Ingrown Toenails
Click on images for larger views One of the most common foot problems that we see is that of an ingrown toenail. These come in all sizes and shapes and do not seem to be related to any specific age. In most instances when we see a patient with an ingrown toenail, it is something that has been bothering them for at least 10 years. Generally, patients don't come to see us until the toe becomes infected or the pain becomes so intense that they can no longer wear shoes. This is foolish because an ingrown toenail can be permanently eliminated with a simple procedure. What is an Ingrown Toenail Toenails are produced by microscopic cells that lie across the base of the nail. These cells, called matrix cells, produce a nail that is shaped exactly as they are. The shape of these cells and thus the shape of the toenail is determined by our genetics and also can be altered during our lives by trauma. Once the nail becomes incurvated figure 1, it becomes very difficult to trim and begins to grow in to the toe. Often when we try to trim the nail, it is so deep in the groove that a small spicule remains  figure 2. Then as the nail grows forward, this spicule will penetrate the skin and an infection will ensue. How do we "Cure" an Ingrown? Patients are always surprised at how simple it is to permanently eliminate an ingrown toenail. This is a simple office procedure where the toe is anesthetized, then the  ingrown portion of the nail border is removed figure 3. Care is taken not to remove any more of the nail than is necessary, thus giving a good cosmetic result. following this, a chemical called phenol is applied to this area of the toe where the nail border was removed. This chemical cauterizes the matrix cells that have produced the offending portion of the nail. Only a small dressing is applied following the procedure. The patient is then able to return to normal footgear immediately and resume their normal activities. Within a matter of weeks, it is very difficult to tell that anything has been done. Patients almost always exclaim after having had this procedure done: "why didn't I do this 10 years ago"! |
