TREATMENT OF INGROWN NAILS

This is a situation when the side parts of the big toe nail curl under the surrounding skin (the so-called nail fold) and grow into it, causing pain and inflammation of the nail fold. An ingrown toenail may develop on only one side or on both sides of the finger at the same time. An ingrown toenail is a condition that usually affects the big toe. The problem of ingrown toenails affects people of all ages, regardless of gender, although it is relatively more common in young people.

Symptoms and complaints of ingrown toenails:

• Pain in the nail fold on the side where the nail grows under the skin. The pain intensifies especially when walking and when wearing shoes that are too tight
• The skin of the nail fold on this side is slightly swollen and red
• If, as a result of hygiene neglect and lack of proper treatment, bacterial infection of damaged skin occurs, the symptoms become much more severe. The pain is stronger, becomes constant, and sometimes gives a pulsating sensation. Swelling and redness in the skin around the nail are very visible, and touching it causes the patient particularly severe pain. When pressed, a small amount of cloudy, sometimes purulent secretion comes out from under the skin covering the ingrown part of the nail.
• In very neglected cases, the infection may cover the entire finger, spreading to the subcutaneous tissue (so-called digital phlegmon). The entire finger then becomes red, swollen and painful

Causes of ingrown toenails:

• Wearing shoes that are too tight and pinch your toes
• Improper nail cutting. An incorrectly cut nail grows not only forwards, but also sideways, and its sharp edge gradually digs into the skin of the nail fold, damaging it and causing inflammation
• Flat feet
• Posture defects
• Incorrect structure of the nail plate

However, it should be emphasized that many people, even though they follow all recommendations regarding foot hygiene, suffer from ingrown toenails, which may indicate that they are particularly predisposed to this disease.

Prevention methods:

• Avoiding wearing shoes that are too tight
• Clipping your nails correctly. Make sure that the free edge of the nail is not rounded (bevelled nail edges), but straight or even slightly concave. In particular, you should avoid inserting the sharp end of scissors or a file between the nail and the surrounding skin, as it causes minor skin wounds, which constitute a portal of infection for bacteria.
• In order to avoid other forms of infection of the nail fold, do not cut the so-called "cuticles" with scissors or even special nippers. Instead, after moistening them with water, they should be gently pushed back using your thumb every day.

Possible complications:

• Bacterial infections of the skin of the nail fold (so-called paronychia)
• Spread of infection to the skin and subcutaneous tissue of the entire finger (so-called digital phlegmon)

General recommendations:

• Comfortable, well-selected footwear
• Foot hygiene
• Clipping your nails correctly
• In case of inflammation, soaking the finger in warm soapy water for several minutes, repeated several times a day, may be helpful

Ingrown toenails drug treatment:

• Analgesics in case of severe inflammation or infection - popular analgesics and anti-inflammatory drugs available in pharmacies without a prescription are usually sufficient
• Antibiotics – used extremely rarely, only in case of extensive and severe infection of the entire finger

Surgical treatment:

In our center we use the so-called wedge nail excision method. The procedure involves cutting out a narrow strip covering the ingrown part of the nail along with the adjacent nail fold at the site of ingrowth. A properly performed resection procedure covers part of the nail plate, its bed, matrix and nail fold. The resulting skin and nail defect is left unstitched. As it heals, the nail usually regains its proper shape and no longer tends to become ingrown. The procedure is performed under local anesthesia and is completely painless.