In-growing Toenails or Onychocryptosis
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In-growing toenails mainly affect the greater toe and can be caused by footwear, trauma, sporting activities or could be hereditary. These often can be treated during a routine appointment however, if the nail bed is damaged this results in the nail growing abnormally up the side of the toe, the skin may become broken by the nail which could result with an infection, the toe can swell and antibiotics may be required.
Some patients have this condition for years as the nail bed will never right itself, here treatment on a regular basis is required by cutting the nail back along the side, however this is not a permanent solution.
Severe pain, infection or repeated occurrence may require a minor surgical procedure which is performed under strict sterile conditions and with the aid of local anaesthetic. This procedure will cure the problem with patients comfortably walking out of the clinic.
Surgical procedure available
There are 3 main stages to remove in-growing toenails surgically:
- Firstly a small anaesthetic injection is given either side of the toe which is necessary to numb the area and is performed with a small dental needle. Sensation is checked to ensure complete loss of feeling temporarily. A small ring like tourniquet is then placed over the toe so that bleeding is minimal.
- Secondly, the offending side/sides of the nail are removed and a chemical called Liquefied Phenol is placed directly onto the nail bed and onto the cells that produce the offending piece of nail, this destroys these cells but only in this part of the nail bed so preventing this part of the nail from growing back.
- Thirdly, the tourniquet is removed and a dressing is put in place and the toe is bandaged.
Patients are asked to bring an open-ended toe shoe to accommodate the initial dressings which is left until 2-3 days later when it is removed by the Podiatrist at the first dressing appointment.
The whole procedure takes about 20 minutes and the patient can walk out. A day of rest after is recommended. A few weeks will pass where dressing appointments are given until the toe is completely healed.
It is important to note that most of the nail plate will remain with only the in- growing segment removed, however the nail plate will be narrower.
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