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In-Grown-1500_430.jpg

INGROWN TOENAIL MANAGEMENT

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An ingrown toenail is a condition in which the side or corner of the nail grows into the flesh.  Ingrown toe nails are a relatively common aliment seen in young children through to elderly.  The development of Ingrown toe nails is associated with:

  • curved/involuted nail shapes

  • incorrect cutting technique

  • footwear being too short, too narrow or inadequate depth of toe box,

  • trauma

  • medication such as Isotretinoin indicated for Acne treatment.

Ingrown toe nails can be quite sore and infection is often present.  Antibiotics are commonly prescribed to assist with management. Those with diabetes or immune compromised are at greater risk of infections.

 

Management at home

  • Cutting nail straight across, do not cut down the side of the nail

  • Soaking the foot in warm salt baths combined with topical antiseptic (Betadine)

  • Avoiding tight fitting footwear

 

Conservative care with the Podiatrist

Indicated early in the development of ingrown toe nails with a goal to resolve current complaint and prevent recurrent ingrown toe nails long term. From the consultation expect:

  • Education, including nail trimming technique, infection management and footwear advice

  • Removal of small nail spikes when present

  • Nail packing

  • Footwear assessment

 

Surgical Management

Podiatrists commonly perform a procedure called a partial nail avulsion which is a permanent solution to address ingrown toenails.  It is indicated when there is a history of recurrent ingrown toenails or when the prospect of healing the current ingrown toe nails is poor due to the severity of presentation. The procedure involves removing a portion of the nail along with the cauterisation of the nail bed and matrix with phenol.  A study published in 2010 reviewed 197 patients treated with this procedure showed a success rate of 98.5% from this procedure*.

 

*Vaccari S, Dika E, Balestri R, Rech G, Piraccini BM, Fanti PA. Partial excision of matrix and phenolic ablation for the treatment of ingrowing toenail: A 36-month follow-up of 197 treated patients. Dermatol Surg 2010;36:1288–93

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