September 2010 – Patient Sympathy

August 2010 – Back to School Shoewear

July 2010 – Womens Shoewear

June 2010 – Summer Foot Care

May 2010 – Skin

April 2010 – Ingrown Toenails

March 2010 – Barefoot Running

February 2010 – Pediatric Flatfoot

January 2010 – Being a Compliant Patient

December 2009 – Raynaud’s Disease

November 2009 – NA

October 2009 – Shin Splints

September 2009 – Dealing with Corns and Callouses

August 2009 – Relieving Painful Gout

July 2009 – Caring for Plantar Warts

June 2009 – Bunions

May 2009 – Children's Heel Pain

March/April 2009 – Heel Pain

February 2009 – Shoe Fitting

January 2009 – Nail Fungus

December 2008 – Neuroma

November 2008 – Diabetic Foot Care

Ingrown Toenails

April 2010

Published in - Healthy Lifestyles

One of the most common and, quite frankly, most painful conditions I treat is the infamous ingrown nail, or hang-nail. An ingrown nail is just what it sounds like- a part or piece of a nail that, for many reasons, grown into the skin. It can be mildly uncomfortable or exquisitely painful. Like most things it seems to come in waves. A recent Tsunami has hit the office, as it does this time each year. Twice each year I seem to experience an increase in this condition, and Spring is one. The other is Autumn. They’re quite common throughout the year, there’s just an increase during this time.

Why the Spring? Possibly attempting to wear last years walking sneaker or running shoe in spite of the l or 2 pounds, or more, we may have added to our frame over the winter months. Yes, added weight doesn’t just go to your hips and thighs it also lands on our feet but is much less noticeable. Who would’ve thought?

So, an extra half size larger squeezed in last years sneakers can add extra pressure at the tips of the toes, usually the outside of the Great Toe. Yeah, I don’t know what’s great about it, either. It doesn’t do anything extraordinary. Want to impress me, get a job and kick in for the mortgage. Now, that’s what I would call a Great toe!

Shoe wear, is by far the main culprit causing the pressure on the edge and tip of the nail. This can happen to any nail but usually it’s the big toe nail that bears the brunt of the torture. It can also be the style of the shoe. Dress shoes are less accommodating to the foot than a sneaker, casual shoe or even a boot.

Another major reason you may develop an ingrown nail is just plain cutting them incorrectly. Whether doing it yourself or someone at the local salon is, there is a chance that it’s either cut incorrectly or the slightest piece was missed. That piece digs into and breaks the skin, opening a passageway for bacteria to get into and cause an infection.

Many times applying antibiotic cream to the site helps. Even taking antibiotic pills help, but neither eliminates the cause of the infection or pain. You can take antibiotics for as long as you want but it won’t do any good unless that offending piece is removed.

Please keep in mind that I said ‘piece’ and not the entire nail as some patients have been told that they had to have removed. Not true. Sometimes a section of the nail needs to be removed temporarily but it will grow back. I do suggest to some patients that if it is a chronic issue that they have that small section only removed permanently. As far as the temporary or permanent removal of a section goes, it is always, always, always the patient’s decision.

Another factor in developing an ingrown nail can be due to a fungal infection of the nail plate. This causes a thickening or fragmenting of the nail plate. The average nail clipper is useless since it cannot adequately grasp the nail and cut it cleanly. Again fragmenting the nail and acting as a tiny spear which pierces the skin.

Many patients are unable to reach their toes due to bad backs, being overweight, having poor eyesight, arthritic hands or have dementia or Alzheimer’s and are unaware they need to have them cut.

So what’s the solution? If you’re cutting them yourself make certain you’re able to reach them first and not straining to reach them. Cut the nail the entire length across. Whether you cut it straight or on a slight curve, it truly doesn’t matter, just don’t leave any spicules that can cause you problems. This is most frequent the case- you just miss that ever-so-small piece that pokes the side of the toe.

Many people feel and have been told that the nails must be cut straight across. This may be a personal choice as far as style is concerned, which is fine. Toes, like fingers, are rounded and cutting them straight across may cause them to dig into the next toe. Rounding them slightly or cutting the corners slightly might be a better alternative. Everyone is different so what works for one person may not work for the next person.

If you can’t cut them yourself, for whatever reason, have someone else who can do it correctly. If you don’t feel comfortable with someone cutting your nails because you’re afraid they may cut you, I strongly recommend being seen by a Podiatrist sooner rather than later.

The most painful cases I’ve seen is when patients wait to see if it gets better on it’s own or attempt to cut the nails themselves and cut their skin. Now they have an ingrown nail and a small piece of skin missing that can become infected. Of course, they become more painful the longer you wait to have this treated.

Most insurance plans cover basic foot and nail care. Contact a podiatry office at the first sign of an ingrown nail. Save yourself some pain and the possibility of a looming infection, for both our sakes. It’s much easier to treat something in the beginning stages than later on when it’s really infected and painful. Most times the problem section of the nail can be removed without giving an injection or causing pain. Honest, just ask my Mother-in-Law, Lorraine.