Ingrown Toenail (Unguis Incarnates)
Ingrown nail by definition is a nail that is embedded in the skin. This initially results in pain and possible redness. As this continues, this leads to skin infection and more sever pain. Many patients have more pain the more time they spend on their feet. One needs to differentiate between ingrown nail and an ingrowing nail. Ingrowing nail is not yet infected and has little pain. Often trimming your toenails too short may initiate the stage for an ingrown toenail. When trimming the edges of your toenail in order to make it curve to the shape of your toe, it occasionally causes the toenail to grow into the skin of your toe. This causes the sides of the nail to curl down and dig into the skin.
Ingrown toenails could be caused by Onychocryptosis. Onychocryptosis is when a patient has incurvated nails. This will lead to more ingrowing of the nail. This often painful condition may cause any of your nails to become ingrown, but the problem generally affects the big toe. Ingrown toenails are particularly found among teenagers, however, anyone can develop it.
Symptoms of ingrown toenails include redness, swelling, and may soon follow an infection if not treated. Furthermore, they may develop for many reasons. While some cases are congenital, other instances may involve trauma; these may include stubbing the toe or being stepped on the toe. However, the most common cause is tight shoe wear or improper grooming and trimming of the nail.
Ingrown toenails should be treated as soon as they are recognized. Often it can be fixed without a surgical treatment. Dr. Ravaei suggests the following options in order to prevent ingrown toenails from occurring: soaking your feet a few times times a day and keep the foot dry for the remainder of the day, be sure to wear shoes that leave space for comfort for the toes (recommend wearing open-toe shoes until the condition heals), use ibuprofen in order to relieve pain.
In addition to the signs of pain, redness, and swelling of the toenail, symptoms may appear prior to it. Early in the course of an ingrown toenail, the end of the toe becomes reddened and painful with mild swelling; however there will be no indication of pus or drainage. When touching it, you may feel warmth but you will not have a fever. Within a short time period, extra skin and tissue will grow around the sharp point of the nail. A yellowish drainage may begin. This is the body's response to the trauma of a nail causing irritation to the skin. Nonetheless, this does not mean that it is necessarily an infection.
If excessive inflammation, pain, and swelling are present, it is possible that the toenail is infected and it should be treated. In this case, the swelling will become worse, and there may be white- or yellow-colored drainage from the area. A lighter-colored area of the skin may be surrounded by red skin. Although it is unusual, you may develop a fever. Most patients are not aware that the nail is very close to the bone in the foot. Thus it is quite possible for a patient with an ingrown nail to end up with bone infection. It is much harder to treat bone infection that an ingrown nail. That is the reason that Dr. Ravaei takes ingrown nails very seriously.
If this is the case, you may need to take oral antibiotics and the nail may need to be partially or completely removed. Dr. Ravaei may need to surgically remove a portion of the nail, the underlying nail bed, and some of the adjacent soft tissues. At times when part of the nail is removed some form of anesthesia is required. Most of the time the anesthesia is a local anesthetic, this is the same anesthetics patients get, when they go to the dentist.
Surgery is effective in eliminating the nail edge from growing inward. For those who may have chronic and recurrent infection in their ingrown toenails, they may need to have it permanently removed. This requires for part of the nail to be burned with acid or laser. Dr. Ravaei almost never burns the whole nail root since he does not think this will present a cosmetically appealing result.
If the patient's infection continues to come back, Dr. Ravaei may remove part of the patient’s ingrown toenail. He will inject your toe with an anesthetic and use scissors in order to cut away the ingrown part of the toenail thus preventing any disturbance with the nail bed. An exposed nail bed may be very painful. Removing your whole ingrown toenail may take 3-4 months for your nail to re-grow.
After many years of experience in the field, it has become evident that Dr. Ravaei is the most competent and trust-worthy podiatrist for this procedure. He is recommended by many and patients have had no complaints.
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