In-Grown toe nails have been at the centre stage when it comes to old wives tales. From cutting your nails straight across to cutting a wedge from the centre a number of home remedies have been floated for dealing with nails which are causing soft tissue damage and pain which has been described as being up there with child birth. In this brief article we will look at what can be done conservatively as well as what surgical options are available in the treatment of ingrown toe nails and preventative measures which can be taken if you think you may be at risk of such an issue.

Conservative Treatment
In many cases a non re-occurring in-grown toe nail can be easily treated by a podiatrist with the use of sterilized equipment. It can be relatively pain free, with very little risk and you should be able to return to work or play instantly. In some circumstances the prescription of antibiotic may be required if a local infection is present.
After this has been complete the podiatrist may supply you with some tips in reducing the chances of re-occurrence, such as; using a tooth brush to clean the area, taping the plantar aspect of the toe away from the in-growing side or a change in footwear.
If the ingrown toe nail continues to re-occur over a number of weeks or months then a more aggressive option may be required.

Surgical Treatment
The process of surgical intervention for ingrown toe nails is relatively simple and low risk in the world of surgery; however, there is a ten percent chance of the surgery not working. The podiatrist will explain much of the following information in depth and then have you sign a legal document regarding consent and acknowledgement of risks.
If you have previously had issues associated with injections the practitioner will ask that you bring another person to the procedure with you for support and to drive you home. In some circumstances you may be asked to visit the GP to have some anti-anxiolytic prescribed to limit stress around the time of surgery.
Secondly, you will be placed in the newly cleaned podiatry chair with a drape and betadine or chlorhex wash. The podiatrist will then begin to inject a local anesthetic into the toe and massage the area for increased uptake into the tissue. Once complete anesthesia has been achieved then the podiatrist will continue with the procedure.
A tourniquet will be placed over the toe to reduce blood supply and an eponychium retractor used to separate the toe nail from the connective tissue of the toe. Once the toe nail has been detached from the digit itself, a number of straight line cuts can be made down the line of the toe nail to the distal edge of the nail matrix. A nail splitter can then be used to separate the pathological nail from the rest of the nail and the nail matrix before a set of mosquito forceps are used to remove the nail spike in completion.
Finally a small amount of the chemical phenol will be used to destroy the nail matrix and reduce the chances of the slither of nail returning. Once the podiatrist is of the belief that the tissue has been successfully damaged he will then remove the tourniquet from the toe and encourage bleeding to dilute the phenol. An iodine based product is then applied to the area to limit further chance of infection and the toe dressed with a thick layer of gauzed and highly visible tape to protect the toe and make other aware that it has had trauma to it.
Although subjective, there is often very little pain after surgery and work or play can begin within 2 days of the procedure taking place. Most of the time the podiatrist will encourage a number of short visits post surgery where they are able to wash and redress the area of surgery to further reduce infection risk as well as inspect for any sign of pathological tissue.

So there you have it, a very simple no-nonsense article about how to best deal with ingrown toe nails and how to best prevent them from occurring in the first place. When having issues such as ingrown toe nails looked at do not just look for the cheapest option of treatment as this can lead to further issues down the track, explore your options and weigh up the best value intervention for the money which you are outlaying.
Until next time, thank you for reading.

Jackson McCosker
Director /Chief Editor

3 thoughts on “In-Grown Toe Nails: What you should really do!

    1. Hi Josh,
      Sorry about the very late reply I am still working out the back end of this website.
      The idea behind cleaning the sulci with a tooth brush is to help clear debris and debride of eschar as to not allow increased pressure to build and once again allow the nail to irritate the or ingrow.

  1. I recently received a query regarding this post and how a tooth brush may reduce the re-occurance of in-grown toe nails, alas it has been difficult to find again or has been deleted by the author.
    The use of the tooth brush is to clear out skin and nail debris and reduce increased pressure within the sulci – it is by no means a definite fix but has had some good results clinically in delaying re-occurence.

    I hope this helps

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