Ingrown Nail:
Known as ‘onychocryptosis’, this is a common, painful condition which occurs when the skin on the side of the toenail grows over the edge of the nail or when the nail grows into the skin.
It is most common on the big toe, however it can develop on the other toes.
Usually the side of the nail penetrates deeply and it is difficult to see the edge. Some will just have a nail that appears deeply embedded down the side or sides of the nail. In some, the corner or a small spike of nail may penetrate the skin. It can be extremely painful, red and inflamed and in more severe cases can result in an infection, pus and bleeding. The toe may become red and inflamed.
Ingrown toenails can develop for many reasons:
In some cases the nail is more curved than usual rather than being flat, this will cause the edge of the nail to grow in. The most severe example of this type of nail is one in which both sides of the nail are very curved, this is more commonly called a ‘pincer nail’ and the shape is usually inherited, but can be influenced by trauma or shoe pressure. Trauma, such as stubbing a toe or having one stepped on can cause a piece of nail to jam into the skin.
Incorrect trimming is widely regarded as the most common cause. The nails should be cut straight across avoiding cutting too low at the edge or down the side. The corner of the nail should be filed and be visible above the skin.
Cutting after a bath or shower is recommended as the nails are soft. Pressure from an adjacent toe, a bone deformity (e.g. bunion), tight-fitting footwear or hosiery can also be causative factors.
Signs and Symptoms:
Ingrown nails should be treated as soon as they develop. Unfortunately the first sign of an ingrown nail problem is pain. If the skin is red, painful or swollen on the sides of the nail, there may be an infection.
The ingrown nail is in a warm, often moist, bacteria-rich environment, this provides a convenient entry for germs that cause infection.
Treatment:
The offending spike of nail must be removed using sterile instruments, after this some antiseptic dressing is required for a few days, which in most cases will clear the infection. In some cases a course of antibiotics may be required.
People attempting to self-treat an infected toenail may worsen the problem.
Diabetic persons should consult a registered Chiropodist or their GP for all foot abnormalities.
Fungal nail infections:
Fungal nail infection (onychomycosis) is an infection that causes the nails to thicken and discolour. It is an unsightly and uncomfortable infection that targets the space between the nail plates and the sensitive flesh beneath. The nails of persons with onychomycosis are initially a cosmetic concern. Without treatment, the nails can become so thick that they press against the shoe and cause discomfort.
The big toe is the most susceptible to this condition, however other toes can become infected.
The toenail protects the tender nail bed below and once a fungal nail infection occurs it is guarded by the same shield. Fungal nail is caused by the same fungus that causes athlete’s foot. The fungal organisms (dermatophytes), like the warm, moist, enclosed conditions of socks and shoes. Cutting your nails too short, damage to the nail caused by a bang on the foot, or tight shoes that constrict or rub the toes, can allow the fungus to get under the nail.
The infections they cause are normally confined to the nails, but occasionally spread to the surrounding skin.
Signs and Symptoms:
The infection usually starts at the tip or side of the nails and spreads towards the base of the nail. In the early stages the nail may change colour to off-white or yellow. The nail becomes thicker and crumbly and can eventually crumble away completely. Toenail infections are more difficult to clear totally than skin infections. This is because the nails grow slowly and receive very little blood supply. Because nails grow slowly, it typically takes up to a year for the nail to regain a healthy, clear, thin appearance while treating the infection. Onychomycosis is an ongoing fungal infection and patients with the condition should consult a registered Chiropodist.
Treatment:
Fungal nail infections can recur, often because the original infection did not completely clear or because athlete’s foot has caused reinfection. Because of the thickening your Chiropodist will reduce (thin) the nail as far as possible and recommend a topical treatment.
Patients with diabetes commonly develop onychomycosis because blood circulation is poor in the extremities, and the body’s ability to fight infections is compromised.
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