Dr Information

Summary – ingrowing nail. Most common in adolescent boys, but also prevalent in sports people, dancers, and people who pick at their nails. Can be treated conservatively with shapr removal of the offending spicule in practice. Often requires surgical intervention of partial nail avulsion to remove the offending nail spike, with phenol matrixectomy to prevent regrowth of the spicule.
Literature – partial nail avulsion with phenol matrixectomy is the least invasive, quickest recovery time procedure available today. Podiatrists are trained in this technique, can perform this procedure in their practice under local anaesthetic, and follow up with wound care post operatively.
Diagnostic tip – Staphylococcus aureus can colonise the wound, and erythema needs to be local to the sulcus before local anaesthetic can be administered. Resolving infection with appropriate antibiotics prior to surgical intervention allows good uptake of anaesthetic to the target tissue, and decreases chances of post operative infections.
Testing or imagery – Wound swab can be useful.
Referrals – Refer to podiatrist for assessment, conservative treatment or surgical intervention.

Patient Information

Summary – Ingrowing toenail associated with pain, redness, swelling, pus and bleeding of the side of the toenail.
How does this occur? – onychocryptosis can result from trauma to the toe, sport activities, incorrect cutting of nails, excessively sweating feet.
How can this be helped? – Proper care of toenails, decreasing trauma to toes, removing the spicule, or surgery to remove the spicule under local anaesthetic.
Who can help? – Your podiatrist can remove the nail spike and give tips to help resolve infection. Sometimes the spike has to be removed permanently under local anaesthetic for a permanent solution if the problem is severe or ongoing.