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St Ives Chiropody & Podiatry
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In-grown toe nails (onychocryptosis)

What is an in-growing toe nail?
It is pain/discomfort which occurs due to the nail pressing at the edge or tip of the toe rather than growing straight. Mild in-grown toe nail can be a slight niggling ache or sharp pain when something (e.g. duvet) rests or presses on the toe. Severe in-grown toe nail is where the nail has actually pierced the skin and there may be pus and an over growth of skin (usually very red and inflamed) present.

What causes an in-grown toe nail?
There are many causes of in-grown toe and these can include:
  • The shape of the nail, the nail could be concaved or bridge like in appearance or fan shaped. Kaseem has even treated a child about a year old with an in-grown toe nail.
  • Due to the nail being picked or bitten (mainly in children and adolescents) and sharp edges being left.
  • Due to the nail being cut straight across and sharp edges left.
  • Damage to the nail due to participation in sports or dancing.
  • Congenital nail abnormalities.

Treatment of in-grown toe nail
Cutting out the shard of offending nail can often provide immediate relief in mild cases of in-grown toe nail in some cases. However if the cause of your in-grown toe nail is due to the shape of the nail, then this cutting of the nail may need to be done regularly in order for relief to achieved. If the toe nail has reached the point where there is infection present, it is advisable to see your GP for a course of anti-biotics but if this is not possible, do visit St. Ives Chiropody & Podiatry straight away as removing the spicule of nail will help.

If necessary the option of local anaesthetic injection is available if required. It is not always totally necessary for the infection to be totally cleared before having the nail spicule removed. If the spicule (spike or shard of nail) of toe nail is not removed, once you finish your course of ant-biotics the infection may reoccur due to the nail still being embedded in the flesh. As professionally skilled podiatrists we are capable of dealing with the in-grown toe nail whilst the infection is still present as long as you have a course of anti-biotics.

We would even be able to advise you during the consultation whether anti-biotics are necessary and liaise with your GP where appropriate. For on-going cases of in-grown toe nail that have not responded to conservative treatment, there is a permanent solution available.

Nail Surgery
This is an option if the in-growing toe nail is persistent or does not respond to conservative treatment. Nail surgery is performed under local anaesthetic and is known as a full or partial nail avulsion.

At St. Ives Chiropody & Podiatry we strongly advise it with phenolisation which is the destruction of the nail matrix of the nail bed to burn away the root of the nail. Nail surgery without phenolisation would just allow the nail to regrow exactly the same or worse, which is why after surgical removal of the nail/part of the nail we destroy the nail bed, part of the nail bed that we do not wish to regrow.
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