An ingrown nail is usually referred to any condition whereby inflammation of the surrounding skin of the toenail is present. A “true” ingrown nail occurs when the nail does ingrow into the surrounding nail fold. This may result after the individual has lost the nail and the nail regrows abnormal. A chronically bruised and lost nail may result in an ingrown nail. This occurs because the nail root, nail matrix, has been injured and the nail is now “programmed” to ingrow abnormally.
However, the majority of the time, the “ingrown nail” results after the nail is cut too short within the nail grooves. Bleeding will occur resulting in a granuloma. A granuloma appears as reddish tissue within the nail groove. Granulomas attract bacteria and thus a bacterial infection can develop. The granuloma grows and covers the nail border, thus appearing as an “ingrown nail”.
Signs and symptoms:
- The nail folds which normally covers and protects the nail is red are red and swollen
- The granuloma is present and will bleed easily when manipulated
- Yellow or reddish clear drainage is seen
Treatment:
- Keep the nail groove clean with soap and water
- Apply an antiseptic such as alcohol, iodine solution or Hibiclens solution
- Avoid dancing on pointe until the infection is medically treated
In-Office Medical Treatment
- Temporary resection of the ingrown nail border: The ingrown nail spicule and granulation tissue is removed. This may or may not require a local anesthetic.
- Permanent resection of the ingrown nail border: After removing the ingrown nail and granulation tissue a chemical is applied to the nail groove in order to prevent regrowth of the ingrown nail border. This will require a local anesthetic.
Prevention:
- Keep the nail trimmed to the free edge with a slight curve at the corners
- Do not push back the cuticle nor the nail folds as these protect the nail
- Keep toenails clean and apply alcohol daily on potentially problematic nails
- Evaluate pointe shoes for “dead platforms”
- Access the cause of any toenail discomfort
BIO: Frank Sinkoe, DPM is a native of Atlanta, Georgia who has been practicing podiatry in Atlanta for 23 years. He has a general practice in podiatry and a subspeciality in dance medicine. Dr. Sinkoe serves as the podiatrist for the Atlanta Ballet and is a member of the International Association for Dance Medicine and Science (IADMS). He is married with two children. Reach him at 404-329-5050 or by e-mail at doctorfrank (at) bellsouth.net
