Diagnosis of an ingrown toenail

The diagnosis is made from the combination of symptoms and patient history. In a medical consultation, the risk factors that promote this change should be identified. If necessary, additional swabs can be taken for a bacterial examination or to exclude fungal infections. In advanced stages, especially in diabetics, an additional X-ray of the affected area can be requested to rule out the possibility of the inflammation spreading to the bone.

What to do with an ingrown toenail

The basis of the therapy is the elimination of risk factors that cause the clinical picture. These include wearing suitable, non-pressing footwear and information on correct nail cutting to prevent ingrowth of the nail. In the case of orthopedic malpositions, suitable insoles should be considered.One should pay attention to a good foot care, especially diabetics.

Therefore it is advisable to connect diabetics to a medical chiropodist, a podiatrist. These measures serve not only for therapy but also for prevention. If the inflammation is not yet advanced, home remedies can be used to stop it from progressing.

Lukewarm baths with the addition of curd soap help here. These soften the tissue so that the nail can be better treated with absorbent cotton or ointments. Lining the nail with absorbent cotton, which can be soaked with disinfectants and fastened with plasters, creates a space between the nail and the skin, so that the latter is relieved of pressure.

Passagere immobilization or even elevation of the leg for a few days can also help to alleviate the symptoms. Local application of ointments, such as Povidone-iodine (Braunovidon®) or Ichtholan®, which contain an antiseptic, i.e. disinfectant, and anti-inflammatory component, can help to heal the area. These conservative measures can be initiated with the help of a medical pedicurist, the podiatrist.

If this does not bring about an improvement within a few days or if the inflammation continues to progress, a doctor should be consulted. Antibiotics can help here, depending on the detection of bacteria or pus. Metal clips placed horizontally on the nail can stop the nail from bending too much by pulling, so that the nail no longer presses on the lateral skin.

However, if these conservative measures fail, or if the infections recur repeatedly, surgery should be performed to control the ingrown toenail. In this case, the altered inflamed tissue is removed. Likewise, a vertical incision is made through the nail and removed so that the nail is narrowed and cannot be pressed (Emmert plastic surgery).

Finally, this is sclerosed with a phenolic solution. Diabetics should consult a doctor as soon as possible in the case of such a conspicuous ingrown nail to avoid further complications such as amputation. Furthermore, this could be interesting for you: Nail bed inflammation treatment.

In the case of an ingrown toenail, home remedies can help at the beginning. In an advanced stage, however, medical treatment is unfortunately unavoidable. In the following sections helpful household remedies that can help with an ingrown toenail are listed.

Proper foot care is very important for an ingrown toenail. Dirt, sweat and dead skin flakes should be removed every day under running water. With a moist compress you can carefully clean the inflamed nail.

After cleaning the inflamed nail, the application of ointment can help. A good addition to a wound ointment is for example witch hazel. An ingrown toenail can be treated conservatively if it is not yet severely inflamed.

This means that surgery can be avoided. However, a medical chiropodist or doctor should be consulted for conservative treatment. Self-experiments should be viewed critically.

One of these widespread methods is the insertion of a piece of absorbent cotton between the toenail and the skin. This is to prevent further ingrowth of the toenail and to take away the pressure of the nail on the skin. In preparation, a warm foot bath with bitter salts should be used to soften the nail and the skin of the toe.

This makes it easier to lift the toenail from the skin. When using tools such as tweezers, one must pay close attention to hygiene, otherwise bacteria can easily be carried into the wound. Then a small piece of absorbent cotton formed into a roll is inserted between the lifted toenail and the skin.

Afterwards you can apply an ointment that prevents infection and bandage the toe afterwards. Daily use of this method can have a positive effect on the healing process. Always pay attention to possible signs of inflammation, such as redness, swelling and pain.

If possible, air should also be applied to the treated toe. However, as described above, such manipulative methods are not recommended. The treatment with a nail correction brace is usually carried out by a medical chiropodist (Podiatry).

There are more than 10 different types of nail correction braces, which are specially adapted to the affected nail by a podiatrist. After fitting, the brace is inserted into the nail fold on both sides and fixed in the middle of the nail. This prevents the nail from growing crooked and thus prevents ingrowth.The procedure is painless and is perceived as pleasant by most of those affected.

Sports activities are also possible with a nail correction brace. The duration of a treatment with a nail correction brace varies and usually lasts several months. The costs for this treatment are currently not covered by all health insurance companies.

However, a cost estimate, on which an individual decision is made, can be submitted. The insertion of the brace usually costs between 35 and 50 euros. Costs for follow-up appointments and further foot care are also incurred.

If the toenail grows in slightly and the therapy is started early, taping can already help to get the complaints under control. To do this, the nail wall is glued under tension downwards and outwards, so that the nail has more space. The pain improves immediately.

The adhesive strips should be changed every two hours. Dirt and residues should be removed under running water. Taping enables the nail to grow straight again.

In advanced stages, however, taping is not a therapeutic option and does not improve the condition. Surgery is necessary if there is already a very severe or chronic inflammation caused by an ingrown toenail. By acting early, surgery can usually be prevented.

However, since many affected people do not see a doctor until very late, there is often only one surgical therapy option left. Surgery is also advisable in cases of very frequent recurrences, i.e. disease relapses. The standard procedure in the surgical treatment of an ingrown toenail is the so-called Emmert plastic surgery.

During local anesthesia, a piece of the lateral nail is removed wedge-shaped together with the nail fold and the nail wall. Usually the wound is then left open after careful hemostasis and not sutured. It heals under a sterile dressing.

The complaints are already gone immediately after the operation. Regular wound checks and dressing changes follow. The entire healing process usually takes two weeks.