Ingrown Toenail Removal

Ingrown toenail, a painful condition

An ingrown toenail is when the nails impinge into the soft flesh of your greater toe or the Hallux.  Since a part of the nail disappears into the flesh, the condition is called onychocryptosis, onycho the term for nails and cryptosis, a hidden condition.  The result of this is pain, inflammation, and swelling.  Occasionally laceration of tissue and bleeding can occur as well and if untreated can lead to even life threatening complications as in diabetics. In most cases home remedies suffice and certain others mandate a hospital visit.

Signs and symptoms of an ingrown toenail can range from a simple localized pain to severe spreading pain which might involve underlying muscle groups and the nerves of your foot.  This in combination with diabetes can lead to severe complications like gangrene and osteomyelitis and needs to be taken care of immediately contingent on patient history. This can impair blood circulation and lead to the condition called avascular necrosis meaning lack of blood supply leading to tissue death.

An image of ingrown toenail


The symptoms to look for are pain and tenderness in the toe, inflammation and swelling around the nail, and possible suppuration and infection.

These symptoms if minimal can be taken care of at home with saline and antibiotic soaks and trimming the toenails, but if infection is suspected it is safe to make a visit to the clinic.

The most common causative is ill-fitting shoes, trimming, that is not symmetrical, injuries and curved toenails. Athleticism, repeat injuries, poor Podiatric hygiene, congenital anomalies of the foot or toes, short nails and long toes are some of the other common causes. When the skin folds underlying the nail becomes thick, it leads to further complications like insensitivity and the discordant nail is bound to expose the underlying tissue and make it more susceptible to infections.

An untreated ingrown toenail can lead to infection of the underlying tissues, since toes are exposed to dirt. The infection can spread to the bone marrows and lead to death of bones. This can also lead to the hampering of capillaries and death of surrounding tissue. The end result is septicemia or infection of the blood and cardiac arrest.

If home remedies are useless, a doctor can do a minor procedure such as lifting of the toenails from the nail bed using a floss or cotton to maintain space between the toenail and the tissue and removing a portion of the toenail under anesthetic.  Laser therapy or surgery can be used to remove the toenail and a portion of the nail bed. When both sides of the nail matrix are incised it is called bilateral matricectomy, if the matrix is excised in total it is called as total matricectomy.

Once done, the doctor may also recommend topical or oral antibiotics as preventive or therapeutic.

If you are a diabetic be sure to inform the doctor, since the treatment pattern may vary for diabetics.

Lifestyle adjustments like wearing good-fitting shoes, toenail protection, and proper trimming of toenails is the key to preventing an ingrown toenail.

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