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Painful ingrown toenails. Is there any permanent solution?

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Practicing since : 2006
Answered : 1882 Questions
Hello. I have had issues with both my big toes due to ingrown toenails for some time now. They keep getting infected and ingrown no matter how I cut the nail or how many times I get it fixed. I don't have the money to go to the ER to get it the nail chopped off every 2-3 months. They hurt like hell and I was wondering how logical it would be to have them taken off? They're nothing but a painful nuisance and I'm sick of pain and jumping whenever someone comes near me with shoes on. Would it be possible and how long wod I be out of work?
Posted Mon, 28 Oct 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 2 hours later
Brief Answer:
partial nail avulsion should help you

Detailed Answer:
Thanks for writing to us.
Ingrown toe nail or onychocryptosis can lead to pain, inflammation and infection in surrounding area.
The most definite treatment is partial nail avulsion. In this nail surgery we basically leave a thin strip of nail to grow in centre whil nail is removed completely from both the sides. This is followed by phenolisation of nail matrix. Application of phenol over lateral nail folds prevent ingrowth of nails as it destroys the matrix from which the nail grows.
As such no bed rest is required after nail avulsion, one may resume normal duties however any physical work that can put pressure on treated toe may lead to pain and delayed healing. Usually in a week the avulsed area dries and heals but till then a course of oral antibiotic along with painkillers and topical antibiotic cream application is advised. It is better to keep the area bandaged. I would not advise getting two nails avulsed in the same sitting.

As long as you are not getting you nail avulsed, just dip your nail in warm water and clip the nails in square shape. Dipping in warm water would help in softening the nails and hence clipping would not be painful. This should be done weekly. Also if there is any swelling pain or redness near margins just apply topical antibiotic and steroid cream to reduce swelling and infection. Try to lift nail margins using the blunt end of tooth pick to prevent it from getting embedded in adjacent soft tissue. Also for ingrown nails certain nail solutions containing sodium hydroxide are available over the counter( dr scholl's product) for ingrown toe nail. Regular dipping in warm water, cutting nails regularly and use of such OTC solution may help you quite a lot.
Hope this helped.
Take care
Above answer was peer-reviewed by
Follow-up: Painful ingrown toenails. Is there any permanent solution? 5 hours later
I've had that done once already. I followed doc. Instructions and everything, but the nail grew back really thick and when it got bigger, it got hard and painful to clean and ended up getting infected again. I've had a few friends who've had ingrown toenails and they said it never really goes away. Is amputation even option or is it illogical? I'd be overjoyed if I could just be rid of them.
Amputation of the big toes I mean, not the nail.
Answered by Dr. Kalpana Pathak 11 minutes later
Brief Answer:
ingrown toe nail does not require amputation

Detailed Answer:
Thanks for writing back.
The definite treatment for ingrown nail is nail avulsion and lateral matrix phenolisation. Lateral matrix phenolisation prevents ingrowth of nail. I believe the procedure that you underwent was plain nail avulsion. Had the matrix been phenolised or destroyed by application of highly concentrated phenol, the nail would have not grown on sides permanently as its the matrix from which the nail grows and once the matrix is destroyed nail cant grow on sides.. Surgeons usually perform avulsion while dermatologists/ dermatosurgeons perform nail avulsion with phenolisation. Personally in my practice i perform nail avulsion with phenolisation and it works for almost all who have ingrown nail.
Amputation is in no way advised for ingrown nail.
If you do not want to get the nail avulsed, please follow the conservative measures I have suggested.

Hope this helped.
Should there be any query, please write back
Above answer was peer-reviewed by
Follow-up: Painful ingrown toenails. Is there any permanent solution? 5 minutes later
Does the nail grow back and look normal after that? I'm not a huge vanity type of person but I haven't been able to wear open-toed shoes for a very long time because my toes are embarrassing. Also, is there a way to get rid of infection other than antibiotics that you know of? They always seen to make me nauseous.
Answered by Dr. Kalpana Pathak 8 minutes later
Brief Answer:
please read a detailed answer below

Detailed Answer:
In partial nail avulsion we basically leave central strip of nail and destroy nail laterally that embeds in soft tissue. So to some extent we maintain morphology of nail and it does not look unpleasant. Infact it looks better than thick discolored nail.

As I said earlier also follow the conservative measures as long as you do not want to get the nail avulsed to reduce pain infection and inflammation.
You need not take oral antibiotics.
Just dip your feet in warm water to decrease swelling and help pus from discharging. Do it atleast every alternate days if not daily. Cut your nails weekly after dipping in warm water. Also use a blunt tooth pick to lift the embedded nail and cut this off. Once the nail is dislodges, inflammation will subside. Use an antibiotic cream like mupirocin or nadifloxacin to settle infection. As advised look for sodium hydroxide solution for nails. It helps in dissolution of tough embedded nail and helps the patient symptomatically.

Hope this helped.
Take care
Above answer was peer-reviewed by
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