According to statistics, ingrown toenails occur slightly more frequently in men than in women. However, in both cases it is mainly an ingrown toenail in the nail bed or the nail fold.
Mistakes are most common when cutting nails. As a rule, we tend to cut our toenails rather round, which regularly leads to injuries to the nail bed and also encourages ingrown nails. In addition, the wrong footwear puts pressure on the outside of the nail, which leads to pain when walking.
As a result, many sufferers cut the edges of their nails deeper into the sides. This often leaves small spurs that prefer to grow deeper into the nail fold. This initially leads to an inflammatory change in the toe, which can later be exacerbated by bacteria. Doctors then speak of a so-called Staphylococcus aureus superinfection.
What is often forgotten: Concomitant diseases, such as diabetes mellitus (diabetes), can also cause inflammation and nail changes. Diabetics often lose the feeling of pain in their feet over the years. Pressure points are then no longer noticed as quickly, which exacerbates the problem of ingrown toenails. Regular foot checks are therefore very important for people with diabetes.
The main symptom of an ingrown toenail is pain. This can be so severe that the affected foot does not want to wear socks or shoes. There may also be signs of severe inflammation. For example, there may be swelling, redness and purulent discharge along the nail wall into which the nail has grown.
The diagnosis is made on the basis of the medical history and the symptoms observed(clinical appearance). The pain in the affected toe, accompanied by redness, swelling and possible inflammatory changes, is the most obvious symptom. In the case of severe inflammation and infection, involvement of the deeper skin layers, bones and joints, as can occur in advanced nail bed inflammation, must be ruled out. An X-ray may be necessary for this purpose.
Doctors can use conservative and surgical procedures to treat an ingrown toenail. But what is actually involved?
Conservative treatment measures include, for example, the application of nail braces and regular foot baths to soften the nail wall and separate it from the nail spur. This is usually enough to significantly alleviate the pain.
© Katerina Bond #424243907 | AdobeStock
Slightly antibacterial ointments can also soften the nail wall and expose the ingrown nail spur. This also prevents a bacterial superinfection.
However, if the nail cannot be exposed conventionally or if the infection is too severe, the doctor must intervene surgically. Surgery is particularly favored in cases of bacterial superinfection or recurring (recurrent) disease. Two surgical procedures are available here: Emmert plastic surgery and the laser method:
Surgical incision according to Emmert | Surgery with laser method |
2-day dressing change | No dressing change, daily plaster change is sufficient |
Early removal of corner sutures recommended | No suture removal |
Post-OP treatment and AU approx. 3 weeks | Walking possible immediately |
Elevated positioning for 3 days | Elevated positioning not required |
Aesthetic impairment and nail thinning | Good cosmetic result |
Success rate approx. 70% | Success rate approx. 90% |
Emmert plastic surgery: Nail wedge excision, also known as Emmert plastic surgery, is a medical treatment procedure used to treat an ingrown toenail. Under conduction anesthesia, a wedge-shaped piece of the affected toenail or fingernail is removed together with the corresponding part of the nail bed and the nail matrix.
Laser method: In this procedure, only the nail root cells (matrix) are targeted with a laser beam so that the nail no longer grows back laterally. Only a small wound cavity is created which quickly grows back from the depths. The surrounding tissue and skin are spared. The laser can be used for non-contact, very fine and, above all, precise work.
However, it is important to know that patients with concomitant diseases, such as diabetes mellitus or peripheral occlusive disease(PAD), have a higher risk of complications and wound healing disorders.
At first glance, an ingrown toenail is an easily treatable condition. However, due to the high risk of complications in some people and the high tendency to recurrence, ingrown toenails often pose problems for doctors and their patients.
The earlierthe ingrown nail is detected and treated, the better the chances of recovery and the sooner surgery can be avoided. Particularly in cases where surgical treatment is required, it is also important to eliminate the cause of the ingrown nail, as otherwise the ingrown nail may grow back.
As a prophylactic measure, toenails should not be cut round or too short. Care should also be taken to ensure that the footwear cannot cause pressure points on the foot or toes.
Toenails belong to the skin appendages and are therefore treated by dermatology specialists (skin diseases). Inthe case of surgical corrections, surgical specialists may also be consulted. Ingrown toenails are also checked and prevented by non-medical hands as part of medical foot care (podiatry).
