Author: Hanan Kane

Is My Ingrown Toenail Causing My Toe To Feel Numb?

While the most common descriptors of ingrown toenails from our patients include painful, frustrating, uncomfortable, annoying, excruciating, can’t-wear-shoes-anymore and can’t-sleep-at-night, we recently had a patient call in to book an appointment because he’d had an ingrown toenail for a couple of weeks now, and alongside some pain and discomfort, it was feeling quite numb. Meeting him at the clinic, we discussed that he’d tried looking up online whether numbness, particularly around one side of his big toe, was normal or if it could be a sign of something more sinister – with no luck at all from Dr. Google. So today, our podiatrists at the Auckland Ingrown Toenail Clinic thought we’d answer this question for anyone else stuck in the same boat: Is numbness normal in ingrown toenails?

No, we don’t usually expect your toe to feel numb

First thing’s first: in our experience, numbness is not on the ‘typical’ or ‘expected’ list for common symptoms associated with ingrown toenails. We expect feelings of pain, swelling, redness, bleeding, and even clear/yellow discharge if an infection is present, because given that a piece of nail is currently piercing into your skin, these are all fairly normal responses from your body. Your body wants to stimulate quick healing and direct your immune cells to the site to fight off infection or prevent it – and hence your toe swells and becomes red with the increased blood flow. The action of the nail piercing the skin is painful, and any additional pressure to the area from shoes or bed sheets will exacerbate the pain. This is all expected. Numbness, on the other hand, is a ‘neural symptom’, meaning that it starts from a problem or interruption in one of the nerves in your foot, leg or back that then, instead of delivering clear messages of sensation or pain to your brain, provides a numb feeling. Is the cause of the nerve interruption having your nail pierce the skin? It’s unlikely – especially given that the problem is at the tip of the toe, and if your whole toe is numb, we’d expect the nerve interruption/damage to occur further up the toe or foot.

But, it’s definitely possible

With that said, it could be that your toe is so intensely swollen – and you’ll know if this is happening to you – that all the extra fluid and pressure in your toe is pressing on a nerve and creating those neural symptoms, which can include numbness, pins and needles, burning, tingling and more. So we’re not ruling it out completely or saying that it doesn’t happen, it’s just not the ‘norm’. If this is the case, the numbness would be very localised to the tip of that toe – and wouldn’t extend far down the toe, the foot, or to the other toes. That’s just due to the way our nerves work and give sensation to different areas of the feet.

It could be the symptoms of two problems, simultaneously

It may well be that the numbness you’re feeling is a symptom of another problem, that just so happens to be affecting your problematic ingrown toe, as well as potentially other parts of your feet or legs. There are a number of causes of numbness in the toes and feet, including:
  • Diabetes – this is the most common cause, and arises because, over time, diabetes causes damage to our nerves, which leads to a problem called peripheral neuropathy – which causes numbness and other neural symptoms in our feet. It can also ultimately lead to the complete absence of sensation, so you’ve got to be very careful
  • Arthritis – whether it’s rheumatoid arthritis, osteoarthritis or gout, if you’ve got arthritis in the joints of your feet, particularly at your big toe, and particularly if you’ve got some notable swelling happening, then this may be compressing the nerves in your feet and resulting in numbness in the big toe
  • A new injury – following similar principles to arthritis, if you’ve recently injured your foot, whether it’s a muscle, tissue or bone, and you’ve still got some new or lingering swelling, it may be compressing a nerve and causing your numbness. Or the injury itself may have damaged a nerve, resulting in the same symptoms
  • It’s winter, and the blood vessels in your feet have constricted – a less common but possible cause is vasoconstriction, meaning the narrowing of the blood vessels, in your feet. Cold is a big cause of this, as our body wants to minimise heat loss and so our blood vessels constrict. The result is decreased blood flow, especially at the tips of the toes, which leads to problems like Raynaud’s, frostbite and more. If this is the case, you’ll also likely notice your feet feel quite cold, and may be white and patchy
  • Circulation problems – following on from the above, you may just have circulation problems, and the same process is happening, except that the weather isn’t the cause, but it’s the changes or damage to the blood vessels creating the problem
  • It’s your bunion (if you have one) – finally, it could be related to the joint changes you’re experiencing in the big toe joint at the ball of the foot directly related to your bunion

It’s a clear indicator that you need to treat your ingrown toenail – as your risks increase

Whatever the reason, one thing that’s definitely for sure is that you need to have your ingrown toenail treated ASAP. We rely on our body’s ability to feel to inform us of so much – including when things are going wrong, which we feel as pain. If the numbness is taking over to the point where instead of pain, we feel numb, then our body isn’t alerted to the problems we may be experiencing – including ingrown toenails. This puts you at risk of your nail significantly worsening, developing an infection, or even a secondary infection (which is when it gets pretty bad!), and you being unable to detect it due to the numbness. When you don’t detect it, you don’t know that you need to treat it – and so the problem worsens. It’s a vicious and dangerous cycle, and the long story short is that if you have an ingrown toenail and you’re getting any numbness, reduce your risks and have your ingrown toenail treated ASAP. Most ingrown toenails do not get better on their own, so for most people, they are just delaying the inevitable.

Uncertain as to what’s happening with your toe?

We’re here to help. We’re Auckland’s leading ingrown toenail experts, and offer a number of solutions for painful, frustrating and numb ingrown toenails, including options to fix the problem permanently using a minor surgical procedure. For any questions, or to book an appointment with our team, give us a call on 09 523 2333 or book online. We’re located within the One Health Clinic in Remuera, inside Perform Podiatry.

Does Soaking Your Ingrown Toenail In Epsom Salts Fix The Problem?

A few times every year, we see patients who were under the impression that they could fix their ingrown toenail by doing regular Epsom salt baths. They will have usually tried 3-4 baths over a couple of weeks before they book in to see us because their ingrown toenail hasn’t gone away. This comes as no surprise to us – while Epsom salts may have many benefits, a cure for ingrown toenails is not one of them. Here’s why.

Epsom Salts: What Are They & Do They Do?

Epsom salts are nothing like your regular salt. It is a natural mineral salt containing sulfate and magnesium. While many people talk about the benefits of Epsom salts, they are really talking about the benefits of magnesium, which is thought to help reduce inflammation, help sports performance and recovery, assist in pain relief and reducing muscle soreness, relieve stress, and other similar benefits. Interestingly, these are the benefits found in some smaller and larger studies looking at magnesium, often ingested, not soaking in it via salt baths., As Epsom salts contain magnesium, it is thought that they may have some of these beneficial effects too – though this is not proven.

Ingrown Toenails: A Quick Overview

An ingrown toenail is one where part of the toenail itself (often a sharp nail spicule) pierces the skin surrounding the toe and grows into it as the nail naturally grows. They are often extremely painful, making wearing shoes that press against the toe very uncomfortable. They can have a range of causes, from poor nail cutting habits to tight footwear to injury to the nail and more. For more information about ingrown toenails, click here.

Epsom Salts For Ingrown Toenails

To treat an ingrown toenail successfully, and importantly alleviate the pain, the cause of the problem must be fixed. With the cause being that part of the nail has pierced the skin and is growing into it, it is only by removing this piece of nail that the cut in the skin can heal and close.  Unfortunately, an Epsom salt bath does not remove the nail from within the skin. What it may do is help relieve some pain, but this is only a temporary measure. It won’t be long before walking with a nail still piercing into the toe starts giving you discomfort and pain again. This is why Epsom salts are not a cure for ingrown toenails. What is a cure for ingrown toenails is a partial nail avulsion.

Permanently Correcting Ingrown Toenails

A partial nail avulsion removes the sharp nail spicule that is embedded in the skin, allowing the skin to heal and your pain to go. It is a professional, safe and effective solution and one of the most common procedures carried out in our clinic. It is a permanent treatment because as well as removing the small piece of nail, we also destroy the nail-growing cells at the base of the nail, meaning your ingrown toenail on that side will not recur.  The Benefits Of A PNA Include:
  • The procedure is done simply in-clinic
  • The total appointment time typically doesn’t exceed 60 minutes (with the procedure time typically around 20 minutes)
  • The procedure is performed under local anaesthetic so is pain-free
  • You do not need to take any additional time off work/school following the procedure and can go home immediately
  • You do not need any special boots or braces while the toe heals
  • The procedure causes very little post-procedure discomfort, however, painkillers can be taken should discomfort arise
  • We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
  • We monitor your progress to ensure it is healing well
Recovery time is anywhere from two weeks to two months barring any complications such as infection. We provide you with all the dressings, topical antibacterial solutions and ointments, the post-op shoe and aftercare instructions, all tailored individually to your needs.

Ready To Say Goodbye To Your Ingrown Toenail For Good?

Book your appointment with our experienced podiatrists by calling 09 523 2333 or book online here.

What Else Can The Auckland Ingrown Toenail Clinic Help You With?

Ingrown toenails are our speciality. From one-off treatments to nail surgeries – and even removing the toenail entirely. We love helping patients finally get long-term relief from this painful and frustrating problem. But – are ingrown toenails all we do?  It’s a great question, so today we thought we’d fill you in on all the other things we help our patients with and how.

First: What do podiatrists do?

All our ingrown toenail services are performed by board-registered and experienced podiatrists. Outside of ingrown toenail treatment and surgery, podiatrists spend at least three years studying the anatomy, physiology and biomechanical function of the feet and lower limbs.  Trust us – this isn’t an easy endeavour, given that a single foot has 26 bones, 33 joints and more than 100 muscles, tendons and ligaments! This makes Podiatrists the foot health experts when it comes to pains and problems that develop – and very knowledgeable in their field. Podiatrists are qualified to assess, diagnose and treat problems with the lower limbs, from the waist down. This includes the legs, knees, ankles, feet – and sometimes the hips too. To help you know more about exactly what we do and can help with, here’s a handy checklist of indications that you should see a podiatrist. Do you:
  • Have painful feet?  
  • Experience leg pain?  
  • Have painful knees?  
  • Experience sore hips?  
  • Find walking or standing uncomfortable?  
  • Experience leg or foot pain during sport?  
  • Need advice on correct footwear?
  • Have ingrown toenails?
  • Have a fungal nail infection?
  • Have pain in the opposite leg following an injury or surgery?
  • Want to run better?
  • Want to cycle better?
  • Find it difficult to fit into normal shoes?
  • Have an ulcer that isn’t healing?
  • Notice something about the way your family member walks that seems unusual or wrong?
  • Get very tired after being on your feet during the day for work?
Are you:
  • Worried about the development of your children’s feet?
  • Sick of being told there’s nothing that can be done to reduce your pain and help you feel more comfortable?
  • Regularly tripping or falling?
  • Constantly spraining your ankle?
  • Worried about bumps and lumps on your feet like bunions?
  • Finding it difficult to reach your feet to care for the nails and skin?
  • Diabetic (and therefore high-risk for foot/leg complications)?
  • Training for a marathon or working out and want to reduce the risk of injury?
  • Needing specific assistance for sports like skiing where you have a very narrow boot and not much space to work with?

Introducing: Perform Podiatry

While it becomes very clear once you’ve been in to see us, if you’ve never visited the Auckland Ingrown Toenail Clinic, you may not realise that our clinic is a speciality of our mother clinic, Perform Podiatry. Perform Podiatry is one of Auckland’s leading podiatry clinic, specialising in a range of services including:
  • Pain and injury management
  • Custom foot orthotics
  • Medical pedicures (cosmetic podiatry)
  • Sports medicine
  • Children’s foot problems
  • Wart (verruca) surgery
  • Corns and callus
  • Skin and nail problems
  • Caring for older feet
  • Footwear and footwear modification
  • Arthritis care
  • Diabetes care
  • Splints & braces

Your experienced, comprehensive & all-round team

Perform Podiatry and the Auckland Ingrown Toenail Clinic are staffed with highly experienced, caring and passionate podiatrists that love what they do and caring for patients in all the different ways that we’re skilled to do. Book your appointment online here or call us on 09 523 2333.

How Does Your Nail Look After Ingrown Toenail Surgery?

Partial nail avulsions are our most popular and effective solution to ingrown toenails – permanently. If you’re thinking about having this procedure and have heard that it involves removing a small part of the problematic edge of your toenail, you may wonder what your nail may end up looking like after it has healed.  The simple answer is that, in our clinic at least, your nail won’t look very different from its pre-surgery state. Our experienced podiatrists are careful to only remove the smallest area of nail we need to, to get the ingrown portion of the nail out confidently, while allowing us to get down to the nail-growing cells at the base of your toenail to prevent them regrowing in the future – so the problem nail edge no longer continues to give you trouble. The result is a very straight nail edge that doesn’t curve downwards into the toe. Our patients often describe this as being unnoticeable until they point it out to someone, with which the response is “oh yeah I see what you mean”. With this said, overall the results do vary from person to person, as everyone has natural differences in the shape of their toenail, the size and features of their toes, differences in the amount of skin surrounding their toenails, and more. More than this, some people only have minor ingrown toenails when they have the procedure, while others have severely swollen ingrown toenails, on both sides of the toenail, that have been bleeding for weeks and they’ve had to take antibiotics for the infection. All these features, particularly where there has been new excess tissue growth, can also affect the outcome and appearance of the toe once it has healed. This is something that we’re always happy to discuss with you at your first appointment when we can have a look at your toe, and help you answer any more questions you may have. To help you get a better idea of what you can expect, here are some examples of nails after their procedure, both from our clinic and from others. Before & three months after images of one side of the toenail being treated Two sides of the toenail having the procedure: Before, two weeks after, and six months after the procedure Before, two weeks after, and six months after the procedure One side of the toenail, after surgery Surgery on the left side of the toenail only

Want to know more about ingrown toenails or the nail correction procedure?

You’ve come to the right place! We’ve shared all about ingrown toenails and why they develop here. To learn more about our three treatment options for ingrown toenails, clinic on the links below: For our commonly asked questions around ingrown toenails, please visit our FAQ page or our blog.

Ready to finally get rid of your ingrown toenail with Auckland’s experts?

Ingrown toenails are our speciality, and we’re the only clinic in Auckland to have a section of our practice completely dedicated to permanently resolving ingrown toenails. Book your appointment online here or call us on 09 523 2333

Is My Ingrown Toenail Infected?

An ingrown toenail develops when a small piece of the nail, or nail spicule, pierces the surrounding skin and begins to grow into the skin, instead of growing out independently alongside the skin. It doesn’t take a big piece of nail to cause you tremendous pain and irritation – think of it like a sharp splinter that gets deeper and gets irritated when you walk or wear closed-in shoes. The key here is that an ingrown toenail has pierced and entered the skin, as opposed to just rubbing against the skin and causing painful friction. This means that it has created an open wound – even if it’s all the way down the side of the nail. Wherever there is a wound or an opening of the skin, the risk of infection is also always close by – and it may be even closer in this case given the proximity of our feet to the ground and the dirt it carries. If you’re wondering if the severe pain you’re experiencing from your ingrown toenail is because it’s infected – or if it’s just a deep nail spicule – today we’ve shared some simple signs that may indicate that you have an infection and need more help.

What does an infected ingrown toenail look like?

If your ingrown toenail is infected, you may notice:
  • Clear or yellow discharge coming from the side of the nail
  • Bleeding from the side of the nail
  • Swollen, overgrown or inflamed tissue around the edge of the toenail
  • If an abscess develops, you’ll notice a yellow/white fluid-filled pocket
  • Redness around the side of the nail

What does an infected ingrown toenail feel like?

  • Pain and tenderness around the toenail, especially with the application of any pressure
  • Throbbing at the toenail
  • Heat or warmth around the nail
  • It may feel as if there’s pressure building up beneath the nail

What does an infected ingrown toenail smell like?

Infected ingrown toenails do tend to have a foul or unpleasant smell – which isn’t something that you’d expect from a regular ingrown toenail.

Why infected ingrown toenails are dangerous

Infected ingrown toenails can pose a risk to your health because if your body does not fight off and clear the infection, it can spread or harbour a secondary infection. This may result in the infection spreading to the bone, which is a serious complication and requirements immediate treatment – it may even require surgery.

If you’re unsure – always seek help

It can be difficult to tell an infected ingrown toenail from a non-infected toenail because even without infection, ingrown toenails can swell, and become red and painful. It’s always best to stay safe and put your health first, seeking help at any time that you suspect you may have an infection.

How should you treat an infected ingrown toenail?

Simply put – by seeing your podiatrist! Once an ingrown toenail becomes infected, it requires prompt and effective treatment to both manage the infection and the problem – so that the wound can heal and another infection doesn’t develop. Here at Perform Podiatry, we treat ingrown toenails in one of three ways:
  • Conservative nail care – for first time ingrown toenails, we remove the offending nail spicule if it doesn’t look like the nail will re-grow back and keep causing you pain
  • Partial nail avulsion – for recurring ingrown toenails, we remove the nail spicule permanently, using a chemical to prevent the problematic edge of the nail from growing back in the future
  • Total nail avulsion – for recurring ingrown toenails that have a secondary problem, like a thickened, damaged or distorted nail – or one with a fungal infection too – we can perform a total nail avulsion. This involves removing the entire nail and allowing it to grow back naturally hopefully without the previous issues.

Worried your ingrown toenail may be infected?

If you need help with a problematic ingrown toenail, our team can help. We’re proud to be one of Auckland’s leading podiatry teams, located within the One Health Building on Remuera Road. Ingrown toenails are one of our specialities.  Book your appointment by calling 09 523 2333 or book online.

Think Your Ingrown Toenails Are Worse In Winter? You’re Probably Right. Here’s Why

The beauty of summer is that it allows us to get some relief from our ingrown toenails by wearing open-toed sandals and walk around with bare feet, which can also delay the onset of painful symptoms in the first place. In winter and the chilly NZ spring-time? Not so much. Our ingrown toenails can become worse much faster – and for a number of reasons. Today, our podiatry team have shared why your ingrown toenails tend to feel worse faster in the cooler months, what you can be doing to take care of your feet, and our #1 solution for taking care of ingrown toenails for good.

Why the cooler months aggravate our ingrown toenails

Unfortunately, it’s our own actions that tend to leave our nails feeling worse in these months. During winter, many people opt for thicker and warmer, or even dual-layered, socks which can greatly reduce the amount of room we have at the front of our shoes. This cramps our toes, pushing our skin and nails into one another, and makes it easier for the nail to pierce the skin.  Much like the above, repeatedly wearing enclosed shoes, particularly when they’re tight or narrow, can also produce the same result. As tight, snug-fitting shoes are a common trait of many of our favourite winter sports like skiing, snowboarding and soccer, this leaves us vulnerable to getting that pain, redness, swelling – and sometimes – infection. Activities that have you repeatedly kicking the ball like soccer, or quickly stopping and starting as you push up off the ground can also push into the ingrown nail and aggravate it, causing your symptoms to spring up and worsen.

Tips for taking care of your ingrown nails and feet

To help care for your ingrown nails over the cooler months, especially when trying to prevent them from recurring, we recommend:
  • Remembering that shoes have width sizing, not just length sizing. Opt for shoes with a wider toe box that will accommodate thicker socks and won’t push your toenail and surrounding skin into one another
  • Keeping your nails trimmed, and trimming them straight across using proper nail tools. The shorter the nail, the more space there is in the shoe, and the lesser the chance of irritating the toenails. Using proper nail-cutting tools will help reduce the likelihood of leaving little nail spicules behind that can turn into ingrown toenails
  • Keeping your feet clean and clearing any build-up from down the sides of your toenails. You already know that dirty feet can encourage the build-up of bacteria and other germs that can irritate the nails – and lead to an infection if an ingrown toenail develops. Regularly clearing any build-ups of dead skin or dirt down the sides of (and beneath) the nails will also help reduce some of pressure which may contribute to ingrown toenails, while helping keep your feet clean
  • Airing your toes. When you get home, give your toes some air and some space. This will help relieve some pressure, while encouraging your feet to dry and discouraging any odour or harmful skin breakdown which may cause damage make you vulnerable to infection
  • Getting your ingrown toenail treated early, and doing it right. There’s a certain way to take your ingrown toenail from 0 to 100 in quick speed – and that’s digging down the side of the nail yourself to try to remove your ingrown toenail. Often, the offending and penetrating nail spicule is small, deep and very difficult to see and feel (without the right equipment!). Digging at it often just makes it worse, and quickly amps up your painful symptoms. Getting it treated by a skilled podiatrist while it’s still a mild ache and not a sharp, shooting pain, will help you have the least pain and the best results

Permanent relief from ingrown toenails

Unfortunately, ingrown toenails can and do tend to come back – depending on what’s causing them. You can read up on all the causes and symptoms of ingrown toenails here. Here at the Auckland Ingrown Toenail Clinic, as part of Perform Podiatry, we offer a permanent solution to ingrown toenails that not only relieves your current symptoms, but also prevents it from coming back – or we’ll redo the procedure free of charge. The procedure is called a partial nail avulsion, and it provides a professional, safe and effective solution to frustrating and painful ingrown toenails. It is one of the most common procedures carried out in our clinic, and works to remove the small part of the toenail edge that is piercing the skin and causing your painful symptoms. We see fantastic results from this procedure and have great satisfaction with it, especially as many patients struggle with recurring ingrown toenails for years first. We love that:
  • The procedure is done simply in-clinic
  • The total appointment time typically doesn’t exceed 60 minutes (with the procedure time typically around 20 minutes)
  • The procedure is performed under local anaesthetic so is pain-free
  • You do not need to take any additional time off work/school following the procedure and can go home immediately
  • You do not need any special boots or braces while the toe heals
  • The procedure causes very little post-procedure discomfort, however, painkillers can be taken should discomfort arise
At the end of the procedure, we dress your toe, provide you with a take-home dressing pack and re-dressing instructions, and continue to monitor your progress to ensure the toe is healing well. You can read more about this procedure and if it’s right for you here

Time to say goodbye to recurring ingrown toenails once and for all?

Trust your foot and nail care to Auckland’s leading podiatry team, situated at the One Health Building on Remuera Road. Book your appointment by calling 09 523 2333 or book online.

Have Diabetes? Your Ingrown Toenails May Be Putting You At Risk. Here’s Why

When you have diabetes, your risk of foot problems increases significantly. This is because the effects of diabetes on your nerves and blood vessels damages two critical processes when it comes to the feet and legs:
  • Your sensation – the ability to feel what’s happening to and around your feet
  • Your circulation – the blood flow to and around your feet
When you have an ingrown toenail, this opens you up to a number of vulnerabilities. If you don’t know much about ingrown toenails, what exactly they are or how they’re caused – read this first. 

You may not be able to detect the severity of your ingrown toenail – or an infection

As unpleasant as painful sensations are, our pain response is a very important way for our bodies to gauge what’s going on, when something is wrong, how bad it is, and alert us to take action. When we lightly strain a muscle, we get a mild pain sensation that lets us know to take it easy next time. When we break a bone, we get immense pain that lets us know to avoid putting pressure on the broken bone at all costs, so it doesn’t worsen, and can start to repair. When our sensation is diminished, we can’t rely on our bodies to get this message to us accurately or efficiently. This leaves us vulnerable to feeling like we may have a mild achy toe, or a very minor ingrown nail that doesn’t require urgent care – whereas in reality it’s already been infected for days and needs to be treated ASAP, before the infection has a chance to reach the bone or we pick up a secondary infection.

If you try treating the ingrown nail yourself, it may be difficult to tell if you’ve got it out

One thing we’d expect when the nail spicule is removed from the skin it has grown into is a big feeling of relief, followed by minimal pain when pushing around the side of the nail (compared to what it used to be – you may still have some tenderness from the wound and the swelling). If your sensation is diminished, it may be hard to tell if you’ve removed all of the nail – or only part of it and it’s just going to keep giving you ongoing problems.  The beauty of having your nail spicule treated in our clinic by our podiatrists is that this is something we do every day, so can not only confidently tell when we have removed the entire nail spicule, but are also able to see it much more clearly. We also have the right tools and equipment to do a great job. It’s worthwhile noting that we always always always recommend that those with diabetes have their ingrown toenails treated by a podiatrist only for your own safety and well-being, however, we know that this isn’t always what happens, hence it’s important to know these risks.

You may worsen the damage

Using home tools to dig around your toenail in an attempt to remove the penetrating nail spicule is a sure way to worsen the damage and make the wound bigger – leaving your body with a much bigger job when it comes to repairing the damage and closing the wound, not to mention increasing your risk of picking up an infection from the size of the wound. This is particularly important when you consider that…

You may have problems with healing the ingrown nail

Good, healthy blood flow is essential in any healing and repair process in the body. As this is impaired in diabetes sufferers, you don’t get the same volume of blood, oxygen and nutrients to the damaged site, which means closing the wound and repairing the damage can be a longer and more laborious process. It’s much the same as diabetic foot ulcers – which many people struggle and often have to have additional treatments and therapies to allow them to heal.

Your body may not be able to fight an ingrown toenail infection effectively

What else does a healthy blood supply carry with it? All the cells that fight infection and help keep us safe. When your body can’t do this effectively, the infection can worsen, spread, you can pick up a secondary infection, and generally, your health can suffer. All this without mentioning the pain and discomfort it can cause!

The best advice: Get your ingrown toenail taken care of by a podiatrist

Taking all the points above into consideration, this is why it’s incredibly important to have your ingrown toenail taken care of by a podiatrist when you have diabetes – and also when you don’t have diabetes. Don’t take our word for it – this is the official recommendation from Diabetes New Zealand, as well as Diabetes Australia and every diabetes resource we’ve ever seen worldwide. Don’t put your feet at risk – book your appointment online here or call us on (09) 523 2333.

Which Ingrown Toenail Treatment Is Best For You?

So you – or your family member – has an ingrown toenail. And you’ve read conflicting information online that’s left you wondering whether you should be soaking your foot in salty water or having the whole nail removed completed. We get it – it can be confusing. So today, we thought we’d give you the information you need to know where to start and what all the options really mean.

First thing’s first: Can I treat my ingrown toenail at home or should I see someone?

If you have an ingrown toenail, it means that a piece of your toenail has actually pierced the skin that surrounds it and has started to grow into it. The point at which the nail pierces varies from person to person – it could be towards the tip of the toe and it may be very obvious by the red, swollen bulge. Unfortunately, for the majority of the people we treat, this nail spicule is deep down the side of the nail and close to where the nail originates, making it incredibly hard to get to, especially if the nail starts to soften from being embedded in the skin for so long.   With the above in mind, let’s examine a few of the common online home remedies and their real effect on the ingrown nail: 1. Soak the toe in warm salty water Soaking the toe in warm salty water can definitely help to keep the area clean and help prevent, or reduce the symptoms of, an infection. What it doesn’t do is treat the ingrown nail and remove it from the skin. To clarify: your pain will continue for as long as the nail is embedded in the skin. While soaking the toe isn’t a bad idea in helping with swelling and preventing infection, it doesn’t treat the problem. 2. Cut a V in the nail This is a goodie. As the old tale goes, if you cut a V in the nail then the edges of the toenail at the ends will start growing inwards to remove the edges of the nail from the skin. Unfortunately, the nail doesn’t grow from the tip of the nail – it grows from the base of the nail at the nail matrix that contains the nail-growing cells. This means that cutting any pattern at the end of the nail won’t affect the growth at the base of the nail. 3. Trim the nail down the side Ah, the home bathroom job. We estimate that 50% of our patients that come see us for their ingrown toenail have tried some form of home treatment first. Unfortunately, without the right tools or being able to see down the side of the nail (not to mention the sometimes excruciating pain levels), this isn’t effective – and if you start cutting down the side and then stop part way because you can’t go any further or the pain gets too much – can actually leave you in a worse place than when you started. 4. Apply antiseptic to the toe Much like soaking in warm water, antiseptic is great for helping treat and prevent infection, but it doesn’t remove the nail spicule from your toe.  5. Wait for it to grow out If you had your nail removed entirely, it may take you 8-12 months for the entire nail to grow back. So we guess the question you have to ask yourself is if you’re happy waiting up to a year for the problem to hopefully resolve itself, assuming that the new nail doesn’t follow suit and just keep growing into the skin. Much more than this, the longer the nail stays in the skin, the longer you’re vulnerable to infection and ongoing pain, swelling and discomfort. You’ll definitely need it treated if an infection develops – so it never gets so bad that it gets to the bone and causes very serious problems. 6. Take anti-inflammatories Sure – anti-inflammatories, when your toe is red and swollen, can help reduce the swelling and hence reduce your pain. But, again. The nail stays in the skin. And when the meds wear off, the problem returns. 

So what treatments do work for ingrown toenails?

Effective treatments for ingrown toenails must remove the nail spicule completely from the skin. Even if a small piece is left, as the nail continues to grow, your pain and symptoms will return. We offer three solutions to ingrown toenails that are safe, proven and effective: 1. Manually removing the nail spicule We refer to this as conservative nail care as it doesn’t involve any ‘surgical’ aspects. We use simple and sterile podiatric tools to trim back and remove the small piece of the nail that has penetrated the skin. 2. Permanently removing the nail spicule Otherwise known as a partial nail avulsion, we class this as a minor surgical procedure as it involves numbing the toe with anaesthetic and then removing a small portion of the nail. What makes it permanent is that after the nail spicule is removed, we apply a chemical that destroys the nail growing cells in the one small section of nail, meaning that the nail edge won’t grow back. 3. Removing the whole nail Known as a total nail avulsion, this procedure involves the safe removal of the entire toenail. While this isn’t our go-to procedure for ingrown toenails, there are some circumstances that make it the best option for our patients, such as where both sides recurrently ingrow and there is a large curvature at the sides of the nail, or when the nail is also thickened or disfigured.

So where should you start?

The short answer is that if this is your first ingrown toenail, manually removing the nail spicule may be sufficient. If your ingrown toenail has recurred multiple times on the same nail, permanently removing the nail spicule is likely right for you. If both sides of the nail have ingrown repeatedly, and there are other problems with the nail like it’s thick, then removing the entire nail may be the way to go. The longer answer is that there are a number of considerations and implications of each treatment option – and factors like your medical conditions, any healing impairments, your work, footwear, daily activity levels, if an infection is present, and much more can greatly influence which option is best for you. This is where we come in – you don’t need to make a choice before you see us for treatment – just book an appointment and we’ll take all of these requirements into consideration and discuss all of your options – and which may be best for you. We’ll go through all the pros and cons, and what you can expect. Book your appointment online or call us on 09 523 2333.

Total Nail Avulsion

A total nail avulsion (TNA) procedure involves the safe removal of the entire toenail. This procedure is indicated in a variety of circumstances, such as cases of ingrown toenails where both sides recurrently ingrow and there is a large curvature at the sides of the nail. Here, instead of removing two larger sides of the painful nail, a patient will opt to simply have the entire nail removed so it can grow back as a normal, straight nail – or not grow back at all depending on the method they choose.

Aside from ingrowing or involuting (high degree of curvature) nails, this procedure is also used as a solution for disfigured, thickened, infected and damaged toenails where the nail itself is causing ongoing pain or great discomfort, especially when wearing shoes and performing daily activities.

Again, this procedure may be performed with or without a chemical matrixectomy. When performed with a chemical matrixectomy, the nail will not regrow and you will no longer suffer from the problems your toenail was causing. When performed without, the nail will regrow from scratch, a process that takes approximately 12 months.

This may produce a new, healthy nail that does not cause the previous problems you were experiencing. For example, where nail thickness was causing ongoing pain and discomfort and was very difficult to reduce, the new nail may grow to a normal thickness and no longer cause the original problems.

Because the growth of your new nail is determined by your body’s nail growing cells and not anything we can control, the nail may also grow back to continue to cause the same original problems. For example, where both sides of the nail were previously ingrowing, the nail may grow back in the same shape and the nail edges will continue to re-grow. This may be the case if the base of your nail has been exposed to injury or trauma, as it may have damaged the nail growing cells and resulted in the abnormal production of nail, resulting in a disfigured nail shape.

Don’t worry, we’ll assess your feet, nails and history of trauma to give the best advice on the best course of treatment for you and the results we’d expect to see. Once you have all of the information, you will be best informed on which procedure will be the best option for you.

The benefits of a TNA include:

  • The procedure is done simply in-clinic
  • The total appointment time typically doesn’t exceed 60 minutes (with the procedure time typically around 20 minutes)
  • The procedure is performed under local anaesthetic so is pain-free
  • You do not need to take any additional time off work/school following the procedure and can go home immediately
  • You do not need any special boots or braces while the toe heals
  • The procedure causes little post-procedure discomfort, however painkillers can be taken should discomfort arise
  • We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
  • We monitor your progress to ensure it is healing well

The Procedure

This procedure is very similar to the PNA, but instead removes the entire nail.

  • We first inject the toe with a common local anaesthetic using the thinnest needle possible for your comfort
  • When the area is numb, we will perform the procedure in which the nail will be detached and pulled out
  • If you already have an infection, it will be surgically drained and any overgrown tissue is cut away
  • Where a chemical matrixectomy is part of the procedure, we apply the chemical (phenol) to the exposed nail base (where the nail growing cells are located), before flushing it away and neutralising the area
  • We dress the toe with a number of dressing materials for optimal healing

Recovery time is anywhere from two weeks to two months barring any complications such as infection. We provide you with all the dressings, topical antibacterial solutions and ointments, the post-op shoe and aftercare instructions, all tailored individually to your needs.

Cost

The all-inclusive cost of the total nail avulsion procedure performed by our highly experienced podiatrists is $390 for one toe. This is an all-inclusive cost, meaning that aside from the procedure, it includes all dressing change appointments, a take-home dressing pack, and your follow-up appointments. If both of your toenails are ingrown and need permanent correction with a total nail avulsion, the all-inclusive cost is $600.

Unsure which procedure is best for you?

Don’t worry – that’s exactly why we’re here. Because ingrown toenails can start from something as simple as your footwear choice for one day, they are unfortunately very common. This is our area of expertise and we see a variety of ingrown toenails every day, from full-blown infected swollen toes to small ingrown nails that don’t appear “bad” but are still quite painful and will only worsen as the nail continues to grow.

We start each appointment by assessing the toenail and discussing the likely cause of the problem. We’ll then be able to go through each procedure and their outcomes, and give you all the information you need to help you make the best choice and get the best results for your feet. After you leave your appointment, if you have any questions, our team is available to speak to during business hours and can also reply by email. We always put your health and well-being first and are here to help you in any way we can!

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    Partial Nail Avulsion

    A partial nail avulsion (PNA) provides a professional, safe and effective solution to the problem of frustrating and painful ingrown toenails. This is one of the most common procedures carried out in our clinic.
    The procedure removes the small part of the toenail edge that is growing downwards/inwards, piercing the skin and causing your painful symptoms. We see fantastic results from this procedure and have great satisfaction with it, especially as many patients struggle with recurring ingrown toenails for years before having the procedure. Don’t worry – the procedure won’t leave your nail looking unsightly or abnormal. Instead, you’ll just have a very straight nail edge that is only slightly narrower than normal. This may be best described as “oh, I see that now that you’ve pointed it out but otherwise I’d never have been able to tell”. Want to know more about ingrown toenails and what causes them? Click here.

    Chemical Matrixectomy

    The PNA procedure can be done with or without a step called a chemical matrixectomy, as described below, to destroy the nail growing cells present at the base of the nail. You’ll be able to discuss the best option for you with your podiatrist, but the primary difference is that the offending nail edge won’t grow back when we perform a chemical matrixectomy as part of your procedure, and it most likely will grow back without one. Without a chemical matrixectomy, it is difficult to predict whether the nail will regrow with a straight nail edge that will fix the problem, or if it will continue to become ingrown and cause you pain. We’ll go through everything including your expected outcome in the consultation to see if a PNA is the best option for you. If the nail has become severely deformed or if removing side sections would achieve an unsatisfactory result, you may choose to have a Total Nail Avulsion (TNA).

    The benefits of a PNA include:

    • The procedure is done simply in-clinic
    • The total appointment time typically doesn’t exceed 60 minutes (with the procedure time typically around 20 minutes)
    • The procedure is performed under local anaesthetic so is pain-free
    • You do not need to take any additional time off work/school following the procedure and can go home immediately
    • You do not need any special boots or braces while the toe heals
    • The procedure causes very little post-procedure discomfort, however, painkillers can be taken should discomfort arise
    • We dress your toe, provide you with a take-home dressing pack and re-dressing instructions
    • We monitor your progress to ensure it is healing well

    The Procedure

    • We first inject the toe with a common local anaesthetic using the thinnest needle possible for your comfort
    • When the area is numb, we will perform the procedure in which a very small piece of nail along the edge that is growing into the skin is cut away and is pulled out
    • If you already have an infection, it will be surgically drained and any overgrown tissue is cut away
    • Where a chemical matrixectomy is part of the procedure, we apply the chemical (phenol) to the exposed nail base, before flushing it away and neutralising the area
    • We dress the toe with a number of dressing materials for optimal healing
    Recovery time is anywhere from two weeks to two months barring any complications such as infection. We provide you with all the dressings, topical antibacterial solutions and ointments, the post-op shoe and aftercare instructions, all tailored individually to your needs. It is important to note that while the procedure, when completed with a chemical matrixectomy, does destroy the nail growing cells, there is always a chance that over time, these cells will heal and regenerate. Unfortunately, this is completely out of our control, as it depends completely on your body’s reparative response. We estimate permanent success in 4 out of 5 patients that we treat at Perform Podiatry. The way we distinguish cell regeneration vs. an ineffective procedure is the time between when symptoms develop. If your procedure was unable to completely remove the ingrown toenail, you should notice pain in the toe within the first few months after the procedure, indicating that the original nail was not completely removed. If this is the case, you must notify us immediately and come in for us to fix the problem. If your symptoms arise 12+ months after the procedure, this is a clear indication that the either your body has regenerated the nail-growing cells, or that re-injury has occurred through other methods in your control, such as continuing to wear tight, restrictive footwear that pushes the skin on your toe into the nail.

    The Cost

    The all-inclusive cost of the partial nail avulsion procedure performed by our highly experienced podiatrists is $390 for one toe. This is an all-inclusive cost, meaning that aside from the procedure on either one or both ingrown sides of the same toenail, it includes all dressing change appointments, a take-home dressing pack, and your follow-up appointments. If both of your toenails are ingrown and need permanent correction, the total all-inclusive cost is $600.