Many of us have experienced ingrown nails or will experience them at some point in life. They are among the most common nail problems. Basically, an ingrown nail occurs when the edge of a nail curves and cuts into the surrounding skin. This may happen on both sides or just one side of the nail bed. You may or may not be able to see the edge.
Typical signs of an ingrown nail include swelling, pain and tenderness. It is not uncommon for a bacterial or fungal infection to be involved. Infections are characterized by spreading and severe pain and ingrown nail pus formation. Ingrown nails are caused by trauma, incorrect nail trimming, and unusually deep nail biting.
Most cases of ingrown nails are treated at home. However, recurrent, severe or infected ingrown nails often require some medical attention. This article centers on ingrown nail treatment with surgery.
What is ingrown nail surgery?
As the name suggests, it is a treatment option for getting rid of troublesome ingrown nails. Below are types of ingrown nail surgery.
This procedure involves making a skin incision on the upper part of the nail without cutting the nail plate. After the incision, the ingrown part of the nail will be exposed after which a portion of it is to be cut. The nail matrix underneath the ingrown portion is also excised. This keeps the nail from growing back. Afterwards, the incised skin is put to its initial position before dressing the affected toe.
Partial nail plate removal:
During this procedure, the part of nail to be removed is lifted and cut up to its origin. The operation is usually done under a local anesthesia. This type of surgery is quite simple. Patients will be able to use footwear in about 4 days. The problem is that chances of recurrence are high.
Complete nail plate removal:
As the name suggests, this procedure involves completely getting rid of the nail plate. It is not a popular form of ingrown nail treatment. In most cases, the option is considered when partial nail removal doesn’t work or when there are abscesses that won’t resolve with partial nail removal. Even worse, recurrence rate is very high after this procedure.
Wedge resection is often considered for infected ingrown nails. During the procedure, the ingrown portion of nail, involved nail matrix and affected soft tissue are all removed. Recurrence rate is low after this surgery.
Full nail avulsion:
During this procedure, the nail matrix is ablated. This means that a new nail will not be able to grow back. Ablation is often done with a chemical known as phenol. Electric current or laser may be used as an alternative. The operation can be done fully, where the nail matrix is completely ablated or partially.
After this procedure, the nail will never grow back again. It involves removal of the whole nail and the tissue that makes nails grow. The treatment is considered for recurring ingrown nails.
Nail fold reduction:
If you are concerned about how your nail will look after surgery, nail fold reduction or removal may be the best option for you. During the procedure, only the soft tissue will be operated on.
As it can be seen, there are different options you can choose from when considering an ingrown nail surgery. Procedures that may permanently change how nails look are indicated for older patients who are not much cosmetically concerned. But at the end of the day, you will be the one to make a final decision. Your doctor may be able to help further.
After ingrown toenail surgery does the nail grow back?
Nails are made of keratin. Under your skin, there is a little factory of nails called the matrix. It keeps making new nail cells which push the older ones above them thus making nails grow. The cuticle keeps germs from reaching the matrix.
So after ingrown toenail surgery does the nail grow back? As we have seen, the main necessity for nail growth is the matrix. As long as the matrix is present, your nails will keep growing back regardless of the number of times you have them removed.
Note that we don’t solely refer to the cuticle or the silvery part that doesn’t hurt when cut when talking about nails. In fact, the nail plate is the largest portion of nails. This means that it will also grow back even after complete nail plate removal.
Some surgeries involve ablation of the nail matrix. You will not be able to have your nails back after such surgeries. It is for this reason that such surgeries are indicated for older patients who are less concerned about looks.
Be sure to ask your doctor whether the surgery you may be considering involves ablation of the matrix. If it does, note that your nail will not be able to grow back. What most doctors do is perform partial matrix ablation. This ensures that nails only fail to grow back on edges where they may grow into skin to cause ingrown nails.
Is ingrown nail treatment with surgery painful?
During ingrown nail treatment with surgery, a local anesthetic is used. This numbs your finger or toe so that you will not feel pain. Any pain or discomfort afterwards can be managed with over the counter pain relievers.
It is also probable that a bandage will be applied after the surgery. It makes it possible for patients to perform daily tasks such as showering with minimum inconvenience. Patients are advised to wear loose-fitting shoes, preferably sneakers for a period of about 2 weeks after surgery. Tight-fitting shoes and high heels force your toenails to crowd together and thus encourage ingrown toenails. You may want to avoid them after surgery. Another preventive measure involves trimming your nails straight across to allow for uniform growth of nail cuticles.
Most ingrown nail surgical procedures are not that invasive. In fact, complete nail plate removal takes about 20 minutes. Such an operation will most likely not prove intolerably painful if pain is present at all.
Why consider ingrown nail surgery
What are the advantages and disadvantages of ingrown nail surgery?
- It may provide a permanent solution to recurrent ingrown nails
- It provides quicker relief to painful ingrown nails compared to treatment at home
- Surgery is a much more practical way to deal with infected ingrown nails, especially when abscesses are involved
- Not recommended for people with blood circulation complications
- It is possible that cosmetic appearance of your nail may be manipulated
- Requires several days of aftercare
What are the available alternatives to ingrown nail surgery?
Not always is ingrown nail surgery necessary. In fact, most people deal with ingrown nails at home. Below are other ingrown toenail treatment options you can try:
- Warm water – Soaking the affected toenail in lukewarm water provides relief to pain and may reduce swelling. You can add Epsom salts or apple cider vinegar to the water for better results.
- Tea tree oil – To keep an ingrown nail from getting infected, apply tea tree oil several times a day. In fact, you can alternatively use other essential oils such as coconut oil and olive oil. Essential oils are known to reduce pain and prevent infection. They also can be used as part of dog ingrown nail options. Note that tea tree oil will not cure an already infected ingrown nail.
- Apple cider vinegar – Apple cider vinegar has two main properties that can help with ingrown toenail treatment. It is an anti-inflammatory and has antimicrobial properties. ACV can be applied directly or be added to foot soak water. Direct application is more practical for an ingrown thumbnail infection.
- Epsom salts – Epsom salt ingrown nail treatment helps reduce inflammation and relieve pain. Add ¾ cup of the salts to a bowl of warm water and soak the affected toe or finger for 15 minutes.
- Antibiotic ointment – Antibiotic ointments keep ingrown toenails from becoming infected. Infected ingrown toenails take longer to heal and can result in even more serious complications. To avoid this, use an over the counter antibacterial ointment such as Bactroban.
- Foot elevation – This works for ingrown toenails, especially for people with circulatory problems. Elevation promotes sufficient blood flow in the affected foot. This can reduce swelling and promote faster recovery.
- Preventive measures – Successful recovery from an ingrown toenail doesn’t mean that it will not recur or affect another nail. To stay on the safe side, learn more about how to prevent ingrown nails. For instance, people who bite their nails are more likely to be affected. Also, cutting your nails too short may break the balance between the growth of nails and nail edge skin.
Don’t hesitate to seek medical treatment for an ingrown nail. While it may seem like a trivial problem, it can result in a serious bone infection when poorly managed.
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