to go to a podiatrist to remove the piece of nail that is causing the problem and the symptoms will disappear almost instantly. But before the appointment we can start putting an antiseptic such as povidone iodine or chlorhexidine and an antibiotic ointment in the area.
I do not advise trying to remove the nail yourself, besides doing infinitely much more damage than your podiatrist will do, usually when doing so it usually breaks leaving a splinter worse than the one that was there and more difficult to access to extract it later.
If sometimes the pain is very severe, the finger is anesthetized and the nail is removed painlessly, although it is rare that we have to resort to anesthesia, since with our surgical instruments and the techniques we use we manage to extract the fragment easily and quickly.
In no way do I advise removing the entire nail, as was done years ago. Unfortunately we still see some cases today. It is excessively traumatic and unnecessary and will make the nail that grows back later more prone to digging in. As all health professionals are taught during their studies: primum non nocere, which translates into English as first do no harm, means that we should not cause greater harm in order to fix a minor problem.
How are the results? What happens if it is not treated?
The results are spectacular, it is one of the most grateful treatments we have in our office. Usually the patient who comes to see me for the first time has an extreme fear, since he has had the problem for months, he has tried to solve it himself or by visiting other health professionals who are not used to treat this type of pathologies and the most they have done is to prescribe an oral antibiotic and make a bandage. The important thing is to understand that our body will not stop fighting to eliminate the foreign body that is nailed until it is removed. Once we perform our intervention, the patient notices it immediately and goes from not being able to practically touch the area to not feeling pain, although if the process has been going on for a long time and the infection is important, we will prescribe antibiotic therapy afterwards.
Now the bad news. Although we solve the problem quickly, it is possible that, because the nail has a strong tendency to dig in, every so often when it grows back it will tend to dig in again. In this case, the person who has already suffered from this problem goes to his podiatrist and solves it. But there are nails with a strong tendency to dig in and it will be a lifelong problem. In these cases we advise surgical intervention.
The ingrown toenail operation is one of the most appreciated that we perform in our clinic. It is performed under local anesthesia and on an outpatient basis. It consists of removing the side of the nail that is nailed killing the root on that side so that it does not grow back leaving the rest of the nail intact. After 48 hours of rest the patient can return to his normal activity making cures until he is discharged normally after ten days. If everything goes as it should, the patient will not suffer the problem ever again.