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Dr. Michael L. Wodka’s Podiatrist Report

Topic — Ingrown Toe Nails

Of the many foot conditions seen in a podiatrist’s office, there are none more painful or more misunderstood than that of chronic Ingrown toenails. From over-the-counter home care products, to bathroom surgery, to the benevolent attempts by medical practitioners to treat these conditions, statistically 98% will reoccur. The following is a brief description concerning the most effective treatment available in permanently alleviating the condition by a relatively painless surgical procedure.

Most ingrown nails arising out of certain body types are aggravated by unyielding footwear – the corner of the great toenail often rubs with a sharp point pressing into the surrounding flesh. Once the piece of nail breaks the skin it causes a typical foreign body reaction consisting of bleeding and bacterial involvement. This is the beginning of the infection which can only be resolved by removing the offending nail edge.

At this stage the problem most often manifests itself with a throbbing pain and occasional drainage. It is at this point where many people employ bathroom surgery to rectify the problem and often succeed In limiting the pain and discomfort associated with the condition. Very often however, a small piece of nail is left deep within the fold to cause rapid return of the Infection once pressure is again reapplied to the foot by a shoe. Often physicians will prescribe oral antibiotics to resolve the condition. However, without removing the imbedded piece of nail the problem will definitely reoccur.

A podiatrist, upon seeing this scenario in an office, will first start out with a detailed history and physical to determine the patient’s past medical history. Underlying conditions such as diabetes mellitus, peripheral vascular disease, or neuropathic type disorders, will be of great concern in determining the course of action. Barring any unforeseen medical complications, podiatrists will most often recommend a corrective surgical procedure to permanently resolve this chronic condition. Utilizing local anesthesia the entire toe can be surgically treated with little if any post surgical pain. The reason for this is that after surgery, once the offending piece of nail has been removed, and the infection drained, there will be very little pain compared to the pain prior to the surgery. The procedure involves removing the offending piece of nail and using a chemical to destroy its growth center. Surgical aftercare consists of soaking and office follow-up visits. Healing is usually uneventful with little if any discomfort within four weeks.

As anyone who has suffered with this type of ingrown toenail can attest to, the pain of the nail combined with fear of the unknown, and the sensitivity of the toe, can be debilitating and cause extreme discomfort when walking about and when in footwear. The ease of surgical resolution and the rapid cessation of chronic pain is a major contribution of the practice of podiatric medicine and surgery.