How is an ingrown toenail treated?

Ingrown toenails are best treated by eliminating the ingrown side of the nail altogether.  Simply cutting the nail back along the corner to reduce the pressure, soaking the toe, or using an antibiotic if there is infection usually only results in temporary relief.  However, for those with poor circulation, a poor immune system, or are generally in poor health, that treatment may be the best option.  For all other people, permanent removal of the nail border is the best way to remove the problem.  In order for an ingrown toenail to be permanently treated, the side of the nail that is pinching in needs to be trimmed off, and the nail root cells growing the nail in this spot need to be destroyed so that no further nail growth occurs there.  This leaves a nail that has a straight edge that does not pinch into the skin.  Without this second step of destroying the nail root cells, the ingrown side of the nail will simply grow again, causing further problems in the future.

In order to make this procedure comfortable, the toe must be numbed with a local anesthetic.  This process involves injecting the toe along both sides at the base of the toe.  Each side takes about 10 seconds to inject, as injecting any faster usually leads to more pain.  From there onward, the toe will be numb for 4-6 hours.  The skin is then cleansed with an antiseptic solution.

The toe is checked to ensure it is numb completely, and a small rubber tourniquet is applied to the toe base to decrease blood oozing that can neutralize the chemical used to destroy the nail root cells.  Bleeding in this procedure is minimal to none, but still must be controlled for the best possible outcome.  Following the tourniquet application, the side or sides of the nail are removed with a straight jaw nail clipper, back to the base of the nail.  Several applications of an acid called phenol are then given to the cells that grow the nail at its base, to destroy them chemically.  The remaining acid is rinsed with an alcohol solution, and the site is cleansed of any loose skin debris.  The toe is then covered with antibiotic ointment and dressing.

Home treatment following the procedure is easy, and involves soaking the toe daily in warm soapy water and covering the site with antibiotic ointment and a band aid.  Usually no restrictions in activity are needed otherwise.

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