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An ingrowing toenail is when part of the nail plate pierces the flesh of the toe. It can be extremely painful and can become inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect any of the lesser toes as well.
Treatments will depend on the severity of the condition and expected outcomes. Non-surgical (conservative) management is an option, and involves reshaping the part of the nail that is ingrowing. If the toe is infected antibiotics will usually be prescribed as part of the treatment. Conservative treatment is very effective but not permanent, and will generally require ongoing maintenance.
For those with recalcitrant ingrowing nails or who a seeking a more permanent solution nail surgery is a very effective option. Nail surgery involves removing the side of the nail that in-grows all the way back to the matrix, where the nail is formed and either chemically burning or sharply excising the matrix to ensure this part of the nail doesn't regrow. The remainder of the nail continues to grow as normal.
There are many causes of ingrowing toenail, and genetics (as with most medical conditions) have a big part to play here. So, a number of people may inherit an ingrowing toenail. Structural and functional deformities may also contribute. Posture, gait and any foot deformity including a flat foot, bunion or hammertoe are often contributing factors. Some nails are naturally curved or involuted, and naturally grow deep into the sulcus (fleshy part) of the toe.
Tight shoes, socks or stockings may push the toe flesh into the nail where it pierces the skin. Excessive sweating can make the skin susceptible to breakdown, or brittle nails can make the nail susceptible to splintering leaving a spike to grow into the toe. Also worth noting is some medications such as isotretinoin (roaccutane) can increase the risk of ingrowing toenails, as can some presentations of fungal infections.
An ingrowing toenail generally does not resolve without intervention. They continue to be painful and they can become infected. Any infection if left untreated can become serious and life-threatening, resulting in septicaemia.
Treatments are generally performed in the clinic. Nail surgery is usually performed under local anaesthesia alone, but can be performed with some sedation or under general anaesthesia if needed. The procedure is performed as day surgery which means you will go home the same day. You are able to walk without crutches but the first 2-14 days you will need to keep your foot elevated as much as possible, depending on the procedure performed. If you have stitches they will be removed at 10-14 days. And then you will be able to return to footwear and activity as tolerable.
Disclaimer: Individual results may vary. Surgery and all health regulated services may carry some risks which you can discuss with our doctor.
Treatment from $650 dependent on the type of procedure.
Most concerns have more than one course of treatment. Feel free to contact us so one of our team can discuss options for your unique concern.
