Ingrown Toenails
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NBC 25 Medical Corner Ingrown Toenails — Dr. Michaels »
Ingrown toenails are very common foot problems. They are caused by deformity of the toenail that is then irritated by tight shoes or hosiery, hereditary factors and in some cases, trauma to the nail. Cutting out the corner or spicule of the ingrown nail does not solve the problem in a permanent fashion. Additionally, cutting a “V” in the middle of the toenail does not help and can hurt the toenail problem.
Ingrown toenails can be compared to common dandelions in many ways. Thinking of your present problem in this fashion will help you to understand our treatment. If you were to walk into your front yard and pull a dandelion off at the grass line, the dandelion returns because you haven’t removed the root of the dandelion. Using a chemical weed killer on the root will rid your lawn of the dandelion in most cases. We do the same thing with the toenail root; we destroy part of it so it never bothers you again. When the toe is traumatized a small amount of root can migrate on the side of the toe. Wherever there is root there will be toenail so then part of your nail begins to grow further down the side of your toe into your skin. The nail then acts like a foreign object causing an infection in your toe.
The treatment of ingrown toenails is performed right in our office. Our procedure is called the phenol and alcohol technique. Using a small amount of local anesthesia, the affected toe is anesthetized. Only the portion of the toenail that is ingrown is then removed. Phenol is the surgical chemical that is then applied to the root of the nail to eradicate the offending portion of the nail root, just as the weed killer destroys the dandelion. The nail is now narrower. Phenol has killed the root only in the corner of the nail, thus eliminating the nail spicule that has caused the pain and infection. Alcohol is then used to cleanse the wound, and a sterile dressing is applied. Our experience has shown this procedure to be 90-95% successful. In most cases this procedure involves little or no discomfort. You may walk on the foot immediately following the procedure, and time off form work or play is not needed. If you have pain then you can take Tylenol as recommended on the bottle; however, most people have little to no pain.
Daily Ingrown Toenail Aftercare
Step 1. Leave the dressing the doctor placed on your toe until the following morning.
Step 2. Remove the dressing and shower, wash with Hibiclens (a special soap available at the front desk).
Step 3. Dry.
Step 4. Apply PolyMem and leave on until the next day. If you didn’t choose the PolyMem option, then soak your foot in warm Epsom salt water for 15-20 minutes 2 times a day. The recipe for the Epsom salt water solution is 4 tbs. Epsom salt per quart of warm water.
