Posts

As we get older the toe nails get thicker. It is a normal part of ageing. That is going to make the cutting of toenails all the more difficult as they are so thick. On top of that aging related thickness, trauma to a nail can also damage the growing area of the nail and cause the nail to become thicker. That trauma could be from years of wearing tighter shoes, a claw toe that puts pressure on the toenail or something like dropping a brick on the foot that damages the nail. Occasionally there is a skin condition associated with the thicker toenails.

Technically a thicker toenail that has no deformity is called onychauxis and if there is a deformity of the nail present, then it is called onychogryphosis. Onycho- means ‘nail’, so its a conditions of the nails.

Once the damage is done to the nail matrix or growing area of the nail in conditions like onychauxis, it is not possible to repair or fix that damage. The nail will always grow that way. If you can not manage to cut and look after the damaged toenail, that is where we come in. Using our tools and our skills we can reduce that problem nail or all of them if they are all affected. This is going to need to be done periodically as the nail will continue to grow back.

On occasion, especially of the toenail is causing a lot of problems it may be possible to remove the nail permanently and destroy the nail matrix so that it does not grow back.

An ingrown toenail is due to a combination of a curved shape to the nail, poor cutting technique and pressure on the toe from the shoe. Many cases can be managed with conservative care periodically and that combined with good self-care can often take care of it. For some, that is not enough and something more drastic and radical seeds to be done to prevent it from becoming such a regular problem.

If you are in that latter category where the problem is ongoing, then please come in and discuss it with us. A minor surgical procedure under a local anaesthetic can remove the side of the of the toenail that is causing the pain and an acid is used on the growing area of the nail to prevent that side or edge of the nail from growing back. Healing afterwards is usually uneventful, but we do like you to wear an open shoe or sandal for up to a week and keep it dry for at least a few days so that it heals up properly. The worst that can usually happen is that a phenol burn may take a little longer to heal (phenol is the chemical that we use to destroy the growing area of the nail so it does not grow back). Please come in and discuss your options if you have this problem.

Ingrown toenails are probably not as common as you think. The most common cause of pain down the side of a toenail is a condition called onychophosis which many people mistake for an ingrown toenail. A true ingrown toenail is when a sharp edge or piece of the nail penetrates the skin to become “ingrown”. This typically becomes red and inflamed and runs of the risk of infection developing. Onychophosis is a callus or a corn that develops down the side of the nail from pressure between the nail and the skin. Typically the nail is curved and there is quite a lot of pressure there. Because of this pressure, the skin thickens up to protect itself, but becomes so thick it forms a painful callus or a corn. Both an ingrown nail and onychophosis cause pain down the side or edge of the nail. That pain is due to the pressure, but one is due to the nail penetrating the skin and the other is due to the pressure on the skin, so you can see why they may often be confused.

An ingrown toenail is treated by a podiatrist skillfully removing the piece of nail that has penetrated the skin. In the long term it may need a minor surgical procedure for a more permanent solution if the condition continues to occur. For an onychophosis, this is where the practical skills of a good podiatrist shine in being able to skillfully debride the callus and corn and file the nail away from the painful area. Like an ingrown nail if this becomes an ongoing problem, minor surgery can be used to remove the edge of the nail to prevent it from being a long term problem.

If you have any pain down the side of the nail, whether it be an ingrown toenail or an onychophosis, then come in an dsee us to discuss your options.

Ingrown toenails can become a real problem and they tend not to fix themselves. A true ingrown toenail occurs when a spike, sharp corner or edge of the nail actually penetrates the skin (becomes ingrown) and can become swollen and infected. A lot of people have pain down the edge of the nail that is not technically an ingrown nail but it is a spike, sharp corner or edge of the nail pushing on the skin, but not actually penetrating the skin. In some cases, a corn or callus may even form down the nail sulcus from that pressure from the nail. We see a lot of ingrown nails at Croydon Total Footcare.

What can be done for an ingrown toenail?

This will depend on what exactly is causing the pain, if the nail has penetrated the skin and just how far down the side of the nail the problem is. The podiatrist will meticulously remove the offending piece of nail and smooth the edge of the nail. If it is deep and maybe infected, a local anaesthetic may be needed.

If the nail is very curved and goes deep down the side, this may be an ongoing problem, so a minor surgical procedure may be needed to remove that side of the nail and a chemical used to stop that part of the nail from growing back. This is often the case if the nail progresses to this stage:

If the nail looks like that, the only solution is the removal of the edge or bit of the nail that has penetrated the skin. Not topical cream or antibiotic is going to take that bit of nail away.

What can you do to fix an ingrown nail?

If it looks like the picture just above, then there is not much you can do, so come in and see us before it gets any worse.

If the nail is not infected, the the best thing that you an do for it is to NOT cut down the egde as that can leave a sharp corner or spike and it could become worse. If you are able to use a nail file to keep the edge of the nail smooth, then that may help.

Your best option is to probably come in and let us have a look at it, clear out the edge of the nail to relieve the pain and discuss the different options you have for the long term and what else you could do to manage it yourself.