Ingrown Toenails

Ingrown toenails, also known as onychocryptosis, is a very common problem seen here at HFAA. All the physicians work very hard to make sure this uncomfortable condition is treated with the most ease possible! 

 

Occurrence:

Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. Ingrown toenails can be painful. Ingrown toenails can start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.  It is imperative that you seek treatment right away for an ingrown nail to avoid infection!

Feel free to read our handout we provide to all our ingrown nail patients here on our website.

Causes:

  • Trimming toenails too short, particularly on the sides of the big toes. (most common!)
  • Shoe pressure (from shoes that are too tight or short)
  • Injury to the nail (think “I dropped a big table on my foot”!)
  • Fungus infection in the toenail which causes a thickening and incurvation of nail into the skin
  • Heredity (“my mom had them and so did I!”)
  • Unstable foot structure (certain foot types are more likely to develop an ingrown nail because of how you walk)

Prevention:

  • Trimming toenails straight across with no rounded corners.
  • Ensuring that shoes and socks are not too tight.
  • Keeping your feet clean at all times.

Treatment Options:

In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks.  If symptoms persist after 2 or more days, please call our office right away to schedule a consultation for your ingrown nail.  Antibiotics are sometimes prescribed if an infection is present.

In cases of increased pain or if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail. Some patients elect to have their toenail or corner of the toenail removed on a more lasting basis.  We can easily perform that here in the office by adding a chemical acid medication to the nail root.  This procedure, called a matrixectomy, is over 90% effective!!

Here is a step-by-step guide to how we surgically remove an ingrown toenail:

  1. Dr. Lockwood will determine if the toe is infected or not – usually infections will have pus or other drainage. This determines whether or not we can perform a matrixectomy, where a chemical is applied to the affected area to kill the nail root and ensure the nail does not come back. If there is an infection present, we can not perform the matrixectomy that day.
  2. We numb the toe. The whole numbing process lasts less than 60 seconds total and is usually the ‘worst’ part of the whole procedure since the numbing medication does burn.
  3. You will then sit and relax for 5 minutes to let the numbing medication take full effect. While you are relaxing, our medical assistant will review the post procedure instructions and you can pick out your bandage color for today’s dressing.
  4. The procedure takes about 5-10 minutes total. We put a drape up so you don’t have to see anything and at the end we can show you the removed toenail if you would like.
  5. During the procedure, Dr. Lockwood will loosen up the corners of the affected nail with a freer elevator (shiny not sharp instrument), and then clip back the offending nail with an English anvil (fancy nail cutter). We remove the nail root (matrix) with a #62 blade and then use a hemostat to take it out and away from the nail bed.
  6. If we are putting a chemical in, this will be done now. You won’t feel anything while we put the chemical in (three 60 second applications). The tourniquet is then removed.
  7. Finally, we will finish up the procedure by dressing the wound. Amerigel Wound Dressing is applied, then 2 pieces of gauze and your bandage color of choice. This is applied tightly to help stop any bleeding. A bandaid at the base of your toe keeps it nice and secure.

     For more information, to schedule an appointment, or to have your ingrown toenail checked out, please contact us at (309) 661-9975

    10 Heartland Drive Suite B
    Bloomington, IL 61704

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