Ingrown toenail, big toenail - treatment, treatment at home. The nail is ingrown - what to do?
Most often, ingrown toenails occur on the big toe, but they can also occur on other toes.
An ingrown toenail can occur in anyone. This condition is more common in adults than in children.
People with thick, curved nails are most prone to developing ingrown toenails.
Ingrown toenails are more common in older people.
Suppuration and other complications of ingrown toenails are more common in people with diabetes.
Why do nails grow ingrown?
How human nails are structured: a brief excursion into anatomy
Nails are appendages of the skin, horny formations. They have the same structure as hair, the top layer of skin.
Nail bed. The place on the finger where the nail is located.
Nail root. Makes up 30% of its length, hidden under the skin.
Nail body. The main part that is located on the nail bed.
Free edge. The part of the nail that extends beyond the nail bed.
Nail folds . Small thickenings on the skin that limit the nail from the back and sides.
On average, the length of the nail increases by 0.15 mm during the day.
Fingernails grow faster than toenails.
On the hands, complete renewal of nails occurs once every 3 months, on the feet – once every 4.5 months.
Over the course of a lifetime, men's nails grow by an average of 3.9 m, while women's nails grow by 4.3 m.
Causes of ingrown toenails
The main cause of ingrown toenails is improperly selected shoes. The worst thing for nails are hard shoes with narrow toes, too short tight shoes. If the finger constantly experiences pressure from the side and above, this contributes to the nail growing into the skin. Another common reason is wearing closed shoes in hot weather, when humid conditions are created inside, causing the nail plate to soften and the epidermis, the top layer of skin, to swell. As a result, the nail begins to grow incorrectly.
Wrong pedicure. Cutting off the corner of the nail may cause it to grow abnormally.
Flat feet and foot valgus (improper position of the feet with outward deviation). People with these disorders find it difficult to choose comfortable shoes; they squeeze their toes, which increases the risk of ingrown toenails.
Onychomycosis (fungal nail infection). The fungus causes ingrown toenails due to the fact that it leads to deformation and thickening of the nail plates.
Congenital predisposition. Some people have irregularly shaped nails and excess tissue on the nail bed.
Finger injuries. A damaged nail may begin to grow incorrectly and unevenly.
Bacterial, purulent infections that affect the nails.
Wearing high-heeled shoes . At the same time, during each step, the foot tends to “slide” down, the toes are pinched in the sharp toe.
Symptoms, appearance
Characteristic symptoms of an ingrown toenail:
- Usually the first symptom of an ingrown toenail is pain. It intensifies while wearing uncomfortable shoes, and can sometimes occur even from minor impacts, for example, when a person touches his toe while covering himself with a blanket. The pain can be very strong, as if the finger was “pierced by a nail.”
- The periungual fold becomes red and swells.
- Over time, new tissue begins to grow near the nail - granulation – it has a characteristic appearance, for which it received the figurative name “wild meat”.
- An ingrown toenail has a high risk of infection. If an infection gets under the nail fold, it becomes even more red and swollen, pus begins to ooze out from under it, the pain intensifies, and the body temperature may rise.
- At first, a slight swelling and soreness appears near the affected nail. Gradually these symptoms increase.
- Then infection occurs. This usually manifests itself in the form of a significant increase in symptoms and discharge of pus from under the nail.
- Eventually, the inflammatory process enters the chronic stage. There is a proliferation of “wild meat”. In this case, we can talk about a neglected ingrown toenail.
What to do if an ingrown toenail festeres?
In this case, you should immediately contact a surgeon. The following symptoms should be a reason to visit a doctor :
- Pain, severe discomfort in the finger.
Swelling and redness, which increase over time, spread up the finger.
Manifestations of ingrown toenails that occur in a diabetic or a person suffering from another disease that leads to deterioration of blood flow in the feet.
Photo of an ingrown toenail:
Appearance of an ingrown toenail:
Infected, inflamed ingrown toenail:
What are the possible consequences of an ingrown toenail?
The main danger with an ingrown toenail is infection. It can spread to the surrounding tissues, to the foot, to the bones, leading to severe purulent complications. In the worst case, the purulent process can be complicated by gangrene.
Ingrown toenail: what to do, which doctor to see?
If you experience symptoms similar to an ingrown toenail, contact your surgeon. The child should be taken to a pediatric surgeon. To diagnose the disease, no additional research is required; an external examination is sufficient. Do not self-diagnose or self-medicate, especially if you suffer from diabetes or other diseases that impair blood flow in the lower extremities.
Treatment of ingrown toenails
Treating an ingrown toenail is quite a difficult task. There are a large number of methods, but none of them are ideal, relapses occur. There are three main areas of treatment for ingrown toenails :
surgical interventions;
conservative (non-surgical) methods;
Surgery to remove an ingrown toenail
Surgical treatment completely eliminates an ingrown toenail, but does not always guarantee a permanent cure for this condition. After the operation, the cause that led to the pathology may remain; as a result, the ingrown nail may appear again on the same or on another finger.
There are three main types of surgical treatment for ingrown toenails.:
removal with a scalpel;
laser removal of ingrown toenails;
radio wave treatment of ingrown toenails.
Schmieden operation for ingrown toenails
The Schmieden operation is a fairly popular method of treating ingrown toenails, as it is characterized by a low probability of relapse (about 5-10%). But the intervention is quite traumatic, and recovery takes quite a long time after it.
large size of the periungual fold;
unsuccessful treatment of an ingrown nail, after which a relapse occurred.
Usually the intervention is carried out under local anesthesia (for young children - under general anesthesia). A tourniquet is placed on the finger to help reduce blood loss.
The surgeon, using scissors with sharp ends, cuts the nail lengthwise, makes a small incision in the soft tissue with a scalpel, and removes granulations.
Then, using a special spoon with sharp edges, the doctor removes the nail matrix, which is responsible for its growth.
The final destruction of the nail matrix is carried out using special chemicals, electrocoagulator or laser.
After the ingrown part of the nail plate and all “extra” tissue are removed, the surgeon applies stitches and a bandage. Sometimes they do without stitches - this will not affect the healing process.
How does an ingrown toenail heal after surgery?
Typically, after Schmiden surgery, healing occurs within a week. During this time, you need to limit the load on the sore leg and change the bandage daily. If an ingrown toenail is complicated by an infection, the doctor may prescribe antibiotics, ointments with healing and antibacterial components. Sutures are removed 7 days after surgery. Complete healing occurs within 1-1.5 months. During this time, you cannot visit the bathhouse or sauna; you must wear the most comfortable, spacious shoes with an open toe.
Treatment of ingrown toenails with laser is highly effective and safe, with low risks of relapse, and a fairly short recovery period. The procedure, just like conventional surgery, is performed under local anesthesia with a tourniquet applied to the finger. The laser literally evaporates “extra” tissue, while destroying pathogens in the wound and stopping bleeding.
The method is similar to correcting an ingrown toenail using a laser, but instead of laser radiation, special radio waves are used. In many clinics, a modern device for radio wave surgery, “Surgitron,” is used for this purpose. Just like laser radiation, radio waves destroy all “unnecessary” tissues, pathogens in the wound, and stop bleeding.
Correction of ingrown toenails without surgery
Treatment of ingrown toenails with plates and staples
There are special staples and plates for treating ingrown toenails. They come in different shapes and are made from different materials. But they all have approximately the same operating principle: a bracket or plate is attached to the nail, one of its ends engages the ingrown edge and brings it up.
non-invasive procedure, treatment is carried out without an incision;
the ability to accurately calculate the correction force;
the patient does not experience discomfort - most models of plates and brackets are practically invisible and do not cause discomfort when worn.
nail deformities;
large granulations ( hypergranulation );
core calluses in the side ridges;
cosmetic indications for nail correction;
inflammation of the lateral nail folds.
ingrown nail;
violation of the shape of the nails;
after removing part of the nail;
inflammation of the lateral nail folds;
hypergranulation.
During tamponade, capolin - a small piece of material that helps reduce pressure on the nail fold and causes the nail to grow correctly. Tamponade can be performed only in the absence of infection and severe inflammation. Hygiene procedures and nail correction are first carried out using special tools.
Capolin tamponade is usually carried out at the earliest stages of an ingrown nail, or for prophylactic purposes, with curved nail plates, to prevent their ingrowth.
Ointments, like other conservative treatment methods, are used mainly in the initial stages of an ingrown toenail or as a complement to surgical and orthopedic methods. They have different effects: some soften the nail plate and normalize its growth, others contain antibiotics and help cope with infection.
The ointment is used 2 times a day - morning and evening;
First you need to give your feet a warm bath with salt for 20 minutes to steam the nail;
Apply a small amount of ointment to the area of the ingrown toenail.
Before applying the gel, you need to perform finger hygiene, wash it with soap and dry it thoroughly with a towel;
place a special fixing ring on the skin in the area of the ingrown nail;
fill the slot in the center of the ring with gel;
The gel must be changed in accordance with the recommendations in the instructions.
Contraindications for use : individual intolerance to the components of the gel.
bandages with Vishnevsky ointment are applied 2-3 times a day;
apply a small amount of ointment to the area of the ingrown nail;
apply 5-6 layers of gauze on top;
secure with a bandage.
Contraindications for use : individual intolerance to the components of the ointment.
How to use for ingrown toenails:
the procedure is performed at night;
place a small amount of ointment on gauze folded several times;
apply to the area of the ingrown nail and cover with polyethylene (you can use cling film);
apply a bandage.
apply a small amount of ointment to a piece of gauze folded several times;
apply to the area of the ingrown nail, apply a bandage;
change the dressing daily.
If there is a purulent cavity under the nail fold, the doctor can inject a certain amount of levomekol into it using a syringe.
Contraindications : individual intolerance to the components of the drug.
apply a small amount of gel to the area of the ingrown nail;
repeat the procedure 1-2 times a day;
the course of treatment is usually 10-12 days, depending on the doctor’s prescription.
hypersensitivity to the components of the drug;
severe dysfunction of the liver and kidneys;
atherosclerosis, angina pectoris and myocardial infarction;
previous stroke, coma;
cataract (clouding of the lens), glaucoma (increased intraocular pressure);
pregnancy and breastfeeding;
children under 12 years of age.
The doctor may recommend doing compresses with dimexide for 2 hours for several days. Or wash the wound with the solution during dressings.
Contraindications : the same as for dimexide gel.
the procedure is performed 2 times a day, morning and evening;
carry out finger hygiene, dry them thoroughly;
Apply a small amount of liquid to the area of the ingrown nail;
Usually a visible effect is observed after a week of use.
the procedure is carried out 1-2 times a day;
apply 1-2 drops of Gehwol liquid to the area of the ingrown nail;
wait until completely absorbed.
There are oils that help soften ingrown toenails and have an antiseptic and regenerating effect. For example, 100% ozonated olive oil is often used. It is used during the tamponade procedure.
Baths for treating ingrown toenails
For ingrown toenails, various baths are used:
Salt baths for ingrown toenails. They relieve swelling and inflammation, help fight pain, and are usually used in the early stages. Salt is taken at the rate of 2 tablespoons per liter of water. The water should be warm enough so that you can steam your feet well.
Baking soda baths. Help reduce swelling and inflammation, soften ingrown toenails. Used in the early stages of the disease. For three liters of water you need to take one tablespoon of baking soda. The foot bath is done for 15-30 minutes, after which you need to lift the ingrown edge of the nail with a clean toothpick and place a cotton wool band under it.
Baths with potassium permanganate for ingrown toenails . Do it three times a day for 10-15 minutes. Use a weak pink solution of potassium permanganate. It has antiseptic properties and helps soften ingrown toenails.
Even if you are going to treat an ingrown toenail at home, you should definitely go to a doctor for an examination. The surgeon will assess the presence and intensity of the infectious process.
Soak your feet in warm water. Foot baths should be done for 15-20 minutes 3-4 times a day. This will help reduce swelling and pain.
Lift the ingrown edge of the nail. You can put a little cotton wool or a piece of dental floss under it so that it is higher than the skin.
Use antibiotic ointments. Apply a small amount of ointment to the periungual fold and bandage the finger.
Wear loose shoes. Until the condition of the toe improves, you should wear open-toe shoes.
For severe pain, you can use painkillers . Ask your doctor which medications and in what form are best for you to use.
If, despite the measures taken, symptoms increase, consult a surgeon. Don't wait for the infection to start spreading.
Do folk remedies help if you have an ingrown toenail?
Traditional methods can help, but before using them you need to consult a doctor. Some of the most popular folk remedies for ingrown toenails :
- Butter. Pre-steam your foot in a bath of baking soda. Place a small piece of butter on the nail, cover it with gauze, a piece of cellophane and bandage it. The bandage must be worn throughout the day. After this, make a soda foot bath again, lift the ingrown edge of the nail and place a cotton swab soaked in butter under it. The procedure is repeated until the nail grows back.
Sea buckthorn oil and plantain. Steam your foot in a solution of soda or potassium permanganate. Place a few drops of sea buckthorn oil in the area of the ingrown nail, wrap it with a plantain leaf, and bandage it. After the swelling subsides and the inflammation subsides, the ingrown edge of the nail is lifted and a cotton band soaked in sea buckthorn oil is placed under it.
Calendula and chamomile. You need to take 50 g of dried calendula and chamomile flowers, pour 1 liter of boiling water. Infuse for 2 hours, then strain and dilute the infusion with another liter of boiling water. Cool to an acceptable temperature, steam the leg into the infusion. After this, the ingrown edge of the nail can be lifted and a cotton wool tourniquet soaked in iodine, butter or sea buckthorn oil can be placed under it.
Alum for ingrown toenails. First, the leg is steamed in a solution of salt, soda or potassium permanganate. Then the area of the ingrown nail is carefully treated with burnt alum and a bandage is applied. Usually the procedure is repeated within 2 weeks.
Badger fat . You can apply a bandage with badger fat to an ingrown toenail after steaming your feet in a bath. You can also place a cotton swab soaked in badger fat under the ingrown edge of the nail.
Video by Elena Malysheva about the treatment of ingrown toenails:
What to do to prevent the nail from growing in: prevention methods
To prevent ingrown toenails, follow these tips::
Trim your nails correctly. They need to be cut across, you can only round them a little. Don't try to give your nail a semicircular shape. Don't cut corners. If you decide to get a pedicure at a salon, ask a specialist to cut your nails crosswise.
Don't cut your toenails too short. There is no need to cut them off at the root; let their free edge protrude a little. Otherwise, the direction of nail growth may be disrupted due to the pressure of the shoes.
Buy comfortable, roomy shoes. She shouldn't put pressure anywhere. Avoid shoes with high heels and pointed toes.
Protect your fingers from injury. This primarily applies to workers who work in conditions that are dangerous in terms of foot injuries. Use shoes that protect your feet well.
If you have diabetes , check your feet daily for ingrown toenails.
FAQ
What to do if an ingrown toenail occurs in an infant or small child?
In young children, ingrown toenails are mainly caused by hereditary causes, wearing uncomfortable tight shoes, and improper cutting of nails. If your child experiences symptoms of an ingrown toenail, you should contact a pediatric surgeon. Treatment methods are almost the same as for adults. Surgery to remove an ingrown toenail in young children is usually performed under general anesthesia.
What is the ICD code for an ingrown toenail?
In the International Classification of Diseases, 10th revision, ingrown toenails are included in the group of “nail diseases” (L60) and are coded L60.0.
How to trim an ingrown toenail?
You cannot shape the edge of the nail into a semicircle or cut off its corners. This can disrupt the growth of the nail plate and lead to its ingrowth into the periungual ridges. You need to cut your nails perpendicularly (you can round them a little, but without cutting the corners), not at the root, leaving a small protruding part of the free edge of the nail plate.
What to do with an ingrown toenail during pregnancy?
If an ingrown toenail occurs during pregnancy, you should consult a doctor who will examine you, correctly assess the situation and prescribe the optimal treatment. You should not self-medicate, since not all medications and folk remedies can be used in pregnant women. You need to visit a surgeon as early as possible, since an infection that develops in the periungual fold can negatively affect both the body of the pregnant woman and the fetus.
What is the danger of an ingrown toenail with diabetes?
Diabetes mellitus can lead to impaired blood circulation in small vessels, so infectious complications of an ingrown toenail are especially dangerous for diabetics. The infection can quickly spread to surrounding tissues and bones, resulting in gangrene that may require amputation.
What to do if the temperature rises with an ingrown toenail?
Typically, an increase in temperature is associated with activation of the infectious process in the affected periungual fold and is accompanied by symptoms such as increased swelling, redness, and pain. Perhaps an increase in temperature and deterioration in general condition indicates that the infectious process has begun to spread to the surrounding tissues and bones of the foot. You need to contact a surgeon and start treatment.