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Ingrown Toenail
Treatment
When the hard toenail
presses excessively against the soft skin on the edges of the nail there is
usually pain. Typically, the nail presses for extended periods of time and an
infection, or paronychia develops. This toenail infection is usually very
painful, develops pus, and causes the end of the toe to become red and swollen.
At least half of the ingrown toenails that we treat are caused by improper cutting of nails. Many people try to cut the corners
of their toenails and either cut the skin or leave a small point of
nail which eventually grows into the flesh. This makes a simple problem more
complicated. Nails should be cut flat across the top, and the corners should not
be cut out. If you feel the need to cut the corners, it should be done only by a
podiatrist.
Most drug store topical "cures" for ingrown
toenails are ineffective. They may soften the nail edge or decrease the soreness
for a short period of time, but they do not cure the problem. The source of the problem is present under the
cuticle at the nail root.

This photograph shows three degrees of
severity of ingrown toenails. The big toe (hallux) has a severe ingrown
toenail, where the nail is curved in almost a complete circle. The second
toe has moderate severity. The third toe demonstrates a mild level
of incurvation. Although it is very common
for the skin around the nail to become infected (called a paronychia), here there is no
infection present.
The cure for an ingrown toenail
usually involves numbing the toe with a local anesthetic such as lidocaine or
novocaine. The
toe will become completely numb and there will absolutely no pain
during the procedure. Approximately a 1/8 inch section of the nail plate
will be removed from the painful corner. If an infection is present, it will be
treated at the same time. The most important part of the procedure involves the removal of that
1/8 inch section
of nail root, so the problem will not return. If the root is not treated,
then the abnormally growing nail plate
will grow back in the same place and cause a similar problem within a few
months.
After treatment a small dressing is placed on
the toe and a regular shoe can be worn. Some people prefer to wear a
wider shoe, tennis shoe, or an open sandal. The foot is soaked in warm
water and the dressing is changed at home the following day.
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