Ingrown toenail - causes, symptoms, treatment methods, prevention

Before treating the fungus, a nail cleaning procedure with onycholysis . Hardware cleaning is very popular due to its advantages:

• Safety for skin and nails (the nail plate is not injured, the skin is not damaged, even with severe fungus it is possible to save the nail);
• Quick removal of damaged tissue;
• Short recovery period;
• Instant improvement in the appearance of the nail;
• No side effects;
• High efficiency and elimination of unpleasant symptoms of fungus;
• Possibility to take tissues for analysis.

*Cleaning nails for the treatment of onychomycosis allows you to effectively fight the fungus and prevent relapses of the disease.

What is an ingrown toenail?

With this disease, the nail plate grows into the periungual fold. The big toe is most often affected. The disease begins with some “provoking” moment - an injury during a pedicure, a bruise, wearing tight shoes, etc. Swelling of the roller occurs, it is pressed more tightly against the nail plate and is slightly injured by it (an abrasion, a microcrack occurs). This, in turn, causes increased swelling and pain. Almost immediately an infection sets in - microorganisms invade the wound. Inflammatory phenomena gradually progress - redness appears in the area of ​​the periungual fold, pain and swelling increase. Pus begins to secrete between the nail and the roller, and later hypergranulations appear there (the so-called “wild meat”). Before infection sets in, ingrown toenails can still be stopped by treatment at home - it will be described below. When suppuration occurs, and especially when “wild meat” appears, conservative treatment is always ineffective; it can only bring a short-term reduction in symptoms. Only surgical intervention can radically help.

Is there a difference between gel nail prosthetics and extensions?

These two procedures are completely different, since each of them uses different substances.

A nail plate that is infected with a fungus and has lost its functionality as a result cannot be extended. During prosthetics, special mixtures with plasticizers are used, which make it possible to create both a durable and plastic nail. In addition, these components have an antifungal effect, which facilitates treatment of fungus after the update. It is worth noting that the technique for carrying out these two procedures is also different.

As you know, human feet are the part of the body that carries a large number of pathogens. That is why during prosthetics, specialists use exclusively disposable devices (spatulas, etc.). This helps prevent fungus or pathogenic bacteria from spreading.

Causes of ingrowth - why does it happen

Most often, an ingrown toenail (synonymous with onychocryptosis) is the result of a combination of several causes.

• Trauma - can be caused by a pedicure (even an unsuccessful tearing off of a small hangnail can cause swelling of the roller, and this will provoke an ingrowth), direct trauma (blow, bruise).
• Wearing tight, uncomfortable shoes, especially with a narrow “toe” and high heels.
• A large (congenital) periungual ridge is one of the serious causes, which, despite numerous operations, can cause repeated ingrowths (relapses). Plastic surgery of the periungual fold helps solve the problem - it will be described below.
• Flat feet - when the first toe deviates outward, there is excess pressure on the cushion from the side of the second toe.
• Pregnancy and the postpartum period - according to statistics, the likelihood of ingrowth increases during this time, apparently, this is due to a temporary change in posture and foot settings.
• Fungal infections of the nails deform the nail and increase the risk of disease.

The direct cause of an ingrown toenail can be either one of the predisposing factors or a combination of them.

Is it possible to speed up nail recovery after removal?

In order for the nail plate to recover as quickly as possible, it is necessary to ensure blood flow to the damaged area. As a rule, complete renewal occurs in 3-4 months, and the nail on the working hand grows much faster. If an operation was performed to remove the entire nail plate, the process will take much longer.

The main rule that should be followed is to follow all the doctor’s instructions and not to overload the sore leg or arm. In addition, bathhouses and saunas are prohibited for some time. To restore the nail, both traditional medicine and cosmetic products are used.

If we talk about the latter, many of them have contraindications and side effects. As for traditional medicine, it is absolutely safe, but the result of its use will have to wait quite a long time. Which method to choose to restore a damaged nail plate should be discussed with your doctor.

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You can purchase cosmetic products both in a store and in a pharmacy. As a rule, they help restore the plate within two weeks. The IBX series of preparations and the “Smart Enamel” varnish, which contains vitamin A and some fruit acids, are very popular. It can be used both to activate the growth of a new nail plate and for prevention.

The drugs included in the IBX series restore the nail, penetrating into the deeper layers, as a result of which the plate grows faster and becomes more durable. However, it must be remembered that for each patient the remedy is selected separately together with the attending physician.

No less popular are folk recipes that have virtually no side effects. In addition, the components for them are inexpensive, but are considered very effective.

Good remedies are masks, rubs and baths:

• Using sea salt.

Sea salt has a positive effect on the nail plates, so you can take a bath with it. It is enough to add 1 tsp. in a glass of water and immerse your toes or hands in the solution for 15 minutes. This procedure must be done every other day for two weeks. However, you should not increase the time, otherwise you may dry out your nails.

• With added oils.

In order for recovery to occur faster, you can rub a few drops of oil (sea buckthorn, olive or peach) into the skin around the nail plates every day. You can also add it to hand cream and treat your hands or feet with it, especially in those places that require it most. Rub it in thoroughly until completely absorbed. The benefits of this product will be considerable if you use it for care every day.

• Oil baths.

Take vegetable oil (one glass), heat it in a water bath and add castor oil (a few drops). Dip your toenails or fingernails into the resulting mixture and wait a little. This procedure is quite effective.

• With the addition of lemon juice.

Another good remedy is lemon baths once a week, but only if you are not allergic to citrus fruits. To prepare, you need to take boiled water (one glass) and add fruit juice. The fingers of the lower or upper extremities are dipped into this solution for 25 minutes. You cannot wash off the product immediately after the procedure; you need to wait until your hands or feet are air-dried, and only then rinse them with warm water.

• Potato masks.

It is enough to take one boiled vegetable, peel it and put it through a blender. Spread the resulting warm paste over the nails, cover with plastic and wrap in a towel. The duration of the procedure is as long as the potatoes cool down. After the paste has become cold, the mask can be washed off and a rich cream applied to the nail plates. It is recommended to do this procedure twice a week.

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• Masks with vitamins.

To restore a nail after prosthetics, you need to buy vitamins A and E in capsules at the pharmacy and make masks based on them. Take one piece of each and add to them vegetable oil (1 tsp), water (1 tsp) and lemon juice (six drops). Mix everything thoroughly, apply to the nail plates of the upper or lower extremities for 20 minutes, then rinse with warm water.

• Gelatin mask.

Gelatin contains a large amount of keratin, so it is an excellent remedy for restoring damaged nails. In order to prepare the mask, you need to take one glass of warm water and add gelatin (1 tbsp.). Then fingers greased with rich cream should be dipped into the resulting mass for 20 minutes.

The main thing is to remember that any product has contraindications, so before using it, you need to make sure that they are absent. In addition, it is necessary to check for allergies to the components contained in the mask. If you have neither one nor the other, then using traditional methods just twice a week, you can achieve very significant results.

In order for nail restoration to occur much faster, you should follow the advice given by leading dermatologists:

1. You need to follow a proper diet, because this is the key to the rapid recovery of nails affected by fungus. Regeneration occurs due to the presence of vitamins and microelements in the products, which ensure rapid growth of the plates.
2. The menu must contain products containing vitamins A and B, which are found in carrots, brewer's yeast, eggs, liver and butter. No less important are vitamins C (gooseberries, bell peppers, citrus fruits, currants) and E (greens and olive oil). If they all enter the body in sufficient quantities, the regeneration process accelerates, blood circulation improves, nails are saturated with oxygen, which means they grow faster.
3. Be sure to include apples, bananas, fermented milk products, buckwheat and goat milk in your diet. They will help make the plates stronger and provide a basis for nail formation.
4. Contact with aggressive substances must be avoided, which means that cleaning agents and detergents should only be used with gloves.
5. Constantly apply oils (olive, peach, grape) to moisturize the plate and the skin located around it.

Symptoms

Diagnosing an ingrown toenail is usually not difficult. The main symptom is pain in the area of ​​the periungual fold, first with pressure, and then at rest. Swelling and redness quickly develop. Pus soon begins to appear between the roller and the nail. Redness increases, and with the use of various remedies it may temporarily decrease, but almost always the process becomes chronic and can last for months. Chronicity of the disease is characterized by the appearance of hypergranulations (“wild meat”). In very rare and advanced cases, inflammation can spread to the phalanx bone - osteomyelitis.

There are usually no changes in the patient's general condition. In a blood test, there may be a slight increase in the number of leukocytes during acute inflammation and an increase in ESR. With prolonged ingrowth, it is necessary to perform an x-ray of the finger to exclude involvement of the phalanx bone in the process - osteomyelitis.

Treatment of nail fungus with innovative PinPointe laser

The Podology Clinic uses the latest nail treatment method using the PinPointe FootLaser micropulse laser. The treatment is quick, painless and guarantees complete elimination of the fungus. But most importantly, laser therapy allows you to do without removing the nail plate!

During the treatment, laser pulses delivered by beams heat the nail to 79° and destroy the causative agent of the disease after the first procedure. Pulse modulation ensures uniform heating of the treated area and prevents burns to the tissues of the nail fold.

Important! Failure to follow recommendations and deviation from the treatment plan will not only not bring the desired result, but can also lead to progression of the disease.

If you are faced with a fungal infection, do not despair and hide your nails from prying eyes in closed shoes. Podology Clinic specialists will help you find a safe and effective solution to your problem and return your feet to a healthy and well-groomed appearance!

Video review of the PinPointe FootLaser laser and interview with Dmitry Zakharchenko (CEO) on the latest device for treating onychomycosis:

Treatment methods

Treatment of an ingrown toenail is carried out using different methods. The main and most reliable method is surgery. Thumb surgery is performed on an outpatient basis and does not require hospitalization. There are several modifications of operations, incl. using radio waves and lasers. The doctor decides which operation to perform on a given patient, depending on the specific situation.

Anesthesia for operations on ingrown toenails is always conductive - a small amount of anesthetic is injected into the base of the finger on both sides under the skin, after which you need to wait 5 - 10 minutes, and the finger will be completely anesthetized. With this type of anesthesia, the operation is completely painless in 100% of cases.

Let's consider the main types of operations. They all solve the problem of how to remove an ingrown toenail.

Regional resection of the nail plate using radio waves or lasers.

This method is the most common, low-traumatic and reliable; it involves removing the ingrown edge of the nail (1–2 mm), treating a fragment of the growth zone with a radio wave or laser, and removing purulent tissue along the edge of the periungual fold. It should be noted that there is no fundamental difference between radio wave and laser exposure; both of these devices ensure reliable destruction of the desired fragment of the growth zone with minimal damage to neighboring tissues.

What not to do

Inadequate treatment of onychomycosis is one of the key reasons for the spread of the fungus and purulent complications. When removing nails you should not:

• interrupt therapy at the first signs of improvement;
• try to remove the entire nail along with the growth zone;
• completely replace pharmaceutical drugs with folk remedies;
• steam your feet in hot water with obvious signs of purulent inflammation of the skin;
• treat the affected areas with warming ointments;
• independently trim the deformed edges of the plates immersed in the skin.

With the hyperkeratotic form of onychomycosis, the horny covering on the fingers is severely deformed, which leads to painful sensations. To alleviate the condition, many patients trim the corners of the free edge of the nail. But such actions in 75% of cases lead to onychocryptosis - ingrowth of the lateral edge of the plate into the nail fold.

Marginal resection of the nail plate with plastic surgery of the periungual fold according to Schmieden

The method is clearly indicated for patients with excess periungual ridge. If you leave such a roller, then in all other types of operations it will still be the cause of relapse. A relative indication is multiple relapses after other interventions.

Surgery technique: a conventional marginal resection is performed using radio waves or a laser, which is supplemented by a wedge-shaped excision of the periungual fold with closure of the defect with sutures. The sutures are removed on days 7–8, after which recovery begins. Relapses after Schmiden's surgery are extremely rare.

Use of traditional medications

In traditional medicine, to remove nails damaged by fungus, special ointments, gels and other preparations are used that are aimed at softening infectious tissues and then cleansing them. In addition, some drugs can not only remove the nail, but are also considered an excellent preventive measure against fungal diseases that are transmitted due to non-compliance with hygiene standards.

If you choose drug treatment, you must remember that self-medication can cause complications. That is why, before you begin to remove damaged nails yourself, you should consult with a specialist.

Self-treatment at home and folk remedies

Such treatment is permissible only in the very initial manifestations of ingrowth, when there is only slight pain and swelling of the cushion. When suppuration occurs, and even more so when “wild meat” appears, treatment at home is ineffective; it may bring temporary relief, but all symptoms will soon return. In these cases, surgery is needed.

Among the “home” methods, we can recommend semi-alcohol dressings with Levomekol ointment. A strip of levomekol ointment is applied to the area of ​​inflammation, after which the finger is wrapped in a gauze cloth soaked in vodka and secured with a regular bandage. The time to wear the bandage is until it dries completely. Can be applied twice a day - morning and night. If the symptoms do not disappear within 2-3 days, you need to consult a doctor who will determine how to properly treat this condition.

You should be warned against using methods such as the use of aloe and celandine. These drugs, like many similar ones, can cause severe local irritation of tissues, and thereby cause the progression of inflammation. In addition, an allergic reaction is possible. Vishnevsky ointment creates favorable conditions for the development of microflora, therefore it is also not recommended for use.

Practice shows that most often, after prolonged use of various “home” and “folk” methods, patients still end up undergoing surgery, but in a more “advanced” state.

How to care for your nails after prosthetics

1. The prosthesis can last about one to three months. The plate can grow back up to one year if the damage to the infected area is strong enough.
2. Since the attachment is carried out to the remainder of the natural nail, a place is formed between the artificial material and the bed where fungus can form and bacteria can multiply. That is why it is necessary to carry out regular treatment with sprays with an antifungal effect (Triclosan, Clotrimazole, tea tree oil).
3. It is worth avoiding frequent wearing of narrow shoes, otherwise compression of the prosthesis may occur and, as a result, injury and deformation of the bed.
4. Every day you should massage the base of the nail. Manipulation is necessary in order to improve blood circulation at the site of injury. To do this, apply cream, rub and massage each finger, more precisely, the base of the nail, focusing on the injured one. If required, a similar procedure should be done with the lower limbs.
5. We must try to exclude situations where there is moisture between the prosthesis and the natural plate for a long time.
6. Prosthetics should only be performed by a specialist.
7. If the artificial nail is too long, it can lead to problems with the development of the natural plate, namely onychodystrophy.
8. You should definitely consult a qualified specialist first.

Conservative treatment methods

They are mainly used for uncomplicated ingrown toenails, when there is no pronounced suppuration or persistent invasion of the nail plate into the tissue of the periungual fold. There are many known methods of conservative treatment - tamponade, application of corrective devices (plastic, metal, glued to the nail, in the form of one- and two-sided staples, etc.). In many cases, treatment with all these methods is quite effective. There are also disadvantages. The main ones include the following:

• Duration of treatment – ​​correction of a nail with staples takes weeks and sometimes months, but the result is not 100% guaranteed, and it is possible that in the end you will still need surgery to remove the ingrown nail.
• High price. The corrective devices themselves are not very expensive, but they need to be constantly monitored, which requires repeated visits to a specialist, and, in total, is not cheap.
• The presence and visibility of a brace on the leg (and it needs to be worn for quite a long time and can only be removed at the end of the course of treatment).
• A good effect can be achieved only if the treatment is carried out by an experienced podologist; there are few such specialists, although many undertake to treat with these methods, often without proper knowledge of the technique.

Preparing for removal

There are several ways to remove horny plates affected by the fungus. To make the procedure less painful, they undergo a preliminary preparation stage:

• Steaming. The first step is to steam your foot in a hot bath. To do this, use a chamomile decoction or a solution of laundry soap and baking soda. The procedure is performed for at least 25-30 minutes.
• Removing the top layer. The softened parts are cleaned off with nail scissors, a nail file or a scraper for better penetration of pharmaceutical products into the lesions.
• Skin protection. Most drugs for removing horny plates contain aggressive additives. Therefore, before applying them, the periungual fold is covered with an adhesive plaster.

After preparation, softening agents are applied to nails with fungus.

Prevention methods

To prevent ingrown toenails, you need to follow several rules, which in most cases help to avoid problems.

Firstly, you need to wear comfortable shoes not with narrow toes, the heel should be no more than 4 cm high.

Secondly, it is necessary to trim the nail correctly - the edge of the nail must “come out” of the roller, and only then can it be rounded. Thus, the pressure on the roller will be not from the “angle”, but from the “plane”, which will reduce the likelihood of ingrowth.

Thirdly, if you have flat feet, you need to wear special orthopedic insoles.

Fourthly, if you have nail fungus, it needs to be treated by a dermatologist or mycologist.

The need for prosthetic nails on the hand or foot

Prosthetics are necessary in the following cases:

• The plate was destroyed due to fungus.
• In case of delamination.
• If, due to injury, nail growth and development stop or are disrupted.
• In the presence of congenital defects (plate in the form of a spoon).
• After nail surgery.
• During ingrowth.
• In case of longitudinal or transverse splitting of the plate.
• In order to create additional space for ingrown nails.
• In case of growth disturbance.

Since fixation of artificial material on the skin is impossible, high-quality prosthetics require that at least a third of the natural plate be preserved. If the nail is completely absent or its size is smaller than necessary, the prosthesis will be unstable, and there is a high probability of damage to the nail in the matrix area.

Before prescribing prosthetics to a patient, the specialist must find out what factors predispose him to this procedure. In addition, he clarifies the presence of contraindications, which include:

• pathologies leading to damage to the nail plate;
• presence of wounds;
• psoriasis;
• diabetes;
• inflammatory process in the ridges located near the plate.

The podologist must first study the characteristics of the patient’s body, take into account the initial circumstances and, based on this, select a more effective and aesthetic way to solve the problem with an ingrown toenail.

Where to delete?

To solve the problem, you need to contact a surgeon. Only this specialist can get rid of an ingrown toenail. When choosing a specialist, you need to be guided by his experience and work experience. It will be useful to read reviews about it from other patients (they can always be found on the Internet). A large number of negative reviews, as well as the lack of reviews, should alert you. The clinic where the doctor works must have the necessary equipment for radio wave or laser removal. The doctor must have sufficient experience working with these devices, because with insufficient exposure to radio waves or lasers, a relapse may occur, and with excessive exposure, damage to adjacent areas of the growth zone may occur, which will cause permanent deformation of the entire nail. The surgeon must also be able to perform plastic surgery of the periungual fold in order to apply this method if there are appropriate indications.

Dr. Elshansky Igor Vitalievich has worked as a surgeon since 1993, candidate of medical sciences, has been treating ingrown toenails for more than 20 years, knows all treatment methods and modifications of operations. The clinic has a radio wave device; there are all conditions for diagnosing and treating ingrown toenails at any stage of the disease.

All our videos on ingrown toenails - https://www.youtube.com/playlist?list=PLP8p3HIB4FTJprjiZKvJ6e_oY2pcnHL6u

Therapeutic pedicure technique

From the outside, a regular hygienic and therapeutic pedicure look the same, but they have significant differences. Not everyone knows what nail cleaning means and why it helps get rid of fungus. This is a deeper cleansing and disinfection of nails. A standard pedicure procedure consists of the following steps:

• Examination of the feet and nails, diagnosis and external identification of defects, assessment of the condition of the skin and nail plates;
• Treatment of skin with antibacterial agents;
• Applying softening oil to cuticles and feet;
• Treating all feet with a softening solution;
• The use of various files and medical devices with attachments to eliminate dead, fungus-affected, rough areas of skin and nails;
• Removing corns that cause discomfort;
• Scrubbing to remove remaining dead skin, peeling feet and nails;
• Application to the affected areas of special antifungal agents recommended by a dermatologist for this type of fungus;
• Performing a light massage to relax, improve microcirculation, and relieve heaviness in the legs.

After the procedure, the master will tell you how to care for your nails and feet at home, and what needs to be done to effectively fight the fungus. It is worth remembering that comprehensive measures are required to defeat a fungal disease. A doctor must prescribe medications and treatment. Cleaning your nails before treating fungus is more of a preparatory procedure.

Care after removal

After removing a nail, the risk of recurrence and bacterial infection increases. To prevent the disease from returning, it is necessary to follow simple rules for wound care and prevention.

• Treat the wound with an antiseptic 3-4 times a day and apply antibacterial ointment.
• Until complete healing, wear a bandage or cover the wound with a plaster.
• Minimize the load on the finger, avoid tight shoes.
• Avoid visiting public baths, swimming pools, and showers.
• Avoid overheating and hypothermia.
• Follow the principles of a healthy, balanced diet.
• To refuse from bad habits.

If your body temperature rises or additional unpleasant symptoms appear, you should immediately seek help from a hospital. Such phenomena indicate the onset of an abscess. Inaction in such situations is fraught with the development of gangrenous processes, which often lead to the need for emergency amputation of the finger.

Hardware and surgical removal methods

To remove a nail affected by a fungus, especially in advanced cases, surgery, the use of a laser or a special pedicure device can be performed.

Operation

The intervention is carried out either in an outpatient clinic or in a hospital. Local anesthesia is used first. The algorithm is as follows:

• using a scalpel, separate the nail from the bed;
• the plate is completely removed;
• the wound is treated with antibiotics and other agents to prevent infection.

After this, the patient is sent home.

Important!

Surgical nail removal may be contraindicated. We are talking about a violation of the permeability of blood vessels in the lower extremities, as well as a low rate of healing of the integument.

Hardware pedicure

A hardware pedicure allows you to remove a toenail. For this purpose, a milling cutter with rotating elements and replaceable abrasive attachments is used. Hardware pedicure is also performed by a doctor, not a pedicurist.

The advantage of the method is that it saves time, because the plate is cut down literally in one go. Compared to, for example, a surgical procedure, this is a more gentle method of removing a nail. Bleeding is eliminated, and since there are no open wounds, recovery is much faster. There are no pains or other unpleasant sensations.

Laser nail removal technique

Laser removal

Another safe way. It allows you to quickly remove a nail affected by fungus. The laser is set to the desired temperature, then the problematic surface is completely or partially removed. The advantage of the technique is the complete removal of the fungus and its spores on the nail plate.

Advantages of the laser procedure:

• excellent result because the mycosis pathogen is 100% destroyed;
• maximum gentle impact on the problem;
• intact (normal, healthy) skin is not affected.

At the same time, the likelihood of mycosis recurrence is negligible.