Dr. Berg's Foot Facts

Posts for category: Ingrown toenails

Some of my patients with ingrown toenails have wondered why I frequently need to do two procedures instead of one to relieve their pain. When a patient first comes to see me with an ingrown toenail, the first step is taking their history to find out how long they've had their symptoms and what's already done at home to treat them. I'll also assess whether the side of the nail that's been painful is red, swollen, has any drainage, or pus.

Once that's done I can decide whether they need a simple course of oral antibiotics, soaks to the toe, a change in shoes, and or a review of how to trim their toenails. I'll also decide whether temporary or permanent removal of the nail is needed.

Resolving Infection and Temporary Removal of Ingrown Toenail (Nail Avulsion)
When there's been an infection which shows up as recent drainage of the nail, redness, or swelling of the skin around the nail border, temporary removal of a piece of the toenail must be done first.

This procedure is called a nail avulsion. It's done at the office, takes only a few minutes, and is relatively painless.  Afterwards, the inflammation around the toenail border usually resolves within a couple of days. Patients are asked to soak their toe at home to assist in healing the infection.

Matricectomy
A second more permanent procedure, called the matricectomy, can only be done after the infection has resolved. In this procedure the "root cells" which lie just under the toenail are cauterized to prevent reoccurence of the ingrown toenail.

You might wonder why the matricectomy isn't done first. It can be done first if you had no redness, drainage, and in my evaluation no sign of inflammation in the nail border. It's not uncommon to find no redness but some swelling of the tissue, pain on exam, and drainage during the procedure. That's when I must limit the procedure to the nail avulsion.

If the nail has simply been tender for a long time but doesn't have any of those other indicators of infection then the permanent procedure can be performed at the first visit. Otherwise the safest thing is to do the nail avulsion first and then the matricectomy.

A chemical is used during the matricectomy to cauterize the root cells. It would be like pouring gasoline on a fire if the toe was still infected. But by the time you heal up from the first procedure, usually within a week, it is safe to do the matricectomy to help prevent reoccurence of the ingrown toenail.  Following the second procedure it takes about two weeks to heal and it's my responsibility to check your toe at that time to be sure all has healed well.

If you have an ingrown toenail, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

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In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

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By Dr. Rion Berg
February 03, 2016
Category: Ingrown toenails
Tags: fungus   hammertoes   ingrown toenails  

We hardly ever think about our toes or toenails. And why would we? Besides washing them, cutting them, and perhaps painting them we stuff them into shoes where they're almost always out of sight. Although, we occasionally run into a wall or dresser in the middle of the night, we don't think of our toes as usual culprits of pain unless we're diehard athletes.  

However, you're lucky if you manage to get through life with just a stubbed toe. Here are some painful toe conditions to be on the lookout for so that you know what to do about them.

Ingrown toenails

Ingrown toenails occur when the nail grows into the skin causing pain, redness, and swelling. Most common in the hallux or big toe, ingrown nails can occur on your other digits as well. For minor pain, you can soak your foot in Epsom's salt using room-temperature water and gently massage the side of the nail fold to help reduce inflammation. If the pain continues or you suspect infection (yellow pus), get yourself to your podiatrist's office pronto for a simple surgery for immediate relief.

Who's at risk/causes

  • Family members- it's genetic

  • Athletes and others who experience trauma to the nail

  • Those who trim their nails along the sides, instead of straight across

Warning: Never try to perform bathroom surgery on your own nails.

Hammertoes

Hammertoes may not be bothersome when they first form, but typically they become painful as they progress. The pain is most noticeable on the top of the toes when they rub against shoes and where the toe contracts. Padding, better shoes, and orthotics can help this condition, but sometimes surgery is warranted.

Who's at risk/causes?

  • Family members- it's genetic

  • Trauma

  • Arthritis

  • Wearing high heels or other tight fitting shoes

Warning: Don't continue to wear high heels or pointy-toed shoes if you have hammertoes.

Toenail fungus

Although toenail fungus is most often talked about because it's unsightly, it can also cause pain. Many people avoid getting it treated because it can be expensive.  They simply paint over it or ignore it. Unfortunately, most toenail fungus doesn't just sit there and stop multiplying. In most cases it progresses, gets thicker, painful, and much harder to treat. Options for treatment include topicals, oral medications, and laser.

Who's at risk/causes

  • People you live with - it spreads

  • Trauma to the nail

  • Some nail salons

  • Going barefoot in public shower rooms

Warning: Fungus can spread through shoes, socks, toenail clippers, and other implements. Don't share any of these items with family members or friends if you have fungus. To sterilize your shoes you might want to purchase the SteriShoe+ Ultraviolet Shoe Sanitizer. If you have teenagers it can also stop stinky shoes in their tracks.

Call us today at 206-368-7000 for an appointment, often same day. You can also request an appointment online.

More information for treating your toes:

9 Tips for Treating Painful Piggies (Ingrown Toenails)
8 Ways To Pamper Your Pregnant Feet
Guide to Eliminating Ugly Fungal Toenails

Get our free foot book "No More Foot Pain", mailed directly to your home.

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

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By Dr. Rion Berg
December 23, 2015
Category: Ingrown toenails
Tags: children   kids  

Recently I've seen a rush of mothers and fathers bringing in their young children for problems with ingrown toenails.  Although ingrown toenails are not that common in kids, when they do occur it's a tough thing for kids and parents. Kids just want to be able to run and play and parents worry about how to help their children with this condition. Parents may also have concerns about how their child will handle the minor surgery needed to treat the ingrown nail.

Before seeing the podiatrist, you can help reduce your child's pain level by using home remedies and taking some practical steps:

  • Soak your kid's foot in room-temperature water with Epsom's salt
  • Gently massage the side of the nail fold to help reduce inflammation
  • Make sure that they are wearing the right shoe size so that their toe avoids repeated irritation. Avoid tight socks for the same reason.

Get it treated by a children's podiatrist

It's important that you find a podiatrist that works well with children and will take the time needed to make the procedure as painless as possible.

Prevention

  • Get your child's feet measured regularly to ensure proper shoe size
  • Trim your child's nails straight across
  • Make sure your child is wearing the right shoe for their current sport's activity

Call us today at 206-368-7000 for an appointment, often same day. You can also request an appointment online.

 

Get our free foot book "No More Foot Pain", mailed directly to your home.

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

You trust your friends. So far they've been loyal, straightforward, and honest. You follow their advice and it works most of the time.

Except when it comes to DIY treatments for ingrown toenails.

Don't get me wrong, DIY treatments have their place. But when it comes to becoming your own bathroom surgeon avoid it at all costs, no matter what your friends tell you. I've had patients try to treat warts and corns, as well as ingrown toenails. The story does not usually end well.

Although you may swear that a particular herb, chicken soup, or cough syrup cuts your cold time in half or lessens your headaches, when it comes to puncturing the skin you just aren't going to have the infection control expertise or know-how to do it correctly and you'll end up lengthening the time of your pain instead of decreasing it. That's because self-treatment can put you at much higher risk for infection.

Now I'm not saying you can't do something to relief the pain or reduce the inflammation. Of course you can. Soaking your toe in epsom salts, lightly massaging the area, and taking an anti-inflammatory can all help. But, these treatments are usually only temporary when it comes to managing ingrown toenail pain.

And for future reference, to prevent ingrown toenails in the first place don't try and scrunch your feet into shoes where your toes have no wiggle room and always, always cut your nails straight across.

To put this nasty toenail problem to rest you're best off seeing a local Seattle podiatrist. At the Foot and Ankle Center of Lake City we've been treating ingrown toenails for over 30 years.

Call us today at 206-368-7000 for an appointment, often same day. You can also request an appointment online.

Get our free foot book "Happy Feet for the Rest of Your Life" , mailed directly to your home.

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

Poor Stephen Strasburg. First this All Star pitcher of the Washington Nationals couldn't start against the Mets in early March because he had an ingrown toenail. Then adding insult to injury he sprained his ankle a couple of weeks later during warm-ups which prevented him from pitching against the Tigers. Although playing baseball doesn't cause the kind of injuries seen in football, it's still important to ensure that you and your child have the necessary information to help prevent foot and ankle problems in this all American sport.

Although I have no idea how Stephen Strasburg developed an ingrown toenail, there are a few factors that make this condition preventable.

  • Cut toenails straight across - many people tend to cut their toenails on the edges to round them out. This can be a big problem as it is one of the main reasons why people develop ingrown toenails.

  • Get your feet measured - we always measure our kids feet when it's time for new shoes, but did you know that our feet get bigger as we age. Shoes that are too tight or too short can also be a culprit in developing ingrown toenails.

  • Check the field for bumps or divots ahead of time - any uneven surface can lead to trauma and injury including ingrown toenails and twisted ankles.

If you do develop an ingrown toenail you'll likely be in a lot of pain and want it taken care of as soon as possible. As a Seattle podiatrist I'm here to tell you that putting you out of pain from this condition can be done in my office during one visit.

Don't wait to feel better. Call us at the Foot and Ankle Center of Lake City at 206-368-7000 or request an appointment online. Same day appointments are often available.