Toes with ingrown toenails can become very painful, red, and infected. Can we treat this for you at home? Yes. We'll spare you from having to see pictures of bad infections and keep it simple with the picture of the mild ingrown nail over there on the right of this page.
Why do some people get ingrown toenails and others do not?
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There's often a genetic component. In residency, Dr. Brown learned about the family tendency to get ingrown toenails when treating multiple young siblings for this issue.
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Tight shoes that push the toes together can increase the chances of getting an ingrown toenail.
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Trauma (or injury) to the toenail can cause mild nail corner irritation to turn into an infected nail corner due to swelling of that area against the nail, from the injury.
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The most common cause though, is improper cutting of the nail corners. Cutting the nail corner back and then pulling it out can cause a sharp "right angle" shape to the nail edge that will then get caught and dig into the skin whenever it tries to grow past it. Using professional nail nippers, Dr. Brown can slant-back cut the nail border back (if desired) to remove the painful corner while also making a smooth nail edge there that will be more likely to grow out without problems.
This leads us to the topic of nail removal. By removal, it can be permanent or temporary and can also be a partial nail removal or total nail removal. Usually patients are referred out to brick and mortar podiatry practices that have the time and staff for important follow-up visits as they take about a month to heal and require several visits after the procedures to properly ensure healing.
Nail Removal:
Why would anyone want to remove a toenail and what does that entail?
There are 2 main reasons for nail removal, and several different ways to do it.
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Recurrent ingrowing toenails.
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Stubborn chronic fungal toenails.
Slant-Backs: With Ingrowing Nails, it usually isn't recommended to completely remove the nail or even to permanently remove it. In the elderly population, usually just the offending nail corner is removed, by first filing it to reduce thickness (which makes the nail corner more flexible there) and then gently clipping the painful nail area out at a slant. Rarely is it necessary to numb the toe with local anesthesia to remove the entire nail border. This is not permanent and allows the nail to grow back. The nails sometimes grow back without ingrowing again.
If the nail border problems do recur, then a permanent nail border (or total nail) removal may be desired, This is done in podiatry offices. The toe is numbed with a local anesthetic, the nail side (or sides or total nail) is removed and to make it permanent, a chemical is added to gently burn the nail matrix so that the nail will not grow back. This chemical burn causes post-op drainage for several weeks so it requires more healing ability (circulation) than for the non-permanent procedures. Podiatrists need to evaluate their patients to make sure they are appripriate candidates for this procedure.
For Fungal Toenails, if antifungal treatments aren't working to resolve the fungus and thickness of the nails, some clients elect to remove the nail (or nails) permanently. This is not very common and is usually reserved for clients with very thick nails and great circulation.