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An ingrown nail on the big toe is the penetration of the nail plate into the lateral edge of the nail fold. Doctors call this phenomenon onychocryptosis. Most often, it is the big toe of the lower limb that suffers. In this case, the nail roller becomes red, swells and becomes inflamed. This is accompanied by intense pain.
Until the suppuration of the tissues occurs, many people do not pay attention to the fact that the nail grows incorrectly and do not consult a doctor about this. As a rule, patients appear in the doctor’s office complaining of severe pain. In 50% of cases, an ingrown toenail is a chronic condition.
Causes of an ingrown nail
The reasons that lead to the fact that the nail grows into soft tissues:
Incorrect cutting of the nail plate. This is the most common cause of failure. This situation happens when a person cuts off the corner of the nail, leaves a sharp edge, a burr, or cleans with scissors under the nail. It is impossible that after cutting the nail, a rounded edge remains in its place. Don’t cut your toenails too short.
Wearing tight shoes that are small or too tight around the toes. When pressure is constantly applied to the nail from the outside, it will begin to change its shape.
Excessive load on the lower limbs.
Nail fungus. This disease leads to the fact that the plate begins to deform, becomes thick, so the nail can grow into soft tissues.
Valgus deformity of the foot, flat feet. The thumb in these diseases is bent, which causes abnormal growth of the nail plate.
Congenital structural features of the nail fold. Sometimes there is too much soft tissue in the subungual pad, which leads to a corresponding problem.
Pregnancy. The problem of an ingrown nail is often encountered by women 2 months after childbirth, during breastfeeding, and also before childbirth, which is associated with increased stress on the lower limbs.
Diseases that negatively affect the nutrition of the nail. These are such pathologies as: diabetes mellitus, endocrine diseases, overweight, disorders in the functioning of the cardiovascular system.
Diseases of the dermatological plan: warts, lichen, psoriasis, etc. All of them lead to the fact that the nail plates will be deformed.
Therapy of cancerous tumors. Both radiation therapy and chemotherapy have a negative effect on cells that are prone to constant growth. This is also true for the nail plate.
Ingrown toenail symptoms
If the nail begins to grow into the roller, then this will be manifested by symptoms such as:
Soreness in the affected area. The pain tends to get worse, especially when walking with shoes on.
Formation of an ulcerative defect in the area of the ingrown nail. An ulcer is the result of constant trauma to the soft tissues.
Swelling of the roller, its hyperemia. These symptoms indicate that an infection has penetrated the soft tissues. The pain intensifies, becomes throbbing.
Excessive growth of tissues on the nail. Such fabrics will have a bright color of fresh meat. This symptom is called granulation.
Deformation of the nail, accompanied by a shortening of the plate and its thickening. These changes in the long course of the violation are irreversible. The soft tissues that surround the nail become rough.
Diagnostics
When the first signs of an ingrown nail appear, you need to go to an appointment with a surgeon or a podiatrist. The doctor will give a referral for a general blood test, which will allow you to assess the degree of the inflammatory reaction. You will also need to determine the level of glucose in the blood. This analysis will make it possible to exclude or confirm diabetes mellitus.
If there are symptoms of nail fungus, then you need to visit a dermatologist. Without eliminating the underlying disease, it will not be possible to cope with the problem of an ingrown nail.
The surgeon can additionally refer the patient to x-rays, which will allow to assess the extent of the lesion, to exclude osteophyte (the so-called bone outgrowth on the finger). The symptoms of this disorder have a similar clinical picture with an ingrown toenail.
Treatment with conservative methods
If the violation has just begun to develop, then it can be dealt with by conservative methods.
Such treatment is carried out at home, but only after a medical consultation:
Baths with antiseptic compositions. Feet can be disinfected in a solution of potassium permanganate, sea salt, baking soda. The procedure is carried out up to 4 times a day. When the tissues become soft, the nail comes out of them. This allows you to carefully remove its ingrown part. After that, you can treat the affected area with iodine. Baths will need to be done until the pathological symptoms completely disappear.
Compress. It is put on all night. The procedure is repeated 3-4 times a day. To prepare the impregnation, 10 ml of dimexide, 1 ampoule of analgin, 1 ml of dexamethasone and 20 ml of water are used. All components are mixed, applied to gauze and applied to the affected area. From above the gauze is covered with cellophane, bandaged and put on a sock. If it was not possible to cope with an ingrown nail with a compress, then you need to contact a surgeon.
Chlorhexidine. A sterile bandage is moistened in the drug solution and placed between the nail and the skin roller. So that the bandage does not dry out, it must be impregnated with Chlorhexidine. Every day, the bandage will need to be pushed deeper and deeper, thereby releasing the nail. If you perform this procedure correctly, you will be able to cope with the problem in the shortest possible time.
Furrow formation. To do this, saw through a vertical strip in the nail with a nail file. Only the stratum corneum of the plate can be affected. This furrow will tighten, which will lead to a natural rise of the nail.
Processing with boiling water. If the inflammation has just begun to develop, that is, the finger is slightly reddened and begins to hurt, then you can use the treatment method described below. It is strictly forbidden to use this method if an abscess is already developing. A sore finger must be lowered into hot water for 1-2 seconds and removed. Repeat the treatment 30 times in 10-20 minutes. Such treatment should continue until the symptoms of the disorder disappear.
Taking medicines. If the pain is very severe, then you can take drugs from the NSAID group, for example, Ibuprofen or Paracetamol.
Treatment should be accompanied by compliance with such recommendations as:
Shoes worn by the patient should be as loose as possible.
Feet must be carefully looked after.
Socks should be changed at least 2 times a day.
Nails must be trimmed properly.
Solutions and ointments for ingrown nails
Balm Nogtinorm. This tool makes the nail plate softer, which makes it easier to get rid of the problem. The drug has an analgesic and anti-inflammatory effect. They are provided with substances that are part of the balm: St. Nogtinorm is applied to the nail roller on the entire nail plate. The legs need to be steamed first.
Ointment Uroderm. The composition of the drug includes urea. This substance softens the nail and surrounding tissues, which allows you to cut the plate without any problems. The ointment is applied to the affected area for 3-4 days. The finger must be dry. The cream is injected into the gap between the periungual roller and the edge of the nail, using a special spatula for this. Then socks are put on the legs and left for a while. After 4 days of this treatment, you can cut off the ingrown nail.
Levomekol. This drug is used only after the nail has been removed by the surgeon. It contains chloramphenicol (antibiotic) and methyluracil (a substance aimed at accelerating metabolic processes in tissues). After the operation, gauze is applied to the treatment area, which is pre-impregnated with ointment. The bandage should be changed regularly. It is used until the wound is completely cleared.
Vishnevsky ointment. This drug is used only if the affected area begins to fester. The composition of the ointment includes birch tar, castor oil, xeroform. The drug is applied to the affected area, and a bandage is applied on top. Take it off in the morning. If the nail has come out of the soft tissues, it can be carefully cut off.
Ichthyol ointment. The composition of the drug, in addition to ichthyol, contains petroleum jelly. This remedy has analgesic, anti-inflammatory and antibacterial effect. It allows you to soften the nail plate. The drug is applied at night under a bandage. In the morning, it is removed and the excess section of the nail is cut off.
Staples and plates
Staples and plates allow you to lift the ingrown part of the nail. They do not cause discomfort to a person, allow you to wear shoes without pain. Their appearance, such devices resemble braces. They must be installed by a doctor.
Surgery
There are several methods of surgical treatment of an ingrown toenail:
Resection of the edge of the nail or the entire plate as a whole. The operation is performed using local anesthesia. If the process is not complicated by suppuration, then cutting off part of the nail plate can be dispensed with. When the infection has joined, the nail is removed entirely. A new plate will grow back after 3 months. However, it cannot be ruled out that re-ingrowth of the nail into soft tissues will occur. To prevent this from happening, you need to remove the granulations and part of the skin on the side of the finger. This will prevent contact between the nail and soft tissues.
Laser processing. If the nail grows into the roller at the level of the cuticle, then cauterization of its ingrown edge and growth cells is performed after the affected plate is removed. This treatment prevents recurrence. The laser affects the growth cells and the ingrown nail, and also removes inflamed tissues and granulations. Laser treatment is the best treatment for ingrown toenails.
Radio wave removal of an ingrown nail. This method does not leave behind scars and scars, and the likelihood of recurrence is minimal. During the procedure, the ingrown nail itself is removed, as well as its matrix and germ cells.
Nail care after surgery. When the nail has been removed, the soft tissues are left unprotected and will hurt. Recovery is quite long and takes about 30 days. At this time, you need to protect the treated area from the penetration of infection into it.
Every day (the first 5 days after the operation), the nail should be treated with antiseptic agents (Hydrogen Peroxide, Chlorhexidine), and then an antibacterial ointment (Levomekol, Ofloxin, Gentaxan) is applied to it. The finger is bandaged with a bandage. The first 5 days the bandage is changed every day, and then every other day.
The leg should be at rest. It must be protected from injury and overload. If a person experiences severe pain, then it is necessary to take painkillers.
A sore toe should not be pinched, so shoes should be chosen wide and comfortable.
Complications
Complications that can result from ignoring the problem of an ingrown nail:
Lymphadenitis and lymphangitis. In this case, the infection through the lymphatic vessels reaches the lymph nodes located in the immediate vicinity and leads to their inflammation.
finger abscess. At the same time, its soft tissues fester and swell strongly.
Osteomyelitis. In this case, bone tissue is involved in the process of inflammation.
Gangrene of the finger. Its tissues turn black and die, amputation of the finger is required.
Prevention
To prevent the nail from growing into soft tissues, the following recommendations must be observed:
Pedicure must be done correctly. Before processing nails, they are steamed. Cut nails in a straight line, without rounding the edges. They need to be carefully processed using a soft nail file for this purpose. Too short nails should not be cut, the free edge should be at least 2 mm. If dirt has accumulated under the nail, then it is cleaned with cotton wool, and not with scissors.
If the nails are ingrown, then you can use a special liquid, for example, GiGi No Bamp Topical Solution, Genwol med. These products soften the skin, prevent its keratinization, and prevent the nail from growing into soft tissues.
Do not wear shoes with a heel greater than 4 cm for women and 2 cm for men.
If there are orthopedic disorders, then you need to use insoles and proper shoes.
Feet should be washed regularly and socks changed.
It is important to get rid of excess weight.
If there are signs of nail fungus, then you should not delay treatment.