|
 |
Contact ACFAOM at:
info@acfaom.org
ACFAOM
5272 River Road, Suite 630
Bethesda, MD 20816
800-265-8263
301-718-6505
Fax: 301-656-0989
|
|
|
|
|
|
Ingrown Toenail
(Onychocryptosis)
What is it?
Onychocryptosis, or ingrown toenail, is a painful condition in which the skin on the side of the toenail grows over the edge of the nail, or when the nail curls and grows into the skin.
What to look for:
Pain in the toenail area, often, but not always in the big toe (hallux). The nail may appear irregularly shaped and smaller than normal, as though part(s) of it are buried beneath the skin at the outer edges and/or tip of the toe. Pain and tenderness in the area may start as a minor irritation and progress to the point where wearing certain shoes becomes uncomfortable or even intolerable. In some cases, the toe may show excessive swelling, have a discharge around the area, or feel hot to the touch. In this case, infection has set in, and the area needs professional medical attention.
Other notes:
If you are a runner, you may find that the pain of an ingrown toenail prohibits you from enjoying your regularly scheduled run. In many cases (whether or not you are a runner), tight socks or stockings, or shoes with narrow toe boxes (dress shoes are a common culprit) may exacerbate the discomfort. Ingrown toenails can bother anyone, from a child to an elderly person.
What it means to you:
Ingrown toenails may not sound serious, and certainly, they've been the subject of jokes for years, but they are annoying, painful and problematic. If you're an athlete or a person whose job involves a lot of standing, walking or running, the problem can sideline you for a while, if not given proper and prompt treatment.
If you've noticed the telltale signs of an ingrown toenail (under "What to look for," above), understand that the problem won't go away by itself. The sooner you recognize and treat this condition (or, in the case of an infected toenail, the sooner you receive treatment), the better your chances are for relief.
What causes it?
The most common cause of ingrown toenails is cutting the toenails incorrectly, so that they grow at an angle into the skin. Over time, the nail will puncture the skin, causing the pain that associated with the condition. (And the pain is not inconsiderable; it has been likened to having a spike or a drill slowly pushed into your toe - ouch!).
Certain foot types or foot mechanics can lend themselves to ingrown toenails as well. In some cases, the nail is simply too large for the toe. In other cases, patients with toes that curl, either due to arthritis or to another problems, may be prone to ingrowth. Finally, trauma to the toe - either stubbing it or perhaps running on it, can drive pieces of the nail into the skin and "train" them to grow that way.
In any case, the problem is apt to worsen without treatment. The environment of most shoes (snug-fitting, with poor ventilation) adds bacteria to the environment. Add those microorganisms to an already injured toe, in a warm, damp, dark area where air doesn't circulate, and you have a cookbook recipe for infection.
What cures it?
IMPORTANT: If you have diabetes, you should see your podiatric physician at the first sign of any problems with your feet or toes, no matter how minor you may think they are. The following precautions and steps may be recommended by your podiatric physician, but should not be undertaken without his/her supervision and consent.
If your health history does not preclude such treatments, there are steps you can take immediately to treat the problem. In many cases where infection is not present, the patient can first clean the foot carefully with soap and water, then soak it in a warm salt-water bath.(A warm vinegar-water solution can be equally effective; use ½ cup of white vinegar for every quart of water).
Dry the foot carefully and apply a mild antiseptic to the area. Bandage the toe carefully (and not too tightly!) This step should be repeated at least three times a day. Make a trip to the local pharmacy and consult with personnel behind the counter. There are various over-the-counter remedies that will help harden the skin and shrink the soft tissue along the edge of the nail so that it grows normally. There are also special commercial bandages that will cushion the area and keep the nail from being driven inward.
If the condition doesn't respond to this treatment, or if you suspect infection has set in, it is essential that you confirm your suspicions by consulting with a podiatric physician. Other conditions have similar symptoms, and a professional can tell the difference. Once a diagnosis is obtained, it is essential to begin treatment immediately. Your podiatric physician will advise you on the most effective means.
In some cases, the podiatric physician can trim or remove the infected nail with a minor in-office surgical procedure in which a portion of the nail or overgrowth of the skin is removed, and the area treated for infection. In many cases, the problem will respond readily to this treatment, and the patient will not have a recurrence.
Some patients, however, find that they experience ingrown toenails over and over. This may include patients with large toenails, or those who simply find that for whatever reason, they are constantly suffering from this condition. In this case, the podiatric physician may elect to make a more permanent solution. In another minor surgical procedure, the doctor will reshape the nail so that it is narrower and less likely to grow into the skin.
How can ingrown toenails be prevented?
The best way to prevent an ingrown toenail is the simplest method of all: keep your toenails trimmed straight across. Regularly trim them, using clippers specifically designed for that purpose. Don't cut the sides of your toenails. If you see the beginnings of an ingrown toenail, clip straight across and follow the conservative measures above. Never pick or pull at the toenail, as over time, it creates an ingrowth that starts earlier and is harder to cure. Additionally, do all you can to protect your feet from trauma (stubbing or pounding), and wear shoes with adequate room in the toebox. If you suspect a problem and it is resistant to the conservative measures above, see a podiatric physician.
Examine your feet regularly. Note any redness, swelling or discoloration. Flex your toes and check for any pain when walking, running or even standing. If there is any, make a quick check of your toes, paying special attention to the appearance of the nails and the skin around them.
Do these symptoms always mean an ingrowth or infection caused by an ingrown toenail?
No - several other problems, including infections of the toenail (such as onychomycosis) or various traumas to the toe can have symptoms similar to those of ingrown toenails. That's why, if it's not getting better, it's important to have a professional look at your foot and make a diagnosis. If you believe that you have an ingrown toenail, and if you try to do your own home-grown brand of surgery - and it isn't an ingrowth after all - the problem could get far worse because of the delay in getting the correct treatment - not to mention any additional trauma you have inflicted on the foot.
Who can help me?
The American College of Foot & Ankle Orthopedics & Medicine (ACFAOM) stands ready to help you find a podiatric physician in your area. Simply click on our foot-help-finder link to find the professional who can help you find the most effective treatment.
|
|
