November 17, 2021

Ingrown nail

The ingrown nail is the result of a conflict between the nail plate and the periungual tissue. It is considered a comorbidity because it impacts the daily life and can generate many underlying problems. It must therefore be treated as quickly as possible. The nail penetrates the grooves more deeply than normal, causing pain of varying degrees of intensity, redness, swelling (inflammation) and sometimes infection. The spur in the groove continues to grow along with the nail, which is why the pain only increases if left untreated. Lack of treatment can also lead to the appearance of a fleshy bud or botryomycoma (inflammatory angioma). In addition, when you have an ingrown toenail, you create a doorway without complications. Indeed, the shoe being an infectious environment, having an ingrown toenail there is not interesting.

It is important to treat the causes of occurrence to avoid recurrence and there can be many:

1- A bad posture: in the majority of cases, the foot will tend to go inward and therefore, during the last phase of propulsion, instead of passing over the pulp of the toe as a whole, we will have hyper support on the lateral side of the big toe along the axis of the foot. As a result, the soft part of the pulp conflicts with the hard nail and with repetitions it becomes inflammatory. We thus enter a vicious circle because the more it will be inflammatory, the more it will get bigger and the more it gets bigger, the more it hurts… And at the end of the race we catch an ingrown nail. We will therefore treat locally at first, then it will be interesting to have a more general approach or we will try to find the favorable factor from a mechanical point of view that causes it to happen and eventually recur. Postural or orthopedic insoles can be of interest in this context

2- A mechanical context (conflict between the lateral bead of the toe and the nail),

3- A bad nail cut

4- Onychotillomania (when you pull your nails out)

5- Trauma or microtrauma

6- A deformation of the nail plate (the shape of the nail): hypercurvature of the nail, mycotic nail, volute nails, fan nails, provence tile, lateral plicatures

7- A constraint of the shoe

8- An enlarged bead of the big toe

9- A hypertrophic callus

10- Subungual exostosis …

How to treat and prevent the appearance of an ingrown toenail? Treating the cause (s) is the best medicine. It will therefore be necessary to ensure:

1- Make an annual postural check-up

2- Wear postural rebalancing insoles if necessary

3- Perform a medical pedicure treatment then:

4- Cut the toenails straight and leave the corners slightly longer

5- Use pliers designed for nail trimming

6- Wear sufficiently wide shoes at the level of the toe box

7- Have good foot hygiene especially for the elderly, diabetics, with circulation problems …

Surgery that doesn’t address the cause of the problem doesn’t actually work.

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