In my 14 years of experience as a podiatrist, I can say that the most rewarding treatment is for ingrown toenails. I say this because they are such a painful condition, and within 10min you can have the sharp pain gone. Ingrown toenails can present from a little bit of inflammation to severe over-sized fleshy infected ingrowns. But no matter how small or big, you can always walk away with relief.
What causes ingrown toenails ?
Ingrown toenails are caused when the side of the nail is applying too much pressure on the skin leading to inflammation. The pressure can be caused by a nail spur caused by incorrect cutting, or by an involuted nail (curly edge) , or by tight footwear, or by trauma. Once the inflammation occurs, it gets further agitated by the nail and more inflammation occurs. If the skin surface is broken then a secondary bacterial infection may occur.
Initial home treatment .
I advise to act quickly on ingrown toenails, so that you may avoid it getting worse and hopefully not requiring any medical treatment. Soak the toe in salty water (about 1tbsp of salt to a luke warm footbath) for about 10min. Then apply a skin antiseptic (eg Betadine) and cover it with a bandaid. Do this daily after the shower in the evenings. It is important you wash your feet at night as they get sweaty and dirty during the day. Avoid using closed toe footwear to reduce any extra pressure on the ingrown toenail. Sports such as football can make it worse, so avoid playing if possible.
What if it doesn’t get better ?
If the ingrown isn’t noticeably improving after 3days, then go see your podiatrist. The podiatrist will gently remove the nail spur or trim the nail. In very severe cases, a local anaesthetic may be required. In cases where there is a repeated history of ingrown toenails due to a high susceptibility, your podiatrist may discuss other options such as nail surgery which permanently stops the ingrown toenails.
Do I need antibiotics ?
In many cases, many of my patients that present to my clinic have already seen their doctor and have been on one or two courses of antibiotics. Unfortunately, they have come to seek further treatment because the antibiotics haven’t completely resolved the ingrown toenail even though they have reduced some of the inflammation. In my personal opinion, I often recommend that you see the podiatrist first, and they will advise you if you should get antibiotics. I find in most cases, antibiotics are not required, especially if you have generally good health. Your toe recovers very quickly and heals from the infection once the offending nail is removed.
Dr Vanessa Hadchiti (Podiatrist)