Scientifically called onychocryptosis and commonly ingrown toenail or fingernail, occurs when an edge of the nail digs under the skin of the toe, the first toe (big toe) being the most frequently affected.
What is the cause of an ingrown toenail?
If the corner of the toenail is not allowed to grow past the skin at the end of the nail groove, it can dig into the skin. This makes the pressure of the shoe even more painful.
It can be the result of many factors:
- Bad cut of nails. We recommend cutting the nail straight and perpendicular to the toe.
- Congenital origin.
- Inappropriate, narrow or uncomfortable footwear.
- Repeated microtrauma.
- Hyperhidrosis (excessive sweating).
What are the symptoms?
Ingrown toenails are a common and annoying disorder whose symptoms are:
- Pain and tenderness on one or both sides of the toenail
- Redness around the toenail
- Swelling around the toenail
- Infection of the tissue around the toenail
How is it diagnosed?
Diagnosis is usually easily made by examination. X-rays or tests are generally not required, unless we suspect that the infection may have spread to the bone.
Complications
If left untreated or undetected, it can lead to a serious infection in the area.
They can be especially serious if the patient has diabetes, or peripheral arterial disease, which can cause decreased blood flow to the extremities and damage the nerves in the feet.
How can it be treated?
There are two types of treatment: conservative and surgical.
Conservative
If detected early, conservative treatment may be sufficient. The pressure on the toe should be minimized with sandals or simply without wearing a shoe for several days.
The goal of non-surgical treatment is to allow the toenail to grow to the end of the toe beyond the nail groove.
Intermittent baths in warm saline may be suggested. If the area is infected, antibiotics may be needed to clear the infection.
Surgical
If the condition has caused permanent hypertrophy of the tissue around the edge of the nail, surgery may be required to treat the condition.
1.- Wedge resection in mild cases
It consists of making a cut on the edge of the ingrown nail with a scalpel and removing the fragment of the nail that causes the injury, and the healing process allows the nail groove to re-form.
2.- Partial extraction of nails and matrix
More severe cases may require the removal of a part of the toenail and the germinal matrix that produces that part of the nail.
Under local anesthesia, the intervention will consist of longitudinally cutting the edge of the ingrown nail to its root, burning it with a laser to prevent it from growing again and removing the spicule. (fragment of the ingrown toenail).
After partial removal of the nail, antibiotic and analgesic treatment should be given. The nail will be aesthetically normal again after a month.
