Ingrown nail– a disease in which the edge of the nail plate grows into the periungual fold.

Facts about ingrown toenails:

• A very common disease that surgeons encounter quite often.
• Most often found on the big toe.
• Typically, the outer edge of the nail grows in.
• An ingrown toenail is often complicated by infection.
• The disease can develop in both adults (about 60% of patients) and children (about 40%).
• Men and women suffer from the disease approximately equally often.

Features of the anatomy of the finger and nail

Nails are derivatives of the skin, just like hair. They cover the terminal phalanges of the fingers and toes and perform a number of functions:

• protection of the sensitive pads of the terminal phalanges;
• participation in grasping small objects;
• nails help the fingers to rest and better touch different objects;
• using nails a person can scratch the skin and relieve the itching sensation;
• You can pick up various objects with your fingernail;
• aesthetic functions: thanks to nails, fingers have a familiar appearance; beautiful, well-groomed nails are one of the important elements of a person’s appearance.

The parts that make up a nail:

• Nail plate. The visible part of the nail. It is a plate of keratinized cells. It has no nerve endings or capillaries. Normally it is pink. When cooling, as well as in cases of disorders of the cardiovascular system, the nail plate may turn pale or acquire a bluish tint.
• Nail bed. This is the surface of the terminal phalanx of the finger on which the nail plate lies. They are connected to each other throughout, except for the free edge of the nail plate.
• Nail root. It is a part of the nail plate that is covered with skin. This is the “living” part of the nail - here are the cells, due to the division of which the nail grows.
• Crescent or "moon". The part of the nail root that is visible from under the skin. Has a whitish color. It is best visible on the thumbs and is practically invisible on the little fingers.
• Cuticle or skin. A thin layer of skin that covers part of the root of the nail. Normally it is soft and small in size. But it can harden and grow on the nail, in which case it spoils the appearance, and burrs can form on it.
• Nail folds. They are pads of leather that limit the nail at the back and sides. It is into them that the side part of the nail grows.

How does a nail grow?

Nail growth occurs due to the proliferation of cells that are located in its root (matrix). Gradually, moving forward, they become keratinized, become dense, and are pressed. Normal nail growth is highly dependent on the condition of the root and nail bed.

Nails on the hands grow faster than on the feet, on the right – faster than on the left. Typically, nail growth accelerates in summer and slows down in winter. Pregnant women's nails grow faster.

It usually takes 3 to 5 months for a nail to grow completely.

The main causes of ingrown toenails

What does an ingrown toenail look like?

At the beginning of the disease, the periungual fold appears swollen and has redness. Sometimes, with severe deformation, it is clearly noticeable how the nail bends.

Over time, as a result of constant trauma, an ulcer appears on the periungual fold.

Infection quickly penetrates damaged skin. The periungual fold swells even more and acquires a bluish or purple tint. Pus is released from it:

In response to infection, the tissues of the periungual fold begin to grow excessively - granulations are formed. These growths resemble raw meat in appearance, which is why they are often called “wild meat.”

An ingrown toenail can also be double-sided.

Symptoms of an ingrown toenail

The main symptom of an ingrown toenail is pain. It bothers you constantly and intensifies significantly while walking, especially if you are wearing tight shoes. Painful sensations are caused by the fact that the skin of the fingers contains a large number of nerve endings.

Why is an ingrown toenail dangerous?

The constant pain that accompanies an ingrown toenail is a rather unpleasant symptom in itself. It prevents you from sleeping or working normally and reduces your quality of life. But more serious complications may develop:

• abscess(ulcer) of a finger;
• osteomyelitis– purulent inflammation of the bone (final phalanx, with possible transition to the joint and above);
• gangrene– necrosis of finger tissue.

People suffering from diabetes mellitus, obliterating endarteritis, atherosclerosis of the vessels of the lower extremities, varicose veins, and impaired immunity are especially at risk. In them, the infection can spread to the foot and lower leg - phlegmon develops. This can result in gangrene and amputation.

Diagnosis of an ingrown toenail

Which doctor should I contact?

Treatment of ingrown toenails is carried out by a surgeon (in children - a pediatric surgeon) and a podiatrist (a specialist in the field of foot diseases). If you discover symptoms, you need to go to a clinic where such a specialist will see you as soon as possible.

Do I need to get tested?

The doctor may prescribe a general blood test to assess the severity of the inflammatory process in the body. Diabetics are prescribed a blood sugar test.

In what cases is radiography needed?

• If there is a suspicion of osteomyelitis.
• If the doctor doubts the diagnosis. For example, there is a disease whose symptoms are very similar to those of an ingrown nail - osteophyte (bone growth on the phalanx of the finger).

Treatment of ingrown toenails

Treatment of ingrown toenails without surgery

Foot baths

Foot baths as a conservative method of treating ingrown toenails can only be used in the initial stages, when there is no suppuration and granulation growth. You can make baths with the following solutions:

• Saline solution. Take a small amount of table salt and dilute it in warm water in a basin. Do foot baths 2 times a day - morning and evening. This helps soften the nail plate and correct its deformations.
• Soda solution. Dissolve a small amount of baking soda in warm water in a bowl. Do foot baths once a day, in addition to salt baths. This helps relieve inflammation and prevent the development of infection.
• Solution of potassium permanganate (potassium permanganate). Take a little potassium permanganate and dilute it in a basin in warm water so that you get a weak pink solution. Do foot baths once a day, in addition to salt baths. A solution of potassium permanganate, just like a solution of soda, helps relieve inflammation and prevent infection from entering the nail fold.

Ointments for ingrown toenails

Name of ointment	Action	Mode of application*
Nailnorm	Balm that is applied to nails and periungual ridges. Compound: St. John's wort horophyte; maclea extract; licorice extract; petrolatum; Palm oil. Effects: relieves pain and inflammation; softens the nail plate and prevents it from injuring the periungual folds; promotes proper growth of the nail plate.	Before using the Nogtinorm balm, you need to steam your feet so that the corners of the ingrown toenail come out from under the nail folds. After this, apply the balm to the nail plate and periungual ridges. Repeat the procedure 1-2 times a day.
Uroderm	An ointment whose active ingredient is urea (urea). Effect: as a result of the action of urea, the nail becomes more flexible and easier to trim.	The ointment begins to be applied 3-4 days before cutting the nails. In the morning and evening, after taking a shower, you need to wipe your fingers dry with a towel. Then take a small amount of ointment, about the size of a grain of rice, and using a special spatula, tuck it between the edge of the nail plate and the periungual fold. After this, do not wear socks, slippers or shoes for some time, so as not to rub off the ointment.
Vishnevsky ointment	Vishnevsky ointment is used for inflammation of the periungual fold. Composition and effects: xeroform powder – is an antiseptic, destroys pathogenic microorganisms; birch tar – improves blood circulation in small vessels and tissue nutrition; castor oil - helps medicinal substances penetrate deeper into the skin.	Apply the ointment to the inflamed periungual fold at night and apply a bandage. In the morning, remove the bandage. If the corner of the ingrown nail comes out from under the roller, you can try to cut it off.
Ichthyol ointment	Compound: Ichthammol is a substance obtained during the dry distillation of bituminous shale; petrolatum. Effects: reduction of pain; slight skin irritation, which improves blood flow and regeneration; reduction of inflammation; destruction of pathogenic microorganisms; softening of the nail plate.	For ingrown toenails, ichthyol ointment is used similarly to Vishnevsky ointment. It is necessary to apply a small amount of ointment to the nail fold at night and apply a bandage. In the morning, remove the bandage and try to cut off the corner of the nail.
Levomekol	Typically, levomekol ointment is used after surgery for an ingrown toenail, complicated by suppuration. Compound: chloramphenicol (chloramphenicol) – an antibiotic that destroys pathogens; Methyluracil is a substance that improves tissue regeneration.	After surgery for a suppurating ingrown toenail, a bandage with levomekol ointment is applied. It is changed until the wound is completely cleansed and healing begins.

*Information about all drugs is presented for informational purposes. If you have symptoms of the disease, consult a doctor. Improper self-medication can lead to negative consequences.

Correcting nail growth using various devices

Previously used methods:

Today, more modern devices have appeared - various metal springs, brackets, plates. Their edges cling to the edges of the nail plate. Due to their rigidity and special shape, these devices press on the central part of the nail and lift its edges.

There are many such devices. The most common of them:

Surgical methods for treating ingrown toenails

Surgeries for ingrown toenails are usually performed under local anesthesia. The operation can be performed on an outpatient basis in a clinic.

Surgical options for correcting ingrown toenails:

Mandatory indications for surgical intervention for an ingrown toenail are conditions such as suppuration and the growth of granulations.

Prevention of ingrown toenails

What needs to be done?

What should you avoid?

Choose the right shoes. Choose spacious shoes with wide toes that allow your toes to move freely. Wash your feet daily with warm water, maintain good hygiene, and change your socks and stockings regularly. Trim your nails correctly, do not round their edges too much, leave corners. Treat flat feet in a timely manner (wear orthopedic insoles) and other orthopedic diseases. Treat fungal foot infections in a timely manner - when the first signs appear, you should immediately visit a dermatologist. When the first symptoms of an ingrown toenail appear, immediately contact a surgeon. In the early stages, you can do without surgery.

Wear narrow shoes, especially those with pointed toes. Trim the corners and round the edge of the nail too much when trimming.

An ingrown toenail is a type of change in which the outer or inner edge of the nail plate on one toe begins to grow into the nail fold area. An ingrown toenail is quite common and can occur at any age, affecting both children and adults.

general description

There is also a medical term for an ingrown toenail - onychocryptosis or incarnation of the nail. Ingrown toenails generally affect the outer side of the nail bed on the big toe. During this pathological process, the affected nail fold becomes swollen and red; inflammation becomes a factor accompanying these changes, against the background of which, in turn, severe pain develops. Subsequently, the inflammatory process can become chronic. The lack of necessary treatment causes the possibility of recurrence of the process.

The problem associated with ingrown toenails occurs due to excessive pressure on the soft tissue surrounding the nail plate. Such pressure can be determined, for example, genetically, by an abnormal shape of the nail on this basis, as well as by the presence of a predisposition to pathological ingrowth due to the influence of the same cause.

A change in the shape of the nail during subsequent ingrowth can be caused by improper trimming of the nails when cutting off the corners. Also, as the reader can assume from the description of the main reason that provokes ingrown nails (compression), it can develop due to wearing excessively tight shoes. In this case, it contributes to compression of the nail from the sides and from above, due to which nail growth is directed into the depth of the periungual ridges, which causes subsequent ingrowth. It is for this reason that the problem of ingrown toenails is often relevant for teenagers and young people who follow fashion, which is why they wear beautiful, but not always comfortable shoes. This especially applies to shoes that are too narrow and shoes with “pointy toes.”

Fungal infections are also considered among the reasons contributing to the development of the pathological growth of the nail, in particular we are talking about damage to the nail plate and its accompanying thickening, which causes such growth. Similarly, the problem we are considering can be caused by injury to the nail plate, as well as foot disorders that develop against the background of clubfoot and flat feet.

Ingrown toenail: symptoms

The main symptom of an ingrown toenail is constant pain noted on the side of the nail fold, which intensifies when wearing shoes, with pressure and when walking. A visual examination allows you to detect an ulcer at the initial stage of the disease - it is small in size and located in the place where the nail fold is most susceptible to injury.

Subsequently, rapid proliferation of granulations occurs, that is, excessive tissue growth occurring on the side of the wound surface of the nail fold. This proliferation is a response to the effects of infection and the processes accompanying the resulting injury. The growth of granulations resembles raw meat, which is why they are usually defined as the corresponding term - “wild meat”. It is with the appearance of wild meat, which can also be accompanied by the appearance of purulent discharge, that we can say that the pathological process has become a chronic form of its own course. At the same time, another type of complaint arises; it concerns significant difficulty in walking.

Returning to the features relevant to such a phenomenon as an ingrown toenail, we note that it is a misconception that only the big toe is affected. This is not true, an ingrown nail can form on any of the fingers, moreover, the ingrowth can even be bilateral. The initial stage of development of the disease is not accompanied by the appearance of fluid or purulent discharge; heat is also not felt when touching the finger at this stage. Later, from the side of the acute angle, skin and additional tissue begin to grow, and, in fact, a yellowish liquid is released; this course of the process indicates the formation of the body’s reaction in response to injury to the nail that irritates the skin. If an infection is added to the pathological process, then the swelling manifests itself in a more pronounced form, this is also accompanied by the release of fluid (white or yellowish), the volume of such secretions increases. The skin surrounded by redness may become pale, and the picture of the pathological process may be accompanied by fever.

Thus, even a disease as harmless at first glance as an ingrown toenail, the symptoms of which in the initial stages may not cause much concern, requires consulting a doctor. In particular, this is necessary when an infection occurs with accompanying fat, the appearance of fluid, pallor of the skin in the area surrounding the redness, increased pain or swelling.

Diagnosis

Based on the changes that the patient can determine independently, it can be understood that it is a specific problem that is relevant - that is, the problem of an ingrown toenail. When visiting a doctor (which, as practice shows, is often done already at the stage of chronicity of the pathological process or at the stage of complications), special diagnostic methods are not used. In particular, you will need to donate blood (general analysis), on the basis of which it will be possible to assess the degree of the current inflammatory process; in addition, this analysis will allow, based on the sugar level, to determine whether the patient has developed diabetes mellitus.

If the process in its progression has reached the stage of development of complications, then radiography may be prescribed for the area of ​​​​the bones of the foot. This measure is necessary, again, for a more detailed study of the characteristics of the course of the disease, because the possibility of a purulent process moving to the bone cannot be ruled out.

If there is a suspicion of a purulent infection, then treatment in a slightly different direction (dermatology) may be required. It is important to understand that if the cause that provoked the development of the disease is not eliminated, then it is pointless to try to eliminate the consequences, one of which is considered to be an ingrown toenail.

Treatment

If complications of an ingrown toenail have not developed in the patient, then treatment is carried out on an outpatient basis. The initial stages of the pathological process, with mild infection and granulation, require conservative treatment. For other cases, with a more progressive form of the process, conservative treatment of an ingrown toenail can act as a preparatory stage of treatment, that is, as therapy preceding further surgical intervention. Also, in any case, it is important to ensure that any type of impact on the nail plate is limited, which is ensured by wearing appropriate shoes (the ideal solution is to walk barefoot if possible). Additionally, you should avoid cutting the nail on the affected finger to such short borders, which usually causes ingrown nails.

Ingrown toenail: principles of conservative treatment

The initial stages determine the possibility of effective treatment of the ingrown toenail and the area affected by it. One of the main directions of influence in this case is the method of warm baths, which provides a direct effect on the feet. These or other types of antiseptics are added to such baths, for example, herbal decoctions (St. John's wort, chamomile), furatsilin, potassium permanganate, etc. If the area where the ingrown nail begins to fester, then after taking baths, bandages with the addition of antibacterial ointments must be applied. If fungal infections are treated, then a special type of drug is used that is intended specifically for this purpose; the main options include Nizoral, Kanizon, Lamisil, etc.

Some time ago, in influencing the affected area, X-ray film in the form of strips was used, placed between the area of ​​​​the skin fold and the nail. With its help, the factor of mechanical impact itself, which causes injury, was eliminated, and the extension of the nail plate that had undergone deformation was gradually ensured. Today, a number of different devices are used that provide a similar effect. These are various brackets, plates, springs, etc. Due to their compact size, any negative impact, for example, associated with wearing shoes, is excluded. Due to the elevation of the edge of the nail, which they provide, it is possible to reduce the pressure they exert on the area of ​​the nail fold, which occurs while simultaneously correcting the shape of the nail and reducing pain. In particular, Fraser clamp, ZTO, B/S plates or half clamps can be used.

Even if conservative therapy does not provide the required effect, and also if the pathological granulations we discussed above appear with the accompanying appearance of purulent discharge, surgical intervention to eliminate the problem of an ingrown nail is considered necessary.

Ingrown toenail: operation (surgical treatment)

Generally, surgery occurs on an outpatient basis, with local anesthesia. There are a number of ways in which the problem in question can be solved through surgery, including surgical excision, the radio wave method, and the laser method. Quite often, a separate part of the nail is removed; this is a resection method. Meanwhile, partial removal does not lead to subsequent relief from the problem - in the vast majority of cases, re-ingrowing of the nail occurs. For this reason, along with part of the nail plate, the corresponding part of the growth area of ​​the nail is removed. Due to this, the newly growing nail turns out to be narrower than the previously growing nail.

If the nail has undergone significant changes due to a pathological process, as well as in case of fungal infection (again, in a severe form), complete removal of the nail plate may be prescribed. Even more severe cases of re-ingrowing nails require not only removal of the nail plate itself, but also the entire area from which the nail grows. The defect that appears as a result of such an intervention is hidden by autodermoplasty with replacement of the area with a skin flap. The nail on this finger will no longer grow at all.

Ingrown toenail: complications

In order to understand how serious the problem we are considering can become, it is necessary to note the complications of an ingrown toenail that develop against the background of negligence regarding the treatment of this pathology. Most often, they develop already when the process becomes chronic; in particular, the development of complications is facilitated by factors relevant to the patient, such as vascular atherosclerosis in the lower extremities, as well as diabetes mellitus.

The listed diseases lead to the fact that the blood supply to the finger, or more precisely to its soft tissues, is subject to disruption, which reduces the ability for their subsequent regeneration, as well as resistance to the effects of infections. Thus, we can distinguish the following pathological conditions corresponding to the complicated course of an ingrown nail:

• Lymphadenitis, lymphangitis. The spread of infection occurs through the lymphatic vessels, due to which their inflammation develops, which is defined as lymphangitis. This inflammation spreads to the lymph nodes located in close proximity to it, and these are the inguinal and popliteal lymph nodes. Here the inflammation remains, leading to their increase, as well as to the appearance of pain, which already corresponds to such a pathological condition as lymphadenitis.
• Osteomyelitis of the nail phalanx. This pathological condition involves the passage of a purulent infection to the bone. It is quite difficult to cure; moreover, amputation of the phalanx of the finger can be considered as an outcome for such treatment. Diagnosis of pathology is carried out on the basis of an X-ray examination of the bone area of ​​the affected finger.
• Abscess. In this case, the toe is affected; this pathological condition consists of the development of purulent inflammation in the area of ​​the soft toe tissue. The accompanying manifestations are based on redness and swelling of the skin along the entire phalanx. In this case, the need for surgical intervention is considered as the main treatment.
• Gangrene of the finger. In this case, the toe undergoes irreversible tissue necrosis, that is, their necrosis develops, accompanied by a characteristic blackening of the skin. The only treatment option for the development of gangrene of the toe is either amputation of the nail phalanx area or complete amputation of the toe.

If symptoms indicating an ingrown toenail appear, you should consult a doctor for a long time or see a surgeon.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

An ingrown nail is a chronic disease in which, for various reasons, the growing nail plate penetrates into the soft tissue of the lateral ridges of the finger. There are various methods of conservative and surgical treatment of this disease, but in the initial stages, before complications arise, you can try to treat an ingrown toenail at home.

The first “big” toe is most often affected. The disease occurs in several stages. It leads to discomfort and pain when walking, and subsequently to inflammation of the tissues, their redness, the release of light serous and bloody fluid, and swelling. The affected area may increase significantly in volume. With the subsequent addition of a staphylococcal infection, suppuration and other (often serious) complications occur that require emergency medical care. Complications are especially dangerous for people suffering from circulatory disorders in the lower extremities and diabetes mellitus.

How to treat an ingrown toenail at home

First of all, one of the ways to both prevent and treat the disease is to properly perform a pedicure, especially paying attention to the correct cutting of the nail. It is necessary to cut at the level of the top of the soft tissues of the finger at a right angle to the side edges, slightly rounding or grinding off the edges with a nail file so that there are no sharp corners left. Do not cut the nail plate too short.

If the soft tissues of the side cushion hang over the sharp edge of the nail, but they are not inflamed, it is necessary to carefully, without injuring them, move them away and cut off only the sharp corner of the nail plate. To make caring for an ingrown toenail easier, you can use one of the pharmaceutical products that soften the nail plate:

1. "Nogtinorm" - nail balm. It is applied to the nail and surrounding skin according to the instructions daily 1-2 times a day.
2. "Uroderm" is a water-based ointment containing carbamide (urea). It has a keratolytic effect and slows down the formation of the stratum corneum, which reduces the pressure of the ingrown nail on the tissue. The ointment is applied for 3-4 days before the pedicure.
3. "Nogtimycin" - applied for 3-4 days to the nail only in the area of ​​its ingrowth. Then, after preliminary steaming in a soda solution, its softened section is cut off.
4. "Scholl" is a liquid that should be applied 2 times a day for 1 week.

These products not only make it easier to process the nail plate, but, by softening it, help the edges emerge from under the tissues of the periungual fold during growth.

What does an ingrown toenail look like?

Treatment for inflammation

Treating a toe with an ingrown toenail and wearing shoes is sometimes difficult due to the pain. In these cases, the question arises of how to numb an ingrown toenail. The pain is caused mainly by the resulting inflammatory phenomena, which are accompanied by swelling. Often, with light pressure on the roller, light, slightly bloody or purulent discharge may appear. Therefore, to relieve pain, measures are necessary to reduce swelling and inflammation of tissues, which will also help prevent complications.

At home, for this purpose, thermal procedures in the form of foot baths with antiseptic solutions should be carried out daily. As the latter, you can add a solution of Chlorhexidine to warm water, use lightly colored warm solutions of potassium permanganate, solutions of furatsilin, warm infusions of herbs (chamomile, calendula, peony, celandine, St. John's wort, eucalyptus leaves) at the rate of 1-2 tablespoons of dry herb per 1 liter of water.

After the foot bath, you can try to cut off only the sharp edge of the nail. At night, it is advisable to apply a bandage to the inflamed area with an ointment or emulsion containing antiseptics or antibiotics - Syntomycin emulsion, Levomycetin ointment. To reduce pain, you can also use antiseptic dressings, but they also contain lidocaine (a local anesthetic). The inflamed edges of the rollers hanging over the nail are carefully moved with a stick with cotton wool wrapped around it or a thick swab and a gauze flagellum, previously soaked in an ointment or emulsion composition, is placed under them.

For inflammation and swelling of tissues, Vishnevsky ointment or Levomikol have a good effect (even in the presence of purulent discharge). Ointment or emulsion dressings are applied overnight and then changed in the morning.

All these procedures must be continued until the inflammatory phenomena are completely eliminated.

People often go to medical institutions with the problem of ingrown toenails. This disease is considered a pathological process, which is characterized by the ingrowth of the nail plate into the soft tissue of the lateral fold. Most often it occurs on the thumb. This problem may occur on both legs at the same time.

The whole process is accompanied by severe pain, inflammation and redness. Walking brings discomfort, especially if the shoes are closed.

Reasons for the problem

The main reasons why the nail plate begins to grow on the foot:

• Trimming is done incorrectly. When the corners are strongly rounded when cutting, excellent conditions are created for ingrowth. Also, cutting at the root contributes to problems.
• Shoes that put too much pressure on your toes. This factor often causes such a problem. The nail is strongly pressed into the lateral ridges of the soft tissues and as a result, ingrowth occurs.
• After a finger injury.
• Foot pathologies contribute to the development of such a disease. It could even be flat feet.
• If a person has a pathology of the endocrine system, then it is also possible to develop ingrown nail plates.
• Diseases that are accompanied by impaired blood microcirculation.
• Diabetes.
• Heredity.
• As a consequence of fungal diseases of the feet.
• Anomaly of the nail bed.
• Long-term loads. For example, this could be a favorite sport in which the load is placed on the legs (basketball, football, volleyball, etc.).

Symptoms of the disease

The first signs of the disease are:

• Severe pain in the nail fold on the side where the nail begins to grow. It is permanent and worsens when walking, especially if you wear closed-toed shoes.
• Ulcers appear at the site of ingrowth, which occur as a result of injury.
• The soft tissue of the finger becomes swollen, red, and throbbing pain appears. This means that an infection has occurred. Purulent discharge may also appear.
• If the disease has been troubling for a long time, the result is deformation and thickening of the nail plate. It may also shorten. Coarsening and suppuration of the soft tissue of the finger appears.

Stages of the disease

There are three stages of this disease. They depend on the depth of ingrowth of the nail plate and on the general damage to the finger:

• Stage 1. It is characterized by hyperemia and throbbing pain in the finger precisely in the area where the process itself occurs.
• Stage 2. At this stage, the nail plate, cutting into the soft tissue, forms a wound. In this case, infection occurs with fungal, coccal or other flora, resulting in the formation of suppuration.
• Stage 3. After drainage, the wound begins to become covered with granulation tissue. The inflammation begins to subside and recovery begins. If the ingrowth continues, the disease becomes chronic. In this case, we are not talking about any complete recovery, because relapse occurs very quickly.

If a patient suffers from diabetes mellitus or trophic ulcers, then all stages of ingrown nails occur quite quickly. In such cases, you should seek help immediately after the first symptoms of the disease appear.

Inflammation and suppuration

If the situation gets worse and the finger becomes inflamed and pus begins to ooze, then you can use ointments for treatment. In such cases, Vishnevsky ointment helps very well. It can draw out pus from inflammation, which in turn helps get rid of the infection.

You need to take a bandage or cotton wool, apply ointment to it and apply it to the sore finger. Be sure to record it! These lotions are best done before going to bed at night so that the leg is in a calm state. After removing the bandage in the morning, you need to try to cut off the problematic nail and apply new cotton wool with ointment.

If the sensations are very painful, the purulent discharge increases, then you should definitely consult a doctor for further treatment.

Treatment options

Surgical method

There are times when getting rid of a problem nail will be the best option. Partial or complete removal occurs. If the ingrowth is small, and the situation is accompanied by a fairly pronounced thickening of the nail fold, then some part of the soft tissue or part of the nail plate that has grown in is removed.

After this procedure, inflammation is minimized or disappears altogether. A few months after such surgical intervention, the nail plate grows completely, and its shape takes on the correct appearance.

In cases where purulent discharge appears from under the nail, or the plate is severely deformed, it is necessary to remove it completely. Very often, as a result of such an operation, damage to the growth zone of the nail occurs. This causes the nail plate that grows to be of irregular shape.

Statistics show that in most cases, surgical treatment does not lead to complete recovery. The disease comes back.

Laser method

This method of treatment is considered less painful and gives a better effect. The essence of the laser method: the ingrown part of the nail is removed along with its growth zone. During the removal process, the inflammation that has formed is neutralized using a laser. After performing this procedure, relapse is unlikely, because the removed edge of the nail no longer grows back.

This treatment method should be used when the disease is accompanied by a fungal infection, because the laser can kill all spores. After the procedure, the doctor prescribes various antifungal agents (ointments, tablets).

Conservative method

This method involves installing various devices on the nail plate that help align it. Use a plastic or metal plate, bracket, or spring. They are small in size, so they do not affect your lifestyle in any way. You can wear your usual shoes and play sports. There are also no contraindications for painting your nails with varnish.

This method of treatment involves not only alignment. And simultaneous relief of pain and inflammation on the finger. After all, the pressure on the soft tissue is relieved, and it can calmly recover.

Radio wave method

This method is one of the modern ones and is considered the most effective in treating this disease. It solves the main problem that none of the previous methods can solve - the absence of relapse of the disease.

This procedure is performed using local anesthesia. The process lasts about 5 minutes and does not require hospital stay. An important advantage is also considered that this method can be used at all stages of the disease.

The essence of the method: The growing part of the nail is removed and the growth zone and nail matrix are treated with radio waves. If necessary, tissue growths are also removed. At the end of the procedure itself, an antiseptic bandage is applied to the sore spot.

After treatment, the patient must ensure that the applied dressing is dry. Full recovery occurs after just a week, but it can happen faster. Throughout this period, the bandage can be changed independently or in a medical facility. The change is made 2-4 times.

Traditional methods of treatment

The problem of ingrown toenails often causes the patient to fear medical institutions and pushes them to use traditional methods. But it is important to know that they give results only in the initial stages of the disease. In such cases, folk remedies are used for at least two weeks until the nail grows to the length at which it can be cut off.

There are such traditional methods of treatment:

1. Using lotions with butter. If you apply a cotton swab soaked in butter to your sore finger every day, then after 2-3 days the pain will begin to subside. After all, such a compress helps soften the skin around the nail. It is good to do foot baths before such a dressing, which help to steam the skin. The procedures are carried out for 2 weeks.
2. Baths with the addition of castor oil. It is considered one of the old ways to treat this disease. Take 3 liters of water and add 100 ml of castor oil and a glass of sea salt. Heat the water a little until the salt dissolves. Use these baths for several weeks. With the help of castor oil, deformed nails regain their correct appearance.
3. Use of aloe. It is necessary to take an aloe leaf, the size of which will coincide with the size of the sore finger, divide it in half and pour boiling water over it. Then apply it overnight, securing it with a bandage. You can make puree with aloe, grate it, and also apply it to the nail. With the help of such procedures, the skin softens and infections are also fought.
4. Using onions and honey. Grate the onion and add 1 tbsp. l. honey The mixture is wrapped in a bandage and applied to the sore finger. Before this, it is better to take a steam bath. Apply compresses at night. This method of treatment is good when pus begins to form on the wound.
5. Lemon and vegetable oil. Grate the zest and add a few drops of oil. Place the mixture in a bandage and secure it on the sore finger. Before this you need to make a soda bath. In the morning, remove the bandage and place a cotton swab under the nail. When the nail is cut, the finger must be treated with iodine to prevent suppuration from forming.
6. Use of pumpkin. Place the pumpkin in boiling water and then grate it. Apply compresses for about 4 hours. This method can be used when suppuration has not yet formed.
7. Compresses using sheep fat. Before using lard, apply a piece of laundry soap to it. It will help soften the nail even more. The bandage needs to be insulated by wrapping it with cotton wool. You can also wear a wool sock. Leave the compress on for about 5 hours. The procedure is best done after the bath and for two weeks.

Prevention

Heredity, which is the cause of the disease, cannot be influenced in any way. But by following these recommendations, you can prevent ingrown toenails:

1. Proper nail trimming. When cutting, the angle should remain as straight as possible. You can't cut too deep.
2. Keep your feet clean at all times.
3. Choose the right shoes. It should be comfortable, not squeeze your fingers, and not float your foot. High heels can also cause ingrown toenails.
4. If fungal infections of the feet occur, promptly treat them.

If you follow basic rules that will help prevent the nail plate from growing into the soft tissue of the finger, then you don’t have to worry about the occurrence of such a problem.

A large number of people around the world are faced with the problem of ingrown toenails. And quite a few of them come to the doctor with the fact that their toenail has grown in and is festering. At the same time, they experience severe pain, discomfort and are unable to move normally. Often in this situation, the only way out is surgical intervention, but in some cases other treatment methods can be used.

Causes of the disease

One of the most common problems in the world is ingrown toenails. They occur even in children and can cause a lot of suffering and anxiety. Moreover, most patients come to the doctor with this problem in rather advanced cases, when inflammation processes have already begun. And some go to the doctor with pronounced purulent changes in the areas of ingrown nail corners.

And every patient is interested in why the nail has grown in and what led to the inflammation. There are many reasons for this, and they should be understood in detail.

1. Wrong pedicure. Not everyone knows that toenails should be trimmed differently than fingernails. The optimal shape for toenails is square, with slight rounding at the corners. It is necessary to trim so that the edges of each nail slightly cover the pad. Rounded, too square shapes with improperly processed corners will serve as a prerequisite for ingrown nail edges.
2. Wearing tight shoes. When wearing excessively narrow shoes, pressure on the toes increases, which can lead to gradual ingrown nail corners. Most often this happens in the area of ​​the thumb, which is most susceptible to pressure. Less commonly occurs in the area of ​​the little finger. Sometimes too loose shoes also serve as a prerequisite for the onset of ingrown toenails. Therefore, it is important to choose a middle ground and select a model in full accordance with your foot size.
3. Genetic predisposition. It has been proven that there are certain genetic prerequisites, as well as anatomical features that can lead to an ingrown nail. An example would be an overly large pad of the finger with thin and delicate skin, coupled with a thick, strong and small nail with a “C” curve.
4. Problems with excess weight. Excess body weight or its sudden increase (during pregnancy) often leads to ingrown nails. This also applies to regularly carrying weights.
5. Heavy loads. Daily excessive stress on the legs always has an unfavorable effect. Therefore, runners, skiers, gymnasts and ballerinas often experience ingrown toenails.

Important! There are many additional reasons, among which it is necessary to highlight fungal infection of the nail plate, injuries, chronic diseases (diabetes), and vitamin deficiencies. Often, the occurrence of ingrown toenails is associated with surgical intervention on the toes. It can also lead to flat feet or club feet.

Direct suppuration of the nail occurs due to infection. This can happen during a pedicure or when you roughly try to separate the corner of the nail yourself. And even if everything was done carefully, but no further processing was carried out followed by the application of a clean bandage, the likelihood of infection is high. Often the root cause of nail suppuration is the wounds that form at the sites of ingrowth. This is especially true for diabetics.

A nail that grows deep into the nail bed itself acts as a kind of foreign body for the body. Therefore, gradually he will try to get rid of the problem. The result of this is an inflammatory reaction, which can develop into a purulent process. Especially if it is too late to pay attention to it or do not start treatment. It is important to carry out a course of therapy at the very beginning of deepening the nail plate.

Symptoms

Symptoms of an ingrown nail and the subsequent development of an infectious process are characteristic, and it is difficult to confuse it with another nail pathology. Initially, there is swelling and some redness in the area of ​​ingrowth, which does not cause much discomfort and can only hurt when pressed. Sometimes there is a feeling of fullness or pressure, but at this stage few pay attention to the problem.

Subsequently, swelling and inflammation begin to increase, and if treatment is not started, purulent changes will appear over time. Outwardly, this is manifested by purple discoloration of the periungual fold, from under which pus is often released. The skin in this area becomes hot to the touch. The reason is the addition of a streptococcal or staphylococcal infection. The leading symptoms at this stage are pronounced.

There is a sharp swelling of the nail and intense throbbing pain that is constantly disturbing. A purulent abscess gradually forms, acquiring a yellowish tint due to purulent contents. At this stage, urgent medical attention is required, since in the absence of treatment there is a high probability of the contents breaking through, penetrating under the nail and spreading the infection throughout the body.

Important! A quick and effective solution is to perform an urgent operation to open the suppuration and remove the accumulated pus. It is performed under local anesthesia and rarely takes more than half an hour. Antibacterial therapy is mandatory, and, if necessary, antifungal therapy.

Conservative therapy

Conservative treatment methods are very effective in the development of ingrown toenails. But only in the very early stages, when the inflammation has not ended in suppuration. And there are no signs in the form of severe swelling, redness, increased local skin temperature or pain. The main goal of treatment will be to push back the sharp corners of the nail plate and trim them carefully.

This can be done after special baths that help steam the soft tissues of the finger and the nail itself. They can be different and based on different ingredients placed in hot water (per 1 liter):

• furatsilin (1-2 crushed tablets);
• salt with soda (1 tbsp each);
• decoction of medicinal herbs (chamomile with St. John's wort, 1 tbsp each);
• potassium permanganate (to a light pink tint).

The duration of such a bath should be at least 10–15 minutes, after which you need to thoroughly dry your feet. It is necessary to try to move the edges of the nail beyond the soft tissues by carefully placing a small piece of cotton wool (in the form of a roller) soaked in an antiseptic (brilliant, iodine) under them. You need to try to make the roller longer so that it can be easily pulled out if necessary. If the nail edges cannot be removed immediately, several similar procedures can be performed.

You can carefully remove the edges of the nail plates and speed up recovery using a number of proven pharmaceutical drugs.

1. Uroderm: a water-based ointment containing urea (urea). It has the ability to have a keratolytic effect and slow down the formation of the stratum corneum. The result of its use is a reduction in the pressure of the nail on surrounding tissues. Must be used in advance, before the pedicure (3 or 4 days).
2. Nailnorm: a balm that helps soften the nail plate. To do this, it is enough to apply the balm 1 or 2 times to the surface of the nail and surrounding tissues.
3. Scholl: effective liquid, should be applied to the nail twice a day for a week.
4. Nogtimycin: applied to the pathological area, after which the medicinal composition should be left for 3 or 4 days. Then you need to steam your feet in a hot foot bath and cut off the loose corner of the nail.

Thanks to the listed means, it is easier to release ingrown corners of nails and the periungual fold as they grow.

If inflammation develops in the affected area, you will need to apply a bandage with an antibacterial composition (Vishnevsky ointment, Tetracycline ointment, Gentamicin ointment). If fungus is present, antifungal agents are needed (Lamisil, Nizoral). And in case of severe pain, the bandages can be additionally treated with lidocaine solution. In more severe cases, oral antibiotics will be required. To prescribe them, you should consult a doctor who can select the most suitable drug.

Hardware treatment techniques

Today, for medical purposes, hardware treatment methods are widely used to help quickly resolve the issue of ingrown nail plates. But it is best to use them at the initial stages of the development of ingrowth processes, while the inflammation is not very pronounced and there are no signs of suppuration yet. Among several methods, the most popular ones should be considered.

1. Hardware pedicure. Its implementation allows you to get rid of a nail with ingrown edges at the beginning of its occurrence. The direct procedure involves the use of a device with special attachments and plates (gold, Podofix, Onyclip, duroplast), which are applied to the surface of the nail, fix the bent side edges and help straighten them. During a pedicure, the surface of the nails is polished, their edges are processed and shortened to give the correct shape. The COMBIped technique is also popular, used for inflammation of the nail folds or unilateral ingrown nails. It uses a special metal bracket with a plate that allows you to straighten only one edge of the nail.
2. Laser therapy. It is a progressive option to combat the problem of ingrown nail corners. It is characterized by minimal trauma and good therapeutic results. The patient feels virtually no pain during the procedure, and the risk of bleeding and infection is minimal. Due to the laser beam, pathological nail tissues are excised quickly, and subsequent recovery is accelerated. It can even be performed on a child. Contraindications for such therapy are allergies to light exposure, the presence of diabetes, acute infections or trophic ulcers, and exacerbation of chronic diseases.
3. Radio wave surgery. Refers to the use of high-frequency radio waves. This method is characterized by low trauma and the ability to completely remove pathological areas of the nails. The likelihood of relapse during radiosurgery is reduced to almost zero. The treatment procedure is carried out under local anesthesia and allows you to quickly cut out the pathological parts of the nail. When performed, the risk of infection is minimal. Necrosis of the tissues adjacent to the nail is practically not observed. As well as pain. The radio waves of the device allow simultaneous disinfection of the wound, which will promote rapid healing without complications. Contraindications to such treatment are: heart failure in the stage of decompensation, the presence of a pacemaker, exacerbation of chronic pathology and acute infectious processes.

Important! Despite the high effectiveness of the listed hardware techniques, before using them it is necessary to undergo a full examination by a specialist. Usually this is a podologist. He will be able to identify the main risks and recommend the most appropriate treatment method.

Home treatments

In the treatment of ingrown nails, folk recipes also have a fairly good therapeutic effect. Their purpose is to give the correct direction of nail growth. This is done by removing the ingrown edges from under the surrounding soft tissues after steaming the toes in the above-mentioned baths.

To accomplish the main task, you can use the following methods:

• scrape off the top layer of the surface of the nail in the lateral sections and in the middle to thin the plate, then place a compact cotton-gauze swab under the ingrown edges, pre-soaked with an antiseptic or antibiotic ointment;
• place a thin plastic plate treated with chlorhexidine or alcohol under the nail edges, then secure with a bandage or adhesive tape;
• take a file, or better yet a triangular file, disinfect the nail and cut 3 grooves on its surface exactly 2/3 of the thickness (on the sides and in the middle).

The result of these actions will be the gradual alignment and unfolding of the nail, which will gradually take the correct position. Thanks to the freed edges, the source of constant trauma and irritation of soft tissues will disappear. As a result, inflammation processes quickly pass.

When suppuration begins in the area of ​​the affected nail, you can stop it with the following home recipes.

Ingredients	Preparation	Application
Chamomile with sage, St. John's wort, lilac and plantain leaves	It is necessary to mix the listed ingredients in equal proportions and add 1 liter of water. Then put the container with herbs on the fire and bring to a boil. Boil for 3 or 5 minutes and remove from heat. Then add baking soda (1 tsp) to the finished broth and dissolve.	Cool the broth slightly and dip the sore finger in it for 15 minutes. After such a bath, you need to try to free the edges of the nail and remove accumulated pus from under them, if there is any there.
Propolis tincture	Place the tincture in warm water in a ratio of 1:5 and stir thoroughly.	It is necessary to dip your fingers in the prepared solution for 15 minutes 3-4 times during the day. Propolis will help draw out the pus and prevent further inflammation.
Salt	Place 2 tablespoons of salt in 1 glass of hot water and dissolve.	You should place your fingers in the hot solution for a few minutes for 30-40 minutes. Then keep it continuously for 15 minutes. This will help cope with suppuration only at the very beginning of its development.

Important! Any medical procedures carried out at home should be agreed with the attending physician. He will help you choose the most effective and safe remedy or select another therapy. You should definitely visit a doctor; sometimes it can be difficult to assess the severity of the inflammation yourself.

Wrong actions

A large list of various methods and drugs used for ingrown nails and their suppuration should be supplemented with a list of illegal actions.

If you have ingrown nail plates, you should not:

• trim growing nails short, cutting off the edges as well: this can worsen the problem; you just need to grow the corners of your nails and cut them according to all the rules;
• insert pieces of matches, cotton wool or gauze under the corners of the nail: this can lead to inflammation; it is necessary to first steam the fingers in a foot bath, and only after that place pieces of a cotton-gauze swab treated with an antiseptic or medicinal composition;
• delay visiting a doctor: sometimes an incorrectly selected treatment method at home leads to very serious consequences, as a result of which you have to remove the nail completely and undergo a long course of therapy.

And if the finger becomes swollen, reddened, with an increase in the temperature of the surrounding skin and the occurrence of purulent processes, you should urgently seek help, and not try to squeeze out the pus yourself. The result can be the spread of infection to underlying tissues and even bones. It is necessary to contact a specialist (surgeon, podiatrist) who will quickly and effectively help cure the inflammation and get rid of ingrown toenails.

Nail prevention

When you manage to get rid of the infection completely and straighten the direction of nail growth, you should not stop there. It is necessary to follow certain preventive measures that will help prevent the problem from recurring and maintain healthy nails.

1. Proper pedicure. It is important to remember that toenails should be cut straight, without rounding the edges. Their shape should be square. Sometimes it is useful to remind the master in a beauty salon who does a pedicure about this. You should also not cut your nails too short. It is better to make their edge protrude slightly beyond the periungual fold. Otherwise, when external pressure is applied, the direction of growth of the nail plate may change.
2. Buying shoes that fit properly. It is best to visit shoe stores in the evening, when your feet swell a little and the size can be selected more accurately. It is necessary to give preference to models that do not pinch or put pressure on the fingers anywhere, and also do not have high heels and narrow toes.
3. Protection from injury. It is necessary to try not to injure the feet and toes, which is one of the prerequisites for the onset of ingrowth processes.
4. Reducing loads. You should love your feet and give them rest regularly. If possible, you should remove your shoes and massage your feet.

Important! Don’t forget about personal foot hygiene, as well as visiting public swimming pools, saunas and baths in personal slippers. This will prevent your feet from becoming damaged by fungus or other infections that can enter through small cracks in the skin.

It is very important to adhere to a healthy diet with plenty of foods rich in healthy vitamins and microelements. The diet should always include vegetables, fruits, herbs and fish products. You should take care of your health and undergo regular medical examinations. It is especially important for diabetics to check their blood sugar.

And most importantly, do not be shy to seek help from specialists. Sometimes this can save you from a long hospital stay and serious consequences. When a nail starts to grow on your finger, all your thoughts are focused on getting rid of it. This is especially true in cases where inflammation occurs in this area and the finger begins to fester.

Severe pain, discomfort and the inability to move freely negatively affect the quality of life and interfere with the ability to calmly carry out daily activities. You can solve the problem in various ways, but you should always start with a visit to the doctor. He will conduct the necessary research and prescribe the most effective treatment. And following preventive measures after full recovery will help avoid a possible relapse in the future.