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Posted on: May 3 2022

If you experience red, hot, swollen and painful toes you may have an ingrown toenail. If you believe this is you, please read on further and learn how to prevent and manage them.

What is an ingrown toenail?

Ingrown toenails, is a portion of the nail that damages the epidermis (the outer layer of the skin) of the sulcus (the skin adjacent to the edge of the nail). If it becomes a chronic ingrown, hyper-granulation tissue often grows over the top of the nail (see photo below)  

What can cause an ingrown toenail

The most common causes of ingrown toenails are 

  • Incorrect cutting of the nail – this can include cutting the nails too short or cutting down the nail edges, sometimes this can encourage the rounded nail to piece the adjacent skin when the nail does grow back
  • Poor fitting shoes – this can include shoes that are too small, narrow at the ends of shoes which cramp and crown the toes which puts extra pressure on the nails and skin. 
  • Sometimes trauma to the nail such as dropping an object on the foot, this changes how the nail grows and can lead to an ingrown toenail 
  • biomechanics (the way you walk) – this can put extra pressure on the skin which pushes into the nail
  • Onychotillomania – in other words picking your toenails
  • on rare occasions other nail conditions/unknown causes.

Is there anything I can do to prevent an ingrown toenail from occurring?

Yes, there is. Below I will list a few things you can do to help  prevent an ingrown toenail from happening.

  • Cutting the nail straight across, avoid cutting down the nail edges and avoid cutting the toenails too short (see diagram below)
  • Do not pick or hack cut your toenails
  • Get correct fitting footwear – invest in shoes that are wider fitting and have plenty of room around your toes. You don’t want too much pressure from the footwear against the side of the nail feet constantly  
  • If unsure, always see a podiatrist for further assessment and to discuss the appropriate management for you

What are the treatment options

There are a few options available for ingrown toenails. Below, I will discuss briefly these options.

  • Routine nail care is when you need to come in have your nails cut when required and the podiatrist can cut them and provide education on prevention strategies  
  • Nail bracing which is akin to teeth braces, changes the shape of the nail to more of a straight curve to the nail
  • Partial nail avulsion
  • This involves surgical intervention. This type of surgery is a very common procedure a podiatrist will perform that is effective option for a painful, chronic ingrown toenail, that typically has not been corrected with the above procedures.
  • Nail surgery is performed under a sterile environment. 
  1. Local anaesthetic is administered into the toe to block any pain and to ensure the toe is numb. A tourniquet is then placed around the toe to stop continuous blood flow to the nail bed, allowing the nail section to be removed.
  2. The nail section is then cut, and removed.  
  3. A chemical Phenol is then used on the nail bed to stop nail regrowth.
  4. The tourniquet is removed and the toe is then cleaned and dressed with sterile antimicrobial dressings to encourage healing of the surrounding tissues and prevent infection occurring after the surgery.

If you believe you have an ingrown toenail that has recently occurred, or an ongoing repetitive ingrown, please don’t hesitate to call the clinic 03 9583 3093 or book online (link).

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