Fixing ingrown toenails with out surgery.

Zombies Tossed My Salad! · July 2009

So I have two pretty bad ingrown toenails on my big toe. What my main question is, is there anyway to get rid of the relatively quickly with out surgery? Because I'd rather not have to go to that

hellobuddy · July 2009

first of all, I think your main concern should be that you have two toenails on one toe.

What you can do, depending on how badly ingrown it is, you can use for example a thin nail file or other thin but not overly sharp instrument to try and dig under the sides of your nails to try and pry it up.. Be very gentle though. after that is done, file down the nail so it doesnt dig its way back down and with a little luck that should be the end of it.

The Black Hunter · July 2009

Keep them clean, change socks often, don't round the nail off too much, as in don't trim too much off the sides, let it only have a very slight curve. My doctor told me that trimming too much off the sides encourages growth there. You should very slightly round off the sharp bits though.

keep your feet dry if you can, you don't have to never get them wet, a fresh splash of water can do some good, but dont let them sit in sweaty socks all the time.

Dont let dirt get in there!

Tav · July 2009

Get the surgery. Trying to fix it yourself will only make it worse. They surgery really isn't that bad.

Wezoin · July 2009

Just a word of warning, the toe surgery that most doctors recommend (where they cut down the sides of the nail and cauterize the skin under the nail) only has about a 50% success rate (in terms of not growing back, my brother had it twice and it grew back both times, my mother had it once and was fine.) The only 100% way to get rid of an ingrown toe nail, and having had it I can say its really not bad at all despite how gruesome it looks, is the Vandenbos procedure. In the 30-something years the doctor who did mine has been doing them there has never been a case of a nail growing back.

If you can manage to cut off the 'spike' of nail that is digging into your toe (any podiatrist should be able to get at it, or use some of the ideas posted above), and it still grows back then the issue isn't with the nail itself but with excess skin around the nail. The Vandenbos procedure cuts away the excess skin, and afterwards you are left with a regular looking nail. The only other option is complete removal of the nail, which is (so I hear) more painful and makes it pretty obvious that you had the surgery (what with the missing toe nail and all.)

Theres a website about it here including a video of the procedure. Its a little gruesome but please don't let it turn you off of the surgery. If you have any questions about it feel free to ask me, I've had it done myself, and did all the home care for my brother's, so I've become a bit of an expert. I should mention the surgery really only takes about 10 minutes total, so its not that big of a deal, although it does require about a week off your foot.

dispatch.o · July 2009

Once you get the nail out of the skin with a file or clippers/scissors you can use the tip of the file to push a small amount of a cotton ball under the edge where it would normally start growing into the skin, it feels a little odd but given time it will prevent the nail from "catching" on the skin and let it grow to normal length.

The biggest problem is people who cut the nail way too short.

Creepy · July 2009

I've done it myself a couple of times. I don't recommend it. Hurts a lot. Not kidney stone bad, but bad.

Belruel · July 2009

when it happens to me i just soak the nail, puncture the pus pocket and cut off the bit digging in. gotta keep the pus pocket drained though or else the pressure is just horrible and it damn well won't heal.

if it is really bad, or else you're squeamish about fiddling around in your toe, see a doctor.

Neb54 · July 2009

Find a good podiatrist and get them fixed. The only part of the operation that hurts is the anesthetic and that isn't too bad. It's not worth the risk of damaging them yourself trying to fix it

Dunadan019 · July 2009

I have had chronic ingrown toe nails (on various toes, both feet) for most of my life.

everytime I get one, I put a pair of clippers under the corner where it is and snip. if the clippers cant get everything thats burried, I clip as far in as I can and then use a pair of tweezers to slowly pull that piece back until I get the piece that was digging in.

infact, as I was typing this I took care of another little one that I got last week and forgot about. thanks for reminding me.

btw, there is pain and blood involved so the best bet if you have insurance is to just see a pediatrist (i think thats the right one)

November Fifth · July 2009

I've had some luck soaking the infected area in hot water with epsom salt.

dispatch.o · July 2009

Dunadan019 wrote: »

I have had chronic ingrown toe nails (on various toes, both feet) for most of my life.

everytime I get one, I put a pair of clippers under the corner where it is and snip. if the clippers cant get everything thats burried, I clip as far in as I can and then use a pair of tweezers to slowly pull that piece back until I get the piece that was digging in.

infact, as I was typing this I took care of another little one that I got last week and forgot about. thanks for reminding me.

btw, there is pain and blood involved so the best bet if you have insurance is to just see a pediatrist (i think thats the right one)

This would be the reason why you have chronic ingrown toenails. Clipping them shorter than the edge of your toe is a terrible idea and a great way to insure you have another.

Charles Kinbote · July 2009

I'm going to piggyback on this thread.

I've had an ingrown toenail on my left foot for about six years now. I've had surgery on it three or four times - the remarkably painful kind where they pump you full of anesthesia and tug your toenail off. It hasn't helped.

I am going to Europe this next year, and I'm planning on walking a lot. I'm tired of my stupid fucking toe. How can I get this shit fixed once and for all?

As for pulling it out and snipping it, I'm not sure that's a possibility anymore - basically the entire left side of my toenail is embedded in the skin.

dispatch.o · July 2009

Shankill Butcher wrote: »

I'm going to piggyback on this thread.

I've had an ingrown toenail on my left foot for about six years now. I've had surgery on it three or four times - the remarkably painful kind where they pump you full of anesthesia and tug your toenail off. It hasn't helped.

I am going to Europe this next year, and I'm planning on walking a lot. I'm tired of my stupid fucking toe. How can I get this shit fixed once and for all?

As for pulling it out and snipping it, I'm not sure that's a possibility anymore - basically the entire left side of my toenail is embedded in the skin.

You need to see a surgeon who will fix it correctly. It will probably involve some cutting and stitches. You may even permanently lose the toenail... but fuck, it's a toenail.

Charles Kinbote · July 2009

I went to a surgeon who specialized in foot surgery on each occasion (with one exception). I got cutting and stitches. I was told I might permanently lose the toenail. It didn't stick.

I need a new solution.

Dunadan019 · July 2009

dispatch.o wrote: »

This would be the reason why you have chronic ingrown toenails. Clipping them shorter than the edge of your toe is a terrible idea and a great way to insure you have another.

I realize that.

I haven't gotten around to finding another foot doctor now that I have insurance. it isn't such a big deal because I don't mind the pain and they never get very far because I cut them.

Dunadan019 · July 2009

Shankill Butcher wrote: »

I went to a surgeon who specialized in foot surgery on each occasion (with one exception). I got cutting and stitches. I was told I might permanently lose the toenail. It didn't stick.

I need a new solution.

a normal foot doctor will cut along the side of the nail that is infected after giving you a local.

they will then remove the nail and put some kind of acid that prevents it from growing.

try that.

Charles Kinbote · July 2009

I have had that. It did not take. Furthermore, it was insanely painful.

I am looking at alternative approaches - you guys recommending mildly altered variants of the exact same surgery to me isn't helping.

matt has a problem · July 2009

There isn't another solution. Well, cut the toe off is a solution. But aside from digging it out and trying to prevent it from growing back in, there's no other treatment.

Charles Kinbote · July 2009

It's this specific surgery or nothing?

I find that more than a little hard to believe.

RubberAC · July 2009

Cut your toe off
alternately just file that shit down pretty much every day and hack away at your foot with (sanitized) tweezers and whatnot

matt has a problem · July 2009

Shankill Butcher wrote: »

It's this specific surgery or nothing?

I find that more than a little hard to believe.

It's not like you can reroute toenail growing, or put metal plates or prosthetics in. The toe grows how the toe grows. If you keep it filed and trimmed every day or two the nail won't grow in, but aside from that, I dunno, wear looser shoes?

Dunadan019 · July 2009

Shankill Butcher wrote: »

It's this specific surgery or nothing?

I find that more than a little hard to believe.

read this.

go have it done again and tell them to use more phenol and more local.

Following injection of a local anaesthetic at the base of the toenail and perhaps application of a tourniquet, the surgeon will remove (ablate) the edge of the nail growing into the flesh and destroy the matrix area with phenol to permanently and selectively ablate the matrix that is manufacturing the ingrown portion of the nail (i.e., the nail margin). The injections themselves have been known to create levels of pain not usually experienced with standard anesthetic injections as the doctor will attempt to press the injection deep into the toe muscle, but in most cases the injection is no different to an inoculation.

This is known as a partial matrixectomy, phenolisation, phenol avulsion or partial nail avulsion with matrix phenolisation. Also, any infection is surgically drained. After this procedure, other suggestions on aftercare will be made, such as salt water bathing of the digit in question. The point of the procedure is that the nail does not grow back where the matrix has been cauterized and so the chances of further ingrowth are very low. The nail is slightly (usually one millimeter or so) narrower than prior to the procedure and is barely noticeable one year later. The surgery is advantageous because it can be performed in the doctor's office under local anesthesia with minimal pain following the intervention. Also, there is no visible scar on the surgery site and a nominal chance of recurrence.

Although the chances of reccurance of ingrowing nails in an area that has undergone Phenolisation are lower than nails who have just had the ingrowing nail removed, if the application of the phenol was inproperly performed or an insufficient quantity of phenol was applied to the afflicted area; the nail matrix can regenerate from it's partial cauterization and grow new nail. This will result in a reccurance of the ingrown nail in approximately 4 - 6 months as the skin that the original ingrowing nail grew under would also recover from the procedure (but the recovery of the skin eitherside of the nail is standard in this type of procedure) as well as the nail.

Many patients who suffer from a minor reccurance of the ingrowing nail often have the procedure performed again, with wiser patients asking the doctor to revise the procedure and try to assure that the procedure is performed correctly. However some patients who suffer a more severe reccurance see a podiatrist who will perform the procedure again or resort to a more drastic and permanent solution (such as removal of the entire nail or the Vandenbos Procedure, which is described above) if there are multiple reoccurances of the ingrowing nail.

edit: you can also have the nail completely removed if you want.

Charles Kinbote · July 2009

what is this vandenbos procedure?

does it hurt like a motherfucker

winter_combat_knight · July 2009

ALL FROM EXPIERIENCE HERE

I tried this many times, and honestly, it doesnâ€™t work for long. Basically what id do is pull back the skin, shove a bus ticket under the nail and force it to grow up out of the skin. It was messy. It would bleed, smell and the skin would remain infected. The BEST idea is to go to your local GP, and have them cut it out. Youâ€™ll save yourself shit loads pain. They place on needle in the side of your toe (doesnâ€™t hurt) and another one bestween the big and second toe (again, it donâ€™t hurt), then they place a rubber back around it, and start cutting about 10 mins later. In 20 mins, DONE! Cleaned, Stitched, Bandaged, and youre done. Youâ€™ll be off your foot for two days MAX. Make sure you get painkillers. I forgot to get mine, and that was one terrible night without sleep. But yeah, this IS the best choice.

Dunadan019 · July 2009

Shankill Butcher wrote: »

what is this vandenbos procedure?

does it hurt like a motherfucker

The Vandenbos procedure was first described by Vandenbos and Bowers in 1959 in the US Armed Forces Medical Journal (Please refer to Reference section for link). They reported on 55 patients and had no recurrences. Subsequently, Dr. Henry Chapeskie performed this procedure on over 560 patients with no recurrences. Unlike other procedures used to treat ingrown toenails, the Vandenbos procedure doesn't touch the nail. In this procedure, the involved toe is first anesthetized with a digital block and a tourniquet applied. An incision is made proximally from the base of the nail about 5 mm (leaving the nail bed intact) then extended toward the side of the toe in an elliptical sweep to end up under the tip of the nail about 3-4 mm in from the edge. It is important that all the skin at the edge of the nail be removed. The excision must be adequate often leaving a soft tissue deficiency measuring 1.5 by 3 cm. A portion of the lateral aspect of the distal phalanx is occasionally exposed without fear of infection. Antibiotics are not necessary as the wound is left open to close by secondary intention. Postoperative management involves soaking of the toe in warm water 3 times/day for 15-20 minutes. The wound is healed by 4-6 weeks. No cases of osteomyelitis have been reported. When healed, the nail fold skin remains low and tight at the side of the nail. This procedure can be performed on mild to severe cases, and preferably before anyone has attempted a nail resection.

basically, they cut the skin around the nail instead of cutting the nail and let it heal.

EWom · July 2009

I had my toenail root removed via burning away with acid. (EDIT FOR CLARIFICATION: By a Doctor, anyone dumb enough to try that themselves deserves the horrible injury they will recieve.)

It is insanely painful for about a month, and they drugged me up for that month pretty good. But since then my toe hasn't even thought about growing a new toenail.

Charles Kinbote · July 2009

all my experiences with the local anesthesia for the surgeries were incredibly, intensely painful

others have concurred with me on this

definitely top five most painful things I've ever experienced

Asiina · July 2009

I had a friend who had the surgery and it took her so long to recover and she described it as incredibly painful. Just take a pair of tweezers or a file and lift the sharp bit of nail out and let it rest over the skin. Do this every day but don't break the nail or you'll have to start over. Let it grow out until it is level with the rest of the nail and longer than the inflamed skin. Then cut it straight (not curved) and the problem should be solved.

If it's too painful to lift the nail try soaking it in warm water for a while.

dispatch.o · July 2009

Shankill Butcher wrote: »

all my experiences with the local anesthesia for the surgeries were incredibly, intensely painful

others have concurred with me on this

definitely top five most painful things I've ever experienced

Shots in the feet/tongue and face are notoriously painful. Most of the other stuff? not at all.

Midshipman · July 2009

matthasaproblem wrote: »

There isn't another solution. Well, cut the toe off is a solution. But aside from digging it out and trying to prevent it from growing back in, there's no other treatment.

This is absolutely not true.

I had ingrown toenails back in high school on both of my big toes (probably from getting my feet stomped on in sports). I got rid of them both by using a solution of silver nitrate on the inflamed/granulated skin that was growing over the edge of the nail. This wasn't quick at all, it took about 2 months to restore my nails to normal, but it worked and my nails look perfectly normal these days. Of course, this was combined with keeping the toes clean and dry as much as possible.

Another method that can be used to head off an ingrown toenail before it gets very bad is to use a common adhesive bandage to pull the skin away from the nail. If you are getting ingrown on the left side of your nail, put one end up the bandage on the left side, wrap around the underside of the toe, and attach the other end just below the nail on the top of your toe.

http://en.wikipedia.org/wiki/Ingrown_toenail#Therapy_by_Band-Aid

This worked for me just a month or two ago when I noticed an ingrown nail just starting to develop.

Wezoin · July 2009

Shankill Butcher wrote: »

It's this specific surgery or nothing?

I find that more than a little hard to believe.

Read my post above: Vandenbos Procedure is 100% sure way to deal with it. The issue isn't with your nail its with your toe, so it cuts off the excess skin around the end of your nail. Very little pain (much less painful than the ones you've gone through already), completely fixes it, and you end up with a normal looking toe at the end.

Wezoin · July 2009

Dunadan019 wrote: »

Shankill Butcher wrote: »

what is this vandenbos procedure?

does it hurt like a motherfucker

The Vandenbos procedure was first described by Vandenbos and Bowers in 1959 in the US Armed Forces Medical Journal (Please refer to Reference section for link). They reported on 55 patients and had no recurrences. Subsequently, Dr. Henry Chapeskie performed this procedure on over 560 patients with no recurrences. Unlike other procedures used to treat ingrown toenails, the Vandenbos procedure doesn't touch the nail. In this procedure, the involved toe is first anesthetized with a digital block and a tourniquet applied. An incision is made proximally from the base of the nail about 5 mm (leaving the nail bed intact) then extended toward the side of the toe in an elliptical sweep to end up under the tip of the nail about 3-4 mm in from the edge. It is important that all the skin at the edge of the nail be removed. The excision must be adequate often leaving a soft tissue deficiency measuring 1.5 by 3 cm. A portion of the lateral aspect of the distal phalanx is occasionally exposed without fear of infection. Antibiotics are not necessary as the wound is left open to close by secondary intention. Postoperative management involves soaking of the toe in warm water 3 times/day for 15-20 minutes. The wound is healed by 4-6 weeks. No cases of osteomyelitis have been reported. When healed, the nail fold skin remains low and tight at the side of the nail. This procedure can be performed on mild to severe cases, and preferably before anyone has attempted a nail resection.

basically, they cut the skin around the nail instead of cutting the nail and let it heal.

And no, it really doesn't hurt other than the local anesthetic, but you aren't going to get away without that with whatever procedure you go for. Only issue is I have never heard of a doctor other than Chapeskie who does it, although he has started training other doctors to do it, and since he's in Canada it may not be the easiest thing to get schedueled. Checkout www.ingrowntoenails.ca. Although, if you show your doctor this they should be able to figure it out.

Charles Kinbote · July 2009

so after all this craziness I thought I would see what was going on down there for the first time in a while. it's been a part of my life for so long that I kinda don't bother anymore.

I cleaned it up, sterilized a medical kit my dad got me a while ago, pulled the skin away from the nail and trimmed the rough edges of the side down. The curious thing is, there really wasn't that red irritated tissue overlapping the nail, and the point of the nail wasn't digging into the skin - it was entirely free. the side of my nail and my wound were, for the most part, separate, and I cut the parts that weren't away. As I was doing this, I noticed something white deep in the wound, so I gritted my teeth, put some sterilized tweezers in there and pulled out a nail fragment that must have been there for ages. I don't know how big it was, but may have been a half a centimeter either way.

I used some sterilized wipes to get it as clean as I could and am currently using three Simpsons band-aids to keep pressure off the area. Tomorrow, I'm planning on getting some proper antiseptics and bandages.

Could this possibly be the answer to my problem? Or have I, at best, eased my discomfort for a little longer?

Fiziks · July 2009

I had a ingrown toenail in high school on my big toe. Went to a podiatrist, had him simply clip the nail first, and was told if it starts to grow back ingrown to see him again.

Sure enough, it grew back ingrown, and I went to go see him for the surgery. Although, I'm not sure why so many people are reporting it to be painful. I started my term paper on JFK at about 5:30, went to the doctors for 6, was out by 6:30 walking just fine (albeit some numbness in my foot from the local anesthesia), any finished my paper by 7:30. Mind you this was also during the middle of track season for me, and I had zero problems with pain or complications.

I'd say at least see a doctor about it. Trying to dig it out yourself can really fuck up your nail, and make it pretty unsightly. It's what my grandfather did, and because of that both his big toenails are about the width of a cigarette.

Charles Kinbote · July 2009

it wasn't painful after the surgery

it's just that the shots I had to get (four the first time!) for the local anesthesia were remarkably painful

yes, they lasted about twenty seconds each, and yes, I'm being a pussy

suck it!

Fiziks · July 2009

Shankill Butcher wrote: »

it wasn't painful after the surgery

it's just that the shots I had to get (four the first time!) for the local anesthesia were remarkably painful

yes, they lasted about twenty seconds each, and yes, I'm being a pussy

suck it!

Well my doctor "froze", not sure of the clinical term, the spots where he was going to anesthetize. So really, I didn't feel a thing. Trust me, I'm quite the pansy when it comes to needles.

Captain Vash · July 2009

SEE THESE TOES?

Both of them, due to my genetic inheritence, were prone to ingrown toenails, on both sides of both big toes..
I had the procedure done where they clip off the offending edge and put some acid on the toenail matrix so your toenail grows back in narrower than before.
It was basically painless. I walked out of the procedure room, drove myself home, and walked to school the next day.
I don't know about all these people saying it was the most painful experience they ever went through, but I had little to no discomfort and had all 4 nail edges done in one sitting.

MAN UP.
GET IT DONE.

edit:

Of course, ymmv, but the "anestethic procedure" my doctor used was the spray some a fine stream of what appeared to be liquid nitrogen onto the area he was about to inject, he then injected me with a local anestethic, which resulted in me not having any feeling in the toe for about 3 days after the procedure.

FyreWulff · July 2009

You're going to have to get it operated on.

Go for completely nail removal. If you just have them take out the sides it will grow back. This happened to me and now I have to wait and see what I'm going to do about it.

Talka · July 2009

Yeah, everyone's right. You need to get the operation.

I know, it sucks to hear. And yeah, the anesthesia shots can hurt like a bitch. But your choice is twenty minutes of pain or a lifetime of pain. You might be able to fix it on your own (I did a few times), but it'll always come back and you run the risk of a pretty bad infection.

So just man up and do it. Honestly I think getting a cavity filled hurts more than this.

Rear Admiral Choco · July 2009

I've actually had a pretty bad problem with these myself lately, and am planning to go to the doctor to get it sorted out. If I do happen to opt for full toenail removal whenever I've got that option, what exactly does that mean for my toe? No toenail forever? Would that affect... well, anything?

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Fixing ingrown toenails with out surgery.

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