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WHAT'S THE PROBLEM?
An ingrown nail occurs when a portion of a toenail on either side of the
toe turns downward and presses into the skin. Nails normally are
nearly flat, with just a slight arcing downward at the borders.
When the border of the nail is turned downward, it begins to injure
the skin.
HOW DOES IT FEEL?
Patient's usually feel pressure
and eventually pain, as the hard and sharp nail edge creates further injury.
Shoes that apply pressure to the toe increase the pain. If an infection develops,
the pain becomes intolerable.
LET'S DO A TEST!
An Ingrown Nail is identified
by the doctor's physical exam. If an infection has developed, the doctor may
send a sample of the drainage to a lab, to identify what bacteria has caused
the infection and which antibiotics will most easily cure the infection.
HOW DID THIS HAPPEN?
A progression of events occurs. Routinely
cutting the nails improperly, down at an angle instead of straight across,
is the most common cause of Ingrown Nails. Wearing narrow or pointed shoes
can apply enough pressure to a normal nail to turn the nail edge downward.
Once the nail matrix, the tissue where the nail grows from, gets injured in
this way, it continues to produce a nail edge that is more vertical than horizontal.
From this abnormal nail growth, the nail edge applies mild pressure on the
skin over a long period of time. The skin at the nail edge thickens and becomes
hardened. You may begin to notice an enlargement or swelling of the skin around
the nail edge. This can be accompanied by an increase in pain. The condition
can progress as a result of other factors. These factors include: pressure
from a tight or pointed shoe, injury such as stubbing a toe, excessive wetness,
either from perspiration or application of ointments or creams, or improper
cutting of nails If these factors come into play, the possibility increases
that the nail edge can then penetrate the skin, just like a knife, and cause
an infection. The skin at the nail edge becomes reddened and swollen. You may
notice drainage or pus from the area and the pain becomes intolerable.

WHAT CAN I DO FOR IT?
In mild cases, where no infection
is present, pain relief can be obtained by applying a standard
moisturizing cream to the nail edge and covering with a bandaid.
This softens the hard skin and often provides temporary pain relief.
In more advanced cases, where redness or obvious infection is present,
seek the attention of a doctor.
WHAT WILL MY DOCTOR DO FOR IT?
In the most minor cases, the
podiatrist will simply cut the nail to shorten it, and show you how to cut
the nail in the future, to prevent ingrowing of the nail again (See below for
instructions on proper nail cutting). In more severe cases, but not those in
which an infection hasn't developed, the podiatrist may gently remove the ingrown
portion of the nail. This affords considerable relief, but is temporary. After
a few weeks, when the nail grows long again, it will again grow in. In cases
where the nail has grown in repeatedly, or more critically, when the nail edge
has penetrated the skin and caused an infection, the podiatrist will perform
a minor procedure called an Ingrown Nail Correction or Matricectomy. The podiatrist
will gently numb your toe, reshape the nail edge and finally, apply a medicine
which will, in most cases, permanently prevent the nail edge from growing improperly
again.
CAN I PREVENT FROM IT HAPPENING AGAIN?
CUTTING NAILS PROPERLY TO PREVENT INGROWN NAILS
Cutting toe nails properly goes a
long way toward the prevention of ingrown nails. Use a safety nail clipper,
available at every drug store on the planet. Cut the nails STRAIGHT ACROSS,
so that the nail corner is visible. If you cut the nail too short so that the
nail corner is not visible, you are inviting the nail corner to grow into the
skin. It is the natural tendency, when the edge of the nail starts to grow
in, to cut down at an angle at the nail edge, to relieve the pain. This DOES
relieve he pain TEMPORARILY, but it also starts the downward spiral, training
the nail to become more and more ingrown. What happens is that cutting down
at an angle creates a space at the nail edge. When the advancing nail edge
reaches the space, it rolls downward, taking the course of least resistance.
The edge becomes more and more ingrown, until it pierces the skin and makes
an infection. So, cut the nails STRAIGHT ACROSS and never have an ingrown nail
again.
LINKS TO MORE INFORMATION
Anatomy of a Nail
SOAR
Medical Associates - Ingrown Toenail
American College of Foot and Ankle
Surgeons - Nail Disorders And Treatments
Society of Chiropodists and Podiatrists
- Ingrowing Toe Nails
Foottalk - Ingrown Toenail (photos
of Matricectomy Repair)
Alan Meyerberg, DPM - Ingrown
Toe Nails
Dr. Michael J. Marcus Ingrown Toenails
and Their Treatment
Drs. Hale & Huppin - Ingrown
Toenails
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