Ingrown nails

One of the more common problems seen in the podiatry office is ingrown nails. These can become severe infections and cause a significant amount of pain. Ingrown nails are particularly common in the pediatric patients. As the child grows the nails can change shape and curve into the edges or borders of the nails. The curving of the nails is a genetic problem and is extremely difficult to prevent.

The majority of ingrown nails seen in the Podiatry office are often caused by the patient themselves. When the nails become curved people try to cut into the corners of the nail. Often times the entire nail is not cut leaving a spike of nail deep inside the border. This spike grows into the skin as the nail continues to grow. The body’s response is to build tissue to protect itself. The edge of the nail also tends to drain and become red and painful.

Preventing ingrown nails can be accomplished by not cutting into the corners and letting the edges of the nails grow out past the skin. Cutting the nails straight rather than curved into the corners can also prevent this problem.

Once an ingrown nail has occurred and has swelling and drainage it is considered to be infected. Often times patient will present to their primary physician or an urgent care where they will be prescribed antibiotics. This will help with the infection but will not resolve the problem unless the offending nail is removed from the skin. When they present to our Podiatry office a procedure will be performed to remove the nail from the border and allow the healing process to begin. This procedure is performed in the office under local anesthesia. The majority of patients do not need any other pain medication however Tylenol is more than sufficient.

Ingrown nails can and do reoccur quite frequently. In situations where a person has had multiple ingrown nails a permanent procedure may be recommended. The permanent procedure is performed in the same manner as the procedure for an infected ingrown nail except that a chemical is used to kill the root of the nail. After the procedure you will still have a nail, it will just be thinner. The permanent procedure cannot be performed on an infected nail. Often times patients will present with an infected ingrown nail. In this situation the non-permanent procedure will be performed to clear the infection than 3 to 4 weeks later the permanent procedure can be performed.

It is important to present to the office as soon as the ingrown nail begins to occur. If the infection is left untreated it can lead to more severe infections including infections in the blood or infections in the bone. In extremely severe cases the ingrown nails have led to amputations due to the spread of infection. It is never good to ignore a problem, but in these cases more than others, it is extremely important to deal with the problem as soon as possible.