Management for ingrown toenails
Ingrown toenails are very common in Singapore and can affect any toenail, and less commonly, any fingernail. They occur when the nail grows into flesh adjoining the nail and can be caused by factors such as injury, improper trimming of the nail or congenital causes. The condition frequently recurs unless the root causes are addressed.
Nails that in-grow typically present with some pain, redness, swelling and (at later stages) pus around the offending nail. Like having a piece of glass or splinted embedded in your skin, the offending spike of the ingrown toenail should be removed promptly. Left unaddressed, the condition will often develop into a painful wound that does not resolve on its own.
Why see a podiatrist?
While many professions claim to be able to handle ingrown toenails, removals, and infections, only podiatrists and orthopaedic surgeons traditionally handle such procedures, and the two tend to have very different approaches. Orthopaedic surgeons often remove the whole nail while podiatry focuses on removing the section of the nail growing into the flesh. Other procedures used by orthopaedic surgeons include the Winograd procedure which involves removal of the nailbed and surrounding tissue. This requires suturing and a longer recovery time due to permanent reshaping of the toe.
Patients with recurrent ingrown toenails will not be able to avoid a minor surgical procedure. If a patient requires cutting back of the nail on a regular basis, resort to taking antibiotics to reduce infection or experience frequent pain and swelling, seeking prompt intervention will help prevent long-term recurrence.
What can a podiatrist do for me?
A podiatrist is a foot specialist qualified to perform various procedures for nail conditions, including managing infections and handling ingrown toenails conservatively and surgically.
Our podiatrists are experts with minimally invasive nail procedures and have developed procedures for resolving this issue with minimal side effects, a short recovery period, and low risk of recurrence.
What are the steps?
Addressing ingrown toenails is dependent on the severity of your case and is subject to an in-clinic assessment. If necessary, your podiatrist will advise a minor surgical procedure to avoid recurrence or spreading infection.
This procedure is known as a partial or total nail avulsion depending on the degree of removal and requires the podiatrist to lift the ingrown portion of the nail from under the edge of the skin. This section is then cut through from the tip of the nail to the root and removed, exposing the nail matrix. To prevent recurrence of the ingrown toenail an ablative agent is administered to the exposed nail bed.
As podiatrists are experts in performing small delicate procedures with razor-sharp precision, there will only be minimal damage to the areas around the ingrown nail. If the nail condition is minor or due to a one-time poor nail cutting technique, then minor surgical procedures can be avoided using non-invasive in-clinic removal techniques.
Following any minor procedures, a wound dressing will be applied and changed periodically to enhance healing and reduce the risk of post-surgical infection.
Advantages
- No stitches, no scars
- Swift recovery – less than 2 weeks post-procedure healing
- No down time – able to return to daily activities quickly
- Low chance of recurring – 2-5% recurrence rate
- Aesthetically pleasing results
In the case of incurvated toenails that lead to chronic pain and infections, the podiatrist may recommend nail surgery instead of routine nail care to manage the condition. Our podiatrists are experts at understanding the nail plate dynamics and can accurately determine if a nail problem will recur. If our podiatrist determines that the ingrown toenail is going to be a problem to your future health, specifically for diabetic, rheumatoid or dementia patients, your podiatrist will advise you accordingly and specifically to avoid hefty or recurrent bills or long term complications to the foot.
Suitability for minor surgical procedures is subject to a thorough assessment, restrictions may apply depending on the status of your health. To understand your suitability for ingrown toenail management procedures, speak to one of our podiatrists today.
