Hi Everyone,

I'll try and be concise--I know I can write books! A few weeks ago, my big toe was really hurting me (along with the rest of the shooting pain, but I digress!). There was an area of redness, and my physical therapist thought I got an infection from dirty pedicure tools (which was NOT the case; I LOVE my day spa!), however, my dermatologist diagnosed a chronically ingrown toenail. I didn't think anything of it, and neither did he, until my feet were pushed up into the top of my shoes by those lovely orthotics that I am trying to really give a good try. So, back and forth between the orthotist and orthopaedic surgeon. The orthotist told me that he could make the orthotics 3/4 length, but the OS is worried about my foot slipping forward, and told me to ask my derm if he'd remove the ingrown nail. My derm said he'd love to, but doesn't have the tools. My OS doesn't do that, so he referred me to a podiatrist--who is retired :) (I had a podiatrist sever one of my foot nerves, so it is with much trepidation that I see another, no matter how great s/he is.) I scheduled with another doctor in the office, but since he wasn't mentioned by name, I don't know if I'll see him. My derm also said he could give me the name of someone who "wouldn't screw me over", so I might try that.

So my question--is this necessary? How does an ingrown toe nail get taken care of? Is there anything else I could try before having it taken care of invasively? Any other ideas/tips? The derm, orthotist, and OS all think that I could probably live with this if I wasn't having my foot pushed up in the shoe, and I agree. I just want to limit as much foot discomfort as possible, and give those orthotics a good try!

--Karyn

Here is some info I found:

Ingrown Toenail
If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail, a common disorder. Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe. But this technique may encourage your toenail to grow into the skin of your toe. The sides of the nail curl down and dig into your skin. An ingrown toenail may also happen if you wear shoes that are too tight or too short. Any of your toenails can get ingrown, but it’s most likely with your big toes.


When you first have an ingrown toenail, it may be hard, swollen and tender. Later, it may get red and infected, and feel very sore. You may see pus drain from it. Finally, your skin may start to grow over the ingrown toenail.

Treatment

To treat an infected ingrown toenail, soak your foot in warm, soapy water several times each day. You may need to gently lift the edge of the ingrown toenail from its embedded position and insert some cotton or waxed dental floss between the nail and your skin. Change this packing every day. If your infection is severe, your doctor may prescribe a course of antibiotics. Learn how to trim your toenails properly. Wear clean socks and open-toed shoes, such as sandals.

If you are in a lot of pain and/or the infection keeps coming back, your doctor may remove part of your ingrown toenail (partial nail plate avulsion). Your toe is injected with an anesthetic and your doctor uses scissors to cut away the ingrown part of the toenail, taking care not to disturb the nail bed. An exposed nail bed may be very painful. Removing your whole ingrown toenail (complete nail plate avulsion) increases the likelihood your toenail will come back deformed. It may take 3-4 months for your nail to re-grow.

Ingrown toenails often recur. If you have a chronic problem with an ingrown toenail, your doctor may recommend another surgical procedure in which the toenail’s formative part is permanently removed.

Prevention

You can lower your risk of developing an ingrown toenail by trimming your toenails straight across with no rounded corners. The length of your toenail should extend out past your skin. The top of each nail should form a straight line across, level with the top of your toe. Some additional guidelines for preventing ingrown toenails include:

Don’t pick at your toenails or tear them off.

Make sure your shoes and socks are not too tight.

Keep your feet clean at all times.

I had an ingrown toenail before the surgery the podiatrist would manouver his instrument in between the skin and nail and remove that potiion of the nail that was bothering me. This went on for appox 5 -6 times before I actually had it removed permanently.

I think you can do that in the early stages and when the nail is not really that hard. It may hurt a little but it beats getting a full ingrown toe nail removal. It lasted for approx 2-3 weeks at a time..

Just a small suggestion.


hope this helps..

Thanks for the information. One question though--once a toenail is ingrown, you have to treat it with home care or medical care, right? It just won't go away on it's own, or will it? It was very helpful info because I had no idea there were different degrees of severity in treating them. I have no idea how severe mine is (it is red, swollen, and tender, but no pus), but I feel better seeing a podiatrist now because I think he will be able to dignose the severity and give me some treatment options. I don't think it's bad enough to warrant the most serious treatment. I have an appointment set for next Tuesday, but I'm thinking I will call the derm and see who he recommends-- depending on where their office is located, that might make the decision.

Thanks!

Karyn

Yes, one a nail is ingrown it will need treatment or it will get worse. I know this from the first one I had, were I ignored it and it got worse to the point where it bled in my shoes. Then I had the toe nail removal surgery and it was 3 months before I wore a shoe again.

Yours sounds like mine in the beginning stages. I also soaked it with epsom salt and put antiobiotic ointment on it. I think you will be fine. If it were oozzing than you would have a problem. Try not to wear shoes that are crushing your toes and when possible let as much air get to it as possible. And keep your feet well lubricated, it think they get worse when your feet are dry..

take care and good luck..