An ingrown toenail occurs when the nail pierces the sulcus of the toe causing pain and infection

Is there a Fix for Ingrown Toenails? Conservative vs Surgical Treatment

Ingrown toenails can be a painful and persistent problem, causing discomfort and inconvenience for many individuals. As a podiatrist, I often encounter patients seeking relief from this common condition. In this blog post, I’ll explore various treatment options, both conservative measures and surgical interventions, to help shed light on the path to comfortable, pain-free feet.

Prevention:
It is worth mentioning the main reasons that people end up with ingrown toenails.

Cutting technique:
Many people find themselves with an ingrown toenail after trying to cut too far down the sides of their nail. The best way to ensure your nail stays away from the skin is to cut straight across the nail, leaving the corners visible so that there is no chance of skin irritation.

Footwear:
Another major culprit for ingrown nails is wearing footwear that is too tight in the toebox. Footwear that tapers in excessively at the toe will apply pressure to the nails, increasing the likelihood of the nail piercing the skin. Make sure that the insole of your shoes is wide enough that your foot does not splay over the sides and your toes do not have to deform to fit within the borders.

Conservative Measures:

Nail Bracing:
One of the first steps in addressing an ingrown toenail involves the use of nail bracing. This non-invasive technique involves applying a small brace to the affected toenail, helping to guide its growth away from the surrounding skin. By gently coaxing the nail into a proper position, patients can experience relief without the need for surgical intervention.

Removing the Shoulder:
In cases where the ingrown toenail is less severe, a podiatrist may opt to remove the sharp edge or corner of the nail that is causing irritation. This procedure is performed with a scalpel blade in a regular appointment and provides immediate relief, allowing the nail to grow without causing further discomfort.

Nail Packing:
Nail packing is another conservative approach that involves placing a small piece of cotton or dental floss beneath the ingrown edge of the nail. This helps lift the nail away from the skin, reducing pressure and promoting proper growth. While this method may offer temporary relief, it is important to consult with a podiatrist to ensure proper application and to address any underlying issues.

Surgical Options:

Partial Nail Avulsion:
When conservative measures prove insufficient, a podiatrist may recommend a more definitive solution such as partial nail avulsion. During this procedure, the offending portion of the nail is removed, providing immediate relief. To prevent regrowth of the ingrown nail, the nail matrix may also be treated.

Phenolisation:
To prevent regrowth and recurrence of ingrown toenails, a podiatrist may employ phenolisation during a partial nail avulsion. Phenol is a chemical compound that, when applied to the exposed nail matrix, helps to destroy the nail root, preventing the ingrown nail from coming back. This minimally invasive procedure is highly effective and has a low risk of complications when performed by a skilled podiatrist.

So which option is best for me?

In the journey to treat ingrown toenails, patients have a range of options to explore, from non-invasive conservative measures to more decisive surgical interventions. While some may find relief through nail bracing, removing the nail shoulder, or packing, others may require partial nail avulsion with phenolisation for a lasting solution.

It is crucial for individuals experiencing persistent ingrown toenail issues to consult with a qualified podiatrist. A proper diagnosis and personalized treatment plan can make all the difference in achieving long-term comfort and preventing future recurrences. Remember, taking steps to address ingrown toenails early can lead to quicker recovery and a healthier, pain-free stride.