Ingrowing toenails (onychocryptosis) can cause significant discomfort and disrupt daily life. This blog aims to provide a comprehensive overview of ingrowing toenails, the surgical procedure to address them, and postoperative care based on information from a patient information leaflet.
What is an Ingrowing Toenail?
An in-growing toenail occurs when the edge of the nail grows into the surrounding skin, causing pain, redness, and sometimes infection. In severe cases, it may lead to pus formation and bleeding. A curved or involuted nail pressing against the skin, while not technically ingrowing, can mimic the symptoms and result in discomfort.
Is It Serious?
If left untreated, an ingrowing toenail can cause infections that may spread to the rest of the toe, leading to more severe complications.
What Causes Ingrowing Toenails?
Several factors contribute to ingrowing toenails, including:
Posture and Gait: Improper foot positioning or walking patterns.
Foot Deformities: Conditions like bunions, hammer toes, or excessive pronation.
Improper Nail Growth: Nails that naturally curl or splay.
Tight Footwear: Shoes, hosiery, and socks that exert pressure on the toes.
Excessive Sweating: Moist skin increases vulnerability to nail penetration.
Poor Nail Care: Incorrect trimming or picking at nails.
Brittle Nails: Sharp edges or breakage can contribute to the problem.
Why Surgery?
The primary goals of surgery for ingrowing toenails are:
Reducing pain and discomfort.
Preventing infection.
Facilitating easier footwear choices.
Potential Risks of Surgery
Like any medical procedure, nail surgery comes with some risks, including:
Regrowth: Occurs in about 5% of cases and may require a repeat procedure if it becomes problematic.
Delayed Healing: Healing may take 4–12 weeks, influenced by factors like age, overall health, and adherence to aftercare instructions.
Reaction to Phenol/Radiolase: The chemical or laser used to prevent nail regrowth may occasionally cause localized redness and delayed healing.
Infection: Following aftercare instructions can help prevent this.
Bleeding: Minimal bleeding is expected, but elevating the foot after surgery minimizes this risk.
Anaphylaxis: A rare but serious reaction to the local anesthetic or phenol.
Preparing for Surgery
Here’s what to keep in mind on the day of your procedure:
Eat beforehand to ensure stable blood sugar levels.
Wear open toed shoes or sandals to accommodate post surgical dressings.
Arrange transportation home, as driving is not permitted for 12 hours after surgery.
Inform podiatry staff of any recent changes in medication or health conditions.
Remove nail varnish before the procedure.
Plan for time off from work, school, or college.
PostSurgery Pain Management
Once the anesthetic wears off, mild pain is expected. Over-the-counter painkillers like paracetamol are typically sufficient to manage discomfort.
Aftercare Instructions
Proper aftercare is critical for healing. Follow these steps:
Removing the Dressing: If it’s stuck, soak your foot in a warm saltwater solution (1 part salt to 4 parts water) for 2–3 minutes to loosen it gently.
Cleaning: After soaking, allow the foot to air dry naturally.
Redressing: Use a clean homemade plaster as demonstrated by clinical staff. Replace the dressing daily until there’s no discharge.
Ending Dressing Use: Once the toe remains clean and dry for three consecutive days, the dressing can be left off.
Key Takeaways
Ingrowing toenails, though common, can become serious if untreated. Surgery provides an effective solution, but understanding the risks and following aftercare guidelines is essential for optimal recovery. If you’re experiencing the symptoms of an ingrowing toenail, consult a healthcare professional to explore treatment options and regain comfort.