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Ingrown nails

An ingrown nail occurs when a damaged portion of nail pierces the skin usually deep in the sulcus (fold of skin along the side of the nail).

There are dozens of causes for ingrown nails. Often they occur due to improper cutting of nails. Always cut to the contour of the toe. Do not cut down into the sides, rather round the sides with a file. Any trauma to the nail can damage the nail’s root and thus its shape. Examples such as high heel shoes, sports, poor fitting shoes and poor foot mechanics can damage the root and the shape in which the nail grows.

I once had a patient present with an ingrown nail in the ball of her foot. Her nail had thickened to the point she could not care for it, and therefore left it to grow for years until it grew down around the end of her toe to the ball of her foot.

Symptoms

Most obvious is pain. You may notice a small brown or darkened area at the side where the nail begins to curve. A puffed, pealing, bleeding area is sign of an advanced, infected ingrown nail. Care should be sought immediately.

Treatment

If the cause is poorly cut nails, then removal of the ingrown portion and education on nail care is all that is needed.

Sometimes allowing the nail to grow past the straight side/curved apex junction will suffice.

If the problem is persistent, a portion of the entire nail may need to be removed permanently. Occasionally, extremely thick painful nails or unresponsive fungal nails may require permanent removal.

Surgical Procedure

The procedure is simple, painless and permanent. The toe is frozen, the offending piece of nail and matrix (root) are separated from the nail bed and removed. A chemical is applied to kill and remaining matrix tissue.

I have researched other methods including laser, and find the chemical matrix treatment to be the most efficacious. Our procedure is more efficient with a significantly faster healing time compared to surgical removal of matrix, which requires stitching the wound. This considerably increases post-operative pain as well as weeks of healing compared with days to heal with the chemical procedure.