Ingrown toenail: causes, treatment,removal, what to do after the operation

Ingrown nail or onychocryptosis is ingrown into the lateral margin.
tissue nail roller part of the nail plate. Most often
the outer edge of the big toe suffers. When the nail grows
nail roller reddens, swells, inflammation occurs,
which is accompanied by severe pain.

Not everyone notices that the nail has grown into the skin, and see a doctor
already at the stage of suppuration and intolerable pain. Ingrown nail
half the cases become chronic.

Why does the nail grow?

The nail grows into the finger due to a number of external causes:

  • неправильно проведенный педикюр (в  95 % случаев) —
    cutting the corner of the nail, leaving a sharp edge, burrs, cleansing
    the free part of the nail with scissors tips. After trimming the nail is not
    there should be a rounded edge, not too short
    cut off the nail.
  • narrow, disproportionate shoes, with narrow toes (see ballet shoes
    – cause of ingrown nail), with constant pressure on the nail
    changes the direction of its growth.
  • increased load on the legs

and some diseases:

  • nail plate fungus – nail fungus leads to it
    deformation and thickening, ingrowth in the periungual roller
  • flat feet, valgus feet – and deformity of the foot occurs,
    and curvature of the thumb, because the second finger is pressing him
    feet
  • congenital excessive amount of soft tissue in the subungal
    cushion
  • pregnancy – often ingrown nail in women soon
    after childbirth (in 1,5-2 months) in the period of breastfeeding
    or late pregnancy
  • finger injury or frostbite
  • diseases that violate the nutrition of the nail – endocrine pathologies,
    diabetes, obesity, cardiovascular diseases
  • skin diseases – psoriasis, warts, lichen, etc., which
    contribute to the deformation of the nails
  • cancer treatment – chemotherapy, radiation therapy
    negatively affect constantly growing cells

Symptoms and signs of an ingrown nail

Signs of ingrown toenail:

  • Pain in the area of ​​the nail roll from the ingrowth of the nail,
    constant, aggravated when walking and wearing shoes.
  • Язвочка в месте врастания ногтя появляются в результате травмирования.
  • The cushion is swollen, red, throbbing pain appears – this is
    the addition of infection, while there are purulent discharge.
  • Excessive growth of tissues (granulation) the color of raw meat on
    toe
  • With a long course – irreversible changes in the nail,
    deformation, thickening and shortening of the plate. Coarsening soft
    tissues. Suppuration.

Survey

To exclude the development of complications and quickly cure ingrown
nail should be addressed to the surgeon or podolog (diseases
Stop). He will direct to:

  • complete blood count – to assess the severity of inflammation
  • blood glucose test – to exclude diabetes

If you suspect a nail fungus on your legs – you should refer to
dermatologist for complex treatment, since in this case
ingrown nail is only a consequence of fungal infection, and
to treat the consequences, and not the disease itself – is hopeless.

При наличии осложнений хирург направит на рентгенографию feet,
to determine the presence or absence of a purulent process on the bone,
and also to exclude such pathology as osteophyte (bone growth on
finger), whose symptoms are similar to onychocryptosis.

Conservative treatment

It is effective in the initial stage of the disease, therefore not
delay with a visit to the doctor, held at home:

Baths and compresses

  • Disinfecting baths with potassium permanganate solutions, food
    soda, sea salt (every day, alternately) 2-4 times a day.
    Softening of the tissues leads to the natural release of ingrown
    parts of the nail. After these procedures, try to carefully remove
    nail and treat the place with iodine. Baths do before disappearing
    signs of onychocryptosis.
  • Attaching a piece of sterile bandage dipped in solution
    Chlorhexidine, between the nail and skin roller. As it dries
    Bandage moistened in an antiseptic. Every day the bandage is slightly advanced
    forward, freeing even more of the nail. With diligent performance
    This home treatment is very effective.
  • Compress: it is done at night for 3-4 days, if
    inflammation is not removed, you should contact the surgeon. Composition:
    10 ml of Dimexidum diluted with 20 ml of water, 1 amp. analgin, 1 ml.
    dexamethasone. Wetted with such a solution swab of gauze,
    applied to the finger, on top of cellophane, bandaged, put on a sock
    for the night.
  • You can use this method: nail file saw through
    on ingrown nail there is a vertical groove (only on the stratum corneum).
    This groove will tighten, thus raising the edge
    ingrown nail
  • With the onset of inflammation (throbbing pain, redness,
    edema), this method is suitable only at the very beginning of the inflammatory
    process for relieving it if an abscess of the finger has begun
    do not and should consult a doctor. Lower inflamed
    finger in a container with very hot water (boiling water) for 1-2 seconds
    (as much as you can tolerate) and so several times (20-30
    once in 10-20 minutes), then repeat the procedure until the pain disappears
    and inflammation.
  • With severe pain, it may be the ingestion of NSAIDs (paracsettamol,
    nimesulide, ibuprofen, etc.)

During treatment, observe the following rules:

  • Wearing loose shoes
  • Immaculate foot hygiene
  • Changing socks 2 times a day
  • Proper nail cutting (see below).

Ointments and solutions for ingrown nails

Noctinorm

It is a balm that softens the nail plate, facilitates
circumcision, relieve pain and inflammation. Composition: экстракты солодки,
mackley, gorofit St. John’s wort, palm oil and petroleum jelly. Application:
1-2 p / day, before use, you should steam your feet to
from under the nail rollers out the corners of the nail, then apply a balm
on the roller and the entire nail plate.

Uroderm

Composition: Основное действующее вещество мази мочевина (карбамид),
которая смягчает ткани и ноготь, облегчая срезание ingrown nail
Application: До стрижки ногтя следует наносить мазь в течение 3-4
days Apply on a dry finger, a special spatula should
fill the cream between the periungual roller and the edge of the nail, put on
socks and leave for a while. After 3 days you can trim
nail.

Levomekol

It is applied only after surgery. Composition:
antibiotic chloramphenicol and methyluracil, which improves regeneration
tissues. Application: После операции накладывается повязка с
levomekol to complete cleansing of the wound.

Vishnevsky ointment

It is used when joining an infection. Composition: касторовое
oil, birch tar, xeroform powder. Application: Наносится
ointment for the night under the bandage, in the morning remove, if the nail came out from under
roller – you can cut it.

Ichthyol ointment

Composition: вазелин, ихтаммол. Reduces pain, inflammation,
irritation, destroys bacteria, softens the nail plate.
Application: На ночь делается повязка с ихтиоловой мазью, утром
снимается и можно остричь nail.

Brackets and plates

They lift the edge of the nail, while not bringing discomfort,
you can wear shoes. Staples look like braces for
teeth. Installed on the nail only by a doctor.

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  • Wearing special plates on the thumb: Subfix,
    Oniclip.
  • Wearing staples: Osthold, Ora, Fraser.

Surgical treatment includes a number of methods.

Resection of the edge of the growing nail or the entire nail plate

Removal of ingrown nail is an operation that is performed under
local anesthesia. If the nail festers, most often remove all
nail plate. New nail grows within 3 months. TO
Unfortunately, after surgery with a large frequency in 3-4 months
there are recurrences of the disease. Therefore, prevention is carried out
recurrence, which is in the plastic nail roll: removal
granulations and parts of the skin on the side surface of the finger. Nail art
the roller stops contacting the nail plate.

Laser cautery

Laser of ingrown nail and germ cells of the nail plate after
удаления ingrown nail Shown with nail ingrowth at level
cuticle. High-tech method, leading to lasting remission.
The laser beam burns out the germ cells and part of the ingrown nail,
simultaneously inflamed tissue and granulations are removed. Laser
коррекция является наилучшим методом лечения ingrown nail

Radio wave removal of ingrown nail

Sparing technique, after surgery there is no seam left, and the probability
complications and recurrence is minimal. During surgery
the ingrown part of the nail is eliminated, and the matrix is ​​also processed
and germ zone.

What to do after surgery to remove an ingrown nail?

  • After resection the nail bed is bare and for some time causes
    pain. Healing takes place over a period of a month, and this
    The period is important to protect the tissue from adhering infection.
  • Every day for 3-5 days nail treatment is carried out.
    bed antiseptics (chlorhexidine, hydrogen peroxide) and
    антибактериальной мазью (Levomekol, Гентаксан, Офлокаин),
    finger ligation with sterile materials. In the subsequent dressing
    make every other day.
  • You should ensure complete rest of the limb in the first few
    day and then keep your foot from overload and injury.
  • If necessary, receive painkillers.
  • It is recommended to wear wide shoes with minimal contact with
    operated finger.

What to do if the nail is ingrown in a child?

In this case, you should immediately recover to the doctor – pain
The threshold for children is very high, so independent actions can
only aggravate the situation. TOак лечить вросший ноготь на ноге у
child, the doctor will decide after the examination.

Complications

  • Lymphangitis and lymphadenitis – the spread of infection
    lymphatic vessels to nearby lymph nodes.
  • Finger abscess – purulent damage to soft tissue with swelling and
    redness.
  • Osteomyelitis – a running case of an abscess, with short
    inflammation passes to the bone (more on osteomyelitis).
  • Finger gangrene – tissue necrosis of irreversible nature, tissue
    become black.

Preventing ingrown nails

  • Правильный педикюр:
    • размягчение ногтей в теплой ванночке до pedicure;
    • nail clipping in a straight line, without rounding the edges like this
      make hands;
    • neat processing of the edge of the nail and soft tips
      nail file;
    • free edge of the nail after cutting should be 2-3
      mm, can not be cut too short;
    • removing excess skin and dirt with a piece of bandage or cotton, but not
      scissors.
  • Apply liquid to prevent ingrown nails (GiGi No
    Bump Topical Solution, Genwol med) – soften the skin, reduce
    keratinization and prevent ingrown nails.
  • Wearing commensurate shoes with a small heel (3-4 cm for
    women, 2 cm for men).
  • Wearing orthopedic shoes and insoles if available
    appropriate pathology.
  • Foot hygiene, regular change of socks.
  • Fighting overweight.
  • Timely treatment of fungal infections.

Автор: врач-гигиенист, эпидемиолог

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