Ingrown toenails are common conditions that affect people of all ages, young and old. Not only do ingrown nails look unsightly, but they can be painful! The pain may keep the person from wearing close-toed shoes, walking or taking part in normal activities.Some patients make the ingrowing nail worse by self treating it by “digging the corner” in the hope that the pain would improve. Often it does not. In fact the toe becomes more inflamed and starts to have throbbing pain. This is the point when people begin to wonder: “Should I visit a nail salon or a podiatrist for treatment?” If you have any issues related to ingrown toenail causing pain, discoloration, or formation of pus, it’s important to visit a podiatrist. First, It’s a good idea to try some home remedies before the visit.
Here are some home remedy ideas:
- Regularly clean and trim toenails to a moderate length.
- Avoid wearing tightly fitted shoes.
- Soak the affected nail in Epsom salt for 15 to 20 minutes daily and apply over-the-counter antibiotic ointments.
- Trim the affected toenail with clean tools.
- Do not use cotton under the toe to lift the corner in the hope that it would improve the pain.It does quite the opposite: introduce bacteria and microorganisms into the nail fold.
- Do not dig the nail corners to alleviate the symptoms; often this makes the toe more swollen and worsening pain.
Top 5 reasons to visit a podiatrist for an ingrown nail are:
- Podiatrists understand the anatomy and pathology of the nail and are better able to diagnose.
- Podiatrists use sterile tools during the procedure so that the chance of infection is less.
- Podiatrists will be able to prescribe antibiotics for the ingrowing nail if needed.
- Podiatrists are licensed professionals and are able to treat complications after an ingrown nail procedure.
- Podiatrists could advise if an ingrown nail procedure is ok to perform after assessing for adequate healing potential in a patient. Often patients with long standing diabetes and poor circulation are not ideal candidates for the ingrown nail removal procedure due to the wound not being able to heal. In such cases there are alternative approaches available, which the provider will mention during the visit.
Ingrowing nail procedure at a podiatrist’s office
The procedure begins with the use of lidocaine injection to the toe, which is what dentists use to anesthetize the gums before dental work. Then the toe needs to be prepped with an antiseptic solution to make sure there are no bacteria on the skin. Sterile tools are then used for the procedure to remove the offending part of the nail. The physician would then thoroughly cleanse the nail fold to remove any remaining nail specks once that is performed, a sterile dressing and antibiotic ointment is used to dress the toe. Often the doctor would also prescribe the oral antibiotic for 7-10 days depending on the extent of infection. Post-procedural steps and how to care for the toe are outlined to the patient. Normally the patient would return in two weeks for a follow-up to ensure that the recovery is going well. As you can imagine, a lot of careful handling and steps involve safely treating ingrown nails at the podiatrist’s office. Now let’s see what we could encounter at a nail shop.
How do a pedicurist remove the ingrowing nail at a nail salon?
Many patients have told me that they use simple tools to remove the cuticles, most are not surgical grade tools. Often what they deem an ingrown nail is completely different from what we learned during podiatric medical school. I also am not sure if the average salon uses any aseptic techniques, or can prescribe an antibiotic ointment or medicines. Receiving treatment for the so-called “ingrowing nail procedure” at a nail salon seems to be very risky because they are not licensed to deal with the patients’ acutely inflammable soft tissue problems. Often not knowing how to treat an ingrown nail and delay could lead to a worse outcome.
Does the ingrown nail procedure hurt?
Generally no. When the toe is anesthetized properly. The patient should feel no pain during the procedure. There are also painless ways to inject the anesthetics to cause less pain during the injection.
Is there a way to permanently remove the ingrown nail?
Yes, Phenol is used for treating and inactivating the nail matrix. This is the part that lies deep and gives rise to the nail. When phenol inactivates the matrix, the chance of ingrown toenails becoming a recurrent issue is reduced since it prevents the nail from developing. Your podiatrist will be able to perform the procedure and apply phenol to the area of the nail. The phenol is applied using a cotton tip applicator and left for a couple of minutes.
This process, and all treatments for ingrown toenails, should be performed by a licensed podiatrist. Although the use of phenol phenol to permanently address the ingrown toenail isn’t a 100% guarantee; there is always a chance the nail will grow again. However, when performed by an experienced podiatrist, the outcome is much better.
Are there any adverse effects to using the phenol (chemical) for the permanent procedure?
Not to my knowledge. Although overzealous use and not using enough chemicals could lead to the nail matrix not becoming fully inactive, which may cause the nail to grow back. There is no risk of skin discoloration, skin being “burned” or other adverse effects.
What should the patient do after the procedure?
Soak the foot in epsom salt and lukewarm water for 15 min daily for 7 days and apply triple antibiotic ointment and band-aid to cover the toe.
Can the patient wear closed toed shoes after the procedure?
Yes, however it is advisable to use open toe shoes during the next two weeks so that the toe does not rub against the shoe and cause pain.
Should the patient take pain medicine after the procedure?
Generally it is not necessary, however tylenol or Advil is advisable if there is pain.
What are some signs to look out for?
Increased redness, pus, throbbing pain, toe becoming dark or dusky. In those cases, immediately reach the doctor at the office for advice.
Does having an ingoing mail have anything to do with fungal nails infection?
Having a fungal infection of the nail normally causes the nail to become thick, and show a lack of having a normal shape which could cause the surrounding soft tissue to become inflamed as the thick nail starts to grow. So it is also important to treat the nail to remove the fungal infection. Your podiatrist will inform you if such a condition is noted.
What should I do if I have diabetes and currently have an ingrown nail that is painful?
If you have diabetes, good care for ingrown nails is essential for your health. This is because some of the side effects of diabetes on your feet include numbness/loss of ability and reduced blood flow, and the ability to heal wounds effectively. These effects put you at risk for a toenail to become ingrown, as well as being ineffective in eliminating infections or wound healing. This means that delayed treatment could lead to ulceration and develop secondary infections that are very dangerous to your overall health. Diabetic ulcers are currently the main cause of lower body amputation – with the exception of traumatic injuries and accidents. If you have diabetes, we will examine your feet in your overall diagnosis and discuss the best options for you now and in the years to come.
So How Do I Treat My Ingrown Toenail – And The Infection If I Already Have One?
We do not recommend trying to cut the nail at home, as the nail often goes deeper than you can see, so most people will not be able to completely remove the edge penetrating the surrounding skin leading to increased pain. You also won’t have the right tool for the job – while we have everything you need to do it quickly and easily – even anesthesia if you need it or want it!
After removing the offending piece of nail, the body is able to effectively heal the wound and fight infection – and of course, we help it by applying betadine (antiseptic) or triple antibiotic. You are encouraged to soak the foot in Epsom salts at home for 7 days – but once the nail is removed, it should be relatively simple and straightforward to cure it and the infection will disappear.
The best way to take good care of your ingrown toenail is to visit your podiatrist. Here at the Ankle & Foot Care Center, Inc., our trained podiatrists could perform the ingrown nail procedure that is safe, pain-free, and will allow quick recovery.