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View Full Version : Ingrown Nails, Their Cause & Cure


Paul in Qatar
12-20-2007, 05:27 PM
My ingrown (big toe, left foot) nail is killing me. I just hacked at it and pulled all the nail I could out of the skin. This is as far as I have ever taken it.

But on the other hand, I am on vacation and have time to do the job right. Who the heck deals with these things? A poditrist I suppose? What can they do for me? How about a pedicure place? Or is that being silly?

Further, I suspect a good block of instruction on how to cut my nails would help me avoid this problem in the future?

Dunawake
12-20-2007, 05:44 PM
My roommate has had some issue with this, and I think he just went to a podiatrist to get it fixed. As far as preventing it, the only help I've ever heard was to avoid cutting the nail back too far once it is growing properly.

WhyNot
12-20-2007, 05:49 PM
Go to a podiatrist. She will probably remove the nail, which sounds harrowing, but really isn't that bad. Then, depending on the shape of your specific foot, toe and nailbed, she'll tell you whether to keep it longer, shorter, rounder or straighter than you have been doing. (Chances are good that it's going to be longer and straighter, but there are exceptions.)

My son had one of his nails (big toe, left foot) removed about a year and a half ago, and has had no problems since, after years of recurrent infections. He was playing soccer in gym class a week after the nail was removed. Apparently, they're not all that important.

GameHat
12-20-2007, 06:31 PM
Yes, see a podiatrist. They will typically cut away the ingrown portion (under local anesthesia) and prescribe antibiotics for any infection.

Back when I used to play soccer, I would get recurring ingrown big toenails, no matter how I cut them. After about 3 trips to the podiatrist he suggested that I get a portion of my toenail matrix deadened.

Basically he cut away just the left and right extremes of the nail (viewed from above) all the way to where the nail emerges from the skin. Then he swabbed the nail bed with some chemical that kills the nail producing cells. The nail does not grow back from these regions.

So, viewed from above: My big toe nails went from this:

(---)

to this:

|--|

after it healed it looks like a normal albeit slightly narrow toenail. Plus the ingrown nails never reoccured again.

DrDeth
12-20-2007, 07:52 PM
A poditrist I suppose? What can they do for me? How about a pedicure place? Or is that being silly?


A foot doc will do an excellent job. See one to start.

However, I found if you ask for a Pedicurist that knows how to work on mens feet, especially ingrown toenails, they can do the job much cheaper and more often- as long as you are not talking about really badly ingown nails.

I have had ingrown toenails all my life, and seen a specialist. But I go every two months to see a particular pedicurist who does an excellent job of preventive maintenence on my feet. Not to mention a foot massage. :D

jjimm
12-20-2007, 08:01 PM
My dad tells me that this used to be a routine procedure that was carried out in a GP's office back in the 1960s and 70s. How things have changed. I haven't met a GP in 20 years who will do anything at all - not even a diagnosis.

Bobotheoptimist
12-20-2007, 09:15 PM
I've never had anyone but my regular doc fix them. Numbs the toe and cuts about half the nail off, wraps it and sends me packing. No big deal, the shots hurt worse than the procedure, but it hurts for a few days after.

No idea how to prevent them. Long nails maybe, but that's far grosser than the occasional operation.

Rucksinator
12-21-2007, 09:04 PM
......... After about 3 trips to the podiatrist he suggested that I get a portion of my toenail matrix deadened.

Basically he cut away just the left and right extremes of the nail (viewed from above) all the way to where the nail emerges from the skin. Then he swabbed the nail bed with some chemical that kills the nail producing cells. The nail does not grow back from these regions......

I've known people that got their toenail removed to fix this problem, and then it grows back. Can the doctor make it so that the nail simply doesn't grow back at all? If so, is there a reason why you would need the nail; why this would be a bad idea?

crowmanyclouds
12-21-2007, 10:33 PM
... Can the doctor make it so that the nail simply doesn't grow back at all? ...Phenolization or phenol matricectomy. (http://www.abimelec.com/dermatologist/phenolization.html)

CMC +fnord!

Chief Pedant
12-21-2007, 11:23 PM
My ingrown (big toe, left foot) nail is killing me. I just hacked at it and pulled all the nail I could out of the skin. This is as far as I have ever taken it.

But on the other hand, I am on vacation and have time to do the job right. Who the heck deals with these things? A poditrist I suppose? What can they do for me? How about a pedicure place? Or is that being silly?

Further, I suspect a good block of instruction on how to cut my nails would help me avoid this problem in the future?

Ingrown nails are caused when the tissue along the lateral (or medial) nail groove heaps up so that the nail begins to grow into the tissue instead of out the end. Sometimes this is caused by primary irritation of the tissue, which then gets inflamed, swollen, and hypertrophied (excess growth). Things such as poorly fitting shoes or playing soccer can trigger this mechanism.
Some people cut their nails too short and the sharp edge digs into the tissue as it grows out.

Either way, the more the nail becomes ingrown, the more the tissue around it gets inflamed, sore, and hypertrophied, and you get kind of a vicious cycle.

Treatment depends on how bad it is. Sometimes you can just reshape the distal nail and it will do fine. Other times you need to cut the edge of the nail off. You never need to take the whole nail off, in my opinion.

If the whole groove is in bad shape and the problem tends to recur, then part of the germinal matrix should be removed so the the nail is narrowed. The germinal matrix is at the proximal end of the nail, underneath; the nail grows from here. This is not a guaranteed fix, but in good hands it's a 95% fix. A podiatrist might do a good job, but so will any competent physician. It's technically simple; you just have to know where to cut.

The germinal matrix can be destroyed by killing the cells with phenol, or by physically cutting away the germinal matrix. I prefer cutting it away, and I have had very good success.

The picture in CMC's link shows what the nail looks like after the border has been removed.

My anecdotal observation is that most approaches are too timid. To do this properly you have to give a good digital block. If you are going to numb the digit up well enough to lop out the nail border, you might as well do a proper job. If an ingrown nail needs treatment, the operator should be confident, experienced, and comfortable with removing the whole border (as well as the germinal matrix where indicated).

GusNSpot
12-22-2007, 02:07 PM
A lot of folks, me included, thought my toe nails were in grown. I did what is suggested here except for the going to a podiatrist part. Finally I went. I did not have ingrown toe nails although they looked exactly like them. I had damages toe bones. The nail will follow the bones. If you have damaged bone tips, you can do all the stuff you want and it will not stop the curl, V shapes, loops and inverted V the nails do. Best & cheapest in the long run to be pain free is removal.

One time, never come back, if done right, both big toes, not gross, does not affect sex, still can go swimming without dying of embarrassment, all that stuff.

Don't need no stinkin Great Toe nails.

I love my nail less toes......

ZipperJJ
12-22-2007, 03:24 PM
My best friend and I both had ingrown nails on our big toes. After years of digging mine out by myself every few months, I went to a podiatrist and had it taken care of for good. It was a crappy week or so with the bum toe, but I told my friend that not having a chronic ingrown toenail was one of the best things I've ever done for myself. My friend went and got his taken care of by the same guy, and he totally agreed.

Go see a podiatrist - it's worth it!

Oh and for the record...mine happened to be infected at the time I saw the doctor, so my medical insurance paid for it. I'm not sure that it'd be covered if it's not a medical emergency.

psychonaut
12-22-2007, 03:42 PM
Don't need no stinkin Great Toe nails.

I love my nail less toes...... :eek: pic?

Fetchund
12-22-2007, 06:35 PM
IANAD!

When I was a kid, I used to get ingrown toenails a lot, because I'd pick them. My dad used to get a tweezers, pull the nail up, pour peroxide in the infection, and stuff a little ball of kleenex in there to keep the nail high.

Hurt like heck, but worked!

GusNSpot
12-23-2007, 12:09 AM
:eek: pic?

Don't ya just love the digital age. Seven minutes from reading your request to this picture for you. (http://www1.webng.com/Dragon43/notoenails.jpg)

Sockmunkey
12-23-2007, 05:29 AM
Icky stuff ahead.


My ingrown big toenail was almost constantly infected for years.
It always had that "infected smell" and a crusty scabby layer in the groove.
Every so often I had to peel away the gunk over it to squeeze out the pus to keep it from hurting.

Eventually, I had it operated on by my regular doc, but he just cut out part of the nail and didn't do anything to keep that part of the nail from growing back.

This struck me as absurd at the time (I was still in HS) since it was obvious that with my wide feet it was inevitable that my shoes would squeeze and start it all over again.

(I have since learned that my foot width is "EEEE" which is the widest that non-custom shoes are made)

Naturally, it gradually went bad again and eventually I went to see a proper podiatrist who took care of the thing permanently by killing a section of the nail bed like GameHat descibes.

The injections to numb it (it took 4 of them!) were worse than the actual operation. I was able to sit back and enjoy the show once the lidocane kicked in.

In the end I was relieved to finally get it taken care of but I still feel like such a sucker for letting myself live with the damn thing for so many years.

For me the moral of this story is: Your regular doc might be mistaken or he might be an idot so consult a specialist if possible.

Paul in Qatar
12-23-2007, 06:49 AM
I am off to Mexico next month. Perhaps I will have it taken care of there. It will be a small adventure and let me see what Mexican medicine is like.

Sockmunkey
12-23-2007, 10:01 AM
Ok, that just gave me a shudder.

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