An ingrown toenail is caused by pressure of the nail against the skin on the side of the nail. Prolonged periods of pressure can cause irritation of the skin, swelling, infection, and pain. Causes of Ingrown Toenails There are several factors that can lead to an ingrown toenail. The first is an abnormality of the soft tissue on the side of the nail. Certain rare diseases can cause a laxity of the skin, but the most common soft tissue abnormality is that seen with tight-fitting shoes. The shoes cause overcrowding of the toes pushing the soft tissue against the edge of the nail. Another common factor that can lead to ingrown toenails is nail abnormalities. Improperly cutting the toenail, cutting it short and curved, can cause the nail edges to turn in. Certain conditions such as lung disease, advancing age, and poor circulation in the extremities from blocked blood vessels can cause the nail to curve. Other less common factors that can lead to ingrown nails are bone spurs under the nail, trauma to the nail, multiple infections, and drugs such as indinavir. Appearance of Ingrown Toenails There are three stages of ingrown toenails. In the first stage the skin on either side of the nail is red and painful to the touch. This is due to inflammation or irritation only - not infection. In the second stage the skin is infected and may bulge over the side of the nail. The affected area may ooze clear fluid or pus. In the third stage the skin has been infected for a prolonged time and is trying to heal itself. The skin does this by forming granulation tissue. This is heaped up extra red tissue that bleeds easily and migrates over the nail edge. DIAGNOSIS of Ingrown Toenails Ingrown toenails are diagnosed clinically by their appearance. TREATMENT of Ingrown Toenails Ingrown toenails are treated based on the stage involved. Toenails in stage 1 can be treated with warm soaks, a cutout shoe, and by elevating the nail with a cotton swab. Symptoms improve after a couple of days, but may not resolve for 2 to 3 weeks. Toenails in stage 2 can be treated with warm soaks and oral antibiotics. Closed-toed shoes and hosiery should not be worn for at least 1 week. If the toenail is especially painful, a portion of the toenail may need to be removed. This is done in the SURGERY under local anesthesia. Toenails in stage 3 need to be treated with partial or full toenail removal. HITCHIN CHIROPODY and PODIATRY can offer removal with local anaesthetic AND can give ANTIBIOTICS Diabetics and Ingrown Toenails People with diabetes must pay close attention to their feet. Diabetics can develop peripheral neuropathies and loose the sensation in their feet. They are also predisposed to getting unusual infections because of the changes in their immune systems. If you are a diabetic and concerned about your foot problems please contact Paul at Hichin Chiropody and Podiatr
Hitchin Chiropody and Podiatry Practice 13 Bearton Green Hitchin Hertfordshire Tel: 01462 456031
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