Some people often suffer from ingrown nails. Others experience discomfort at least once in their lives. Despite being a localized inflammation, it usually causes great discomfort and pain, which needs treatment.
Learn more about the chart and how to care:
Contents
What is a Nail?
Onychocriptosis, popularly known as ingrown toenail, is an inflammation that occurs when the nail hurts the skin. That is, when the tip grows so that it hurts, breaks and injures the skin.
The causes range from wrong nail cuts, tight shoes and trauma to the site. This causes swelling, redness, pain and the formation of pus – which are common symptoms of inflammation.
The most affected finger is usually the first toe (or big toe). But all nails can get stuck.
Despite being well located, this causes great discomfort and can worsen, according to the size and proportion of the inflammation.
Some precautions help to avoid the appearance of the ingrown nail, but it is worth remembering that there are genetic factors involved. Therefore, if they usually occur, it is always important to seek medical help so that guidelines and care can be initiated.
Ingrown toenails in babies
The ingrown nail can appear in early childhood and even in newborns. The manifestation in babies is clinically similar to what happens in adults, with the corners of the nails piercing the lateral skin.
Symptoms are observed on swollen, hardened and reddened skin and sometimes with yellow discharge from the nails.
In young children, the causes range from genetic changes in nail shapes or the use of tight shoes and overalls that cover the entire body, including the feet.
Babies’ toenails are soft and very flexible, so to reduce the chances of growing in the wrong direction, the first preventive measure is to avoid tight clothing.
Dress children with larger numbers of shoes, socks and overalls that cover up to the feet. One should also avoid rounding the corners of the nails and cutting them straight and frequently.
Treatment in the early stages consists of daily massages on the swollen skin with corticoid-based creams, to reduce inflammation and release the corners of the nails.
In more advanced cases, consult a specialist doctor to put some cotton or bandage that will help, little by little, release the corners of the nails and not hurt your fingers anymore.
In both situations, hygiene is essential, so parents or guardians should clean the inflammation site with antiseptic soaps. Treatment requires patience, as it may take a few months.
Surgeries are not indicated for children, unless they are minor procedures performed in the doctor’s office in cases of deformities of the growth of the skin around the nails, which may arise if the treatment is not performed. Contact a pediatrician if the redness spreads beyond the finger area and you have a fever .
Types of Nailed
The ingrown nail occurs mainly on the big toe, but it has the possibility of happening on any other finger. Inflammation can manifest itself in two forms:
Unilateral
When only one corner of the nail is piercing the skin and causing inflammation.
Bilateral
Both sides of the nail are inflamed.
Causes of Nailed Nail
The disease arises when the nail does not grow in a vertical direction, causing the lateral end to pierce the skin.
Of the numerous causes for ingrown nails, the usual reasons are:
Unsuitable shoes
The fingers squeeze with the use of shoes that are tight or unsuitable for certain activities, such as playing sports or standing for a long time with pointy shoes, for example. Situations like this cause the tip of the nail to go under the skin and grow in the wrong direction.
Nail cutting
The cut of the nails should be straight, as round cuts can enter the edges of the sides of the finger and inflame the skin.
The individual will also be vulnerable to the disease when removing the cuticles, a common practice among manicurists. This is because the cuticle acts as a protective layer of the nail, which, among other functions, prevents the nail from growing in the wrong shape and punctures the skin.
Hygiene
Excessive sweating or poor foot hygiene leaves the skin moist and warm, which are risk factors for developing an ingrown toenail. Cleaning your feet and keeping them dry is important to prevent disease.
Avulsion of the nail
Avulsion of the nail, or total pullout, is not recommended except in cases such as cancer or certain fungal infections. After the surgical procedure, the nail tends to grow smaller and more buried within the skin.
Traumas
The ingrown nail can be triggered by trips, bumps or heavy objects falling under the nail. Trauma can also cause ruptures in the nail, which facilitates the penetration of bacteria. Repetitive injuries, like kicking a football, can also cause the disease.
Anatomical variations of the nail
Some people are born with genetic changes, such as special shapes of the fingers, that can put pressure on the other toes. In addition, there are also cases of patients with bent or too large nails, who are more likely to perforate the skin because their growth is not vertical.
Groups of risk
Ingrown nails are common in adults and adolescents, with a lower incidence in children and babies. Between the 20s and 30s, then older people over 60, doctors report more cases in men than in women.
Patients with low immunity, circulation problems or people with diabetes are more likely to contract infections, so they should seek help from a professional frequently and treat their nails regularly, as even small problems can cause complications.
Athletes are more likely to acquire a nail stuck in their feet, due to excessive sweating in this region and the constant friction of the feet with the shoes. If the individual wears inappropriate shoes or wrong sizes, larger or smaller, it increases the chance of inflammation of the nails.
Other factors that can predispose a person to have an ingrown nail:
- Edema in the lower extremities;
- Excessive sweating of the feet;
- Bone or soft tissue tumors of the toes;
- Arthritis;
- Obesity;
- Deformity of the foot, such as bunions or abnormally long toes.
What are the symptoms of Nailed Nail?
The ingrown nail appears when the edge of the nail grows and enters the skin of the finger, causing pain, redness and swelling. Over time, the nail continues to grow and further pierce the epidermis.
The wound previously caused becomes more intense, which causes the worsening of symptoms and the presence of pus, which can be a sign of an infection or a reaction of the organism against the aggression on the skin, since it is at the mercy of bacteria.
Other symptoms must be taken into account in order to make a concrete diagnosis of the disease, such as the bad smell in infected nails, odor caused by the accumulation of fungi and bacteria lodged in the area.
Sometimes, there are also cases of itchy inflamed nails.
The degrees of development of the disease vary its symptoms as follows:
Grade 1
Grade 1 of the ingrown nail usually has mild or moderate pain, without the presence of other symptoms, as this occurs only from the lesion on the skin, without the occurrence of infections.
Grade 2
In grade 2, the ingrown nail also shows swelling and redness at the edge of the skin.
Grade 3
The swelling is accentuated and signs of secondary infections are noted, with the presence of pus and / or blood. Here, there can be discomfort when walking and putting on a shoe, for example.
Diagnosis: how is it done?
Onychocriptosis is one of the most common pathological conditions of nails in the offices of dermatologists and podiatrists. Generally, there is no need for any special techniques for the concrete diagnosis, which is carried out during a visual inspection to confirm the presence of the symptoms.
To determine the appropriate treatment, the professional will assess the degree of development of the disease and if there is the presence of pus, which can be the sign of an infection. This assessment can be carried out based on blood tests and, at an advanced stage, x-ray examinations of the bones.
Treatment: what to do to deflate the ingrown nail?
Even if the nail is only slightly ingrown, you should not cut it at home or touch it. In any case, it is advisable to consult a doctor, especially if the problem is more serious, such as when swelling or pus is present.
After looking for a specialist, treatment consists of a series of measures that must be followed to the letter so that the disease does not worsen. In mild cases, it can be done at home by the patient himself, who, following the guidelines below, will unlock the nail after a week or two:
- Local hygiene with antiseptics;
- Compresses;
- Use of open and well-ventilated shoes.
How does the Podiatrist Unlock a Nail?
Many people try to solve the ingrown nail at home, but the ideal is to seek professionals, like the podiatrist for the simplest cases (without infection). Treatment includes fixing nails that have tortuous shapes and tend to get stuck.
Corrective orthoses can also be used, which reduce pain and force correction of the fingers. This reduces the incidence of the ingrown nail.
Treatment for ingrown nails with pus
If the nail has already broken, or is close to breaking, the doctor should prescribe the use of antibiotic ointments to prevent infections or to treat them.
After applying the medications, you should follow the same guidelines explained above, how to raise the nail and dip them in warm water. In such cases, antibiotic ointments, such as Nebacetin, Nebacimed, may be good options provided they are prescribed by specialists.
Nails ingrown with spongy flesh
Treatment depends on the size of the lesion. Minors can be treated by chemical cauterization, applying an acid under the lesion to cause its destruction.
Basic treatments for ingrown toenails should also be carried out, such as placing a little cotton between the nail and the side meat where the spongy meat was formed. Antibiotics can be prescribed in cases of infection or severe inflammation.
The largest ones, on the other hand, must be treated by electrocoagulation, a surgical procedure used by dermatologists through a device that destroys the tissue damaged by dehydration, rupture and carbonization of the cells.
Depending on the case, the doctor can indicate the surgery to remove the side of the affected nail in order to have access to the spongy meat and then remove it with the procedure mentioned above or by curettage , scraping performed to remove the inflammation.
Surgery for an embedded
For cases that have not been effective with previous treatments, surgery performed under local anesthesia is indicated.
In most cases, the procedure removes only the part of the nail that is stuck. In the postoperative period, the patient is advised to use antibiotic ointments or to take oral antibiotics.
If the disease occurs frequently, the surgical procedure removes the entire side of the nail, inducing vertical growth without injuring the skin on the side. In a few months the nail will return to its original appearance and width.
In severe situations, treatment uses complete avulsion of the nail or chemical destruction, by laser or cauterization of part of the nail to prevent it from growing back.
Post-surgery care
After surgery, the patient should keep the finger elevated for a day or two and avoid moving as much as possible. The bandage is removed a few days after the procedure and it is advisable to carry out the following guidelines:
- Wear sandals or other open-toed shoes;
- Dip your nails in warm water for 15 minutes, twice a day;
- To relieve pain, your doctor may prescribe medications such as aspirin , ibuprofen, or naproxen. Antibiotics can be used to prevent infection.
After partial removal surgery, the nail grows around a few months. If it has been removed in its entirety, it may take a year to fully grow again.
Medicines: which medicine is good for ingrown toenails?
The drugs commonly indicated for the treatment of ingrown toenails are:
- Ketoconazole , antibiotic;
- Neosporin, antibiótico;
- Naproxen , anti-inflammatory;
- Mupirocina, antibiótico;
- Povidine , antiseptic;
- If the patient has pain, Tylenol , Paracetamol and Ibuprofen , analgesics and anti-inflammatory drugs;
- Lidocaine , anesthetic ointment.
Home medicines: what is the natural treatment?
The natural treatment for ingrown toenails consists of those cares that help to avoid or not aggravate the condition. This means:
- Keep the region well ventilated;
- Make compresses with warm water or even anti-inflammatory tea bags;
- Dip your foot in saline;
- Make compresses with cotton soaked in antiseptic, according to medical advice;
- Do not poke, smother or press the area.
Living together
The inflammation region must always be kept clean, preferably clean with hydrogen peroxide, to avoid infections. The patient should not cut the part of the ingrown nail without first consulting a professional.
Do not try to drain the infection or pierce it with a needle, otherwise it may worsen the infection.
If the problem is in the feet, the patient should wear sandals or slippers and avoid closed or high shoes until the end of the treatment.
Colored socks should also be avoided, as they can release dyes on the skin and leak into the wounds, causing complications mainly to allergy sufferers. If the patient has undergone nail removal surgery, follow the same guidelines and also practice resting your feet or hands.
Complications
Ingrown nails do not heal on their own and, if left untreated, can form spongy flesh, where there is an accumulation of pus and inflammation in the skin around the nail.
In addition to discomfort and pain, the disease can serve as a trigger for serious infections in patients with difficult healing and weakened immune systems, such as diabetics and patients with circulatory problems. In this special population, the ingrown nail can cause:
- Ulcers, superficial lesions in cutaneous or mucous tissue;
- Cellulite, soft tissue infection;
- Erysipelas, infection caused by the bacteria Streptcoccus pyogenes ;
- Gangrene, death of a tissue caused by an infection;
- Osteomyelitis, infection of the bones.
How to prevent a jam?
The patient must keep the nails clean and use appropriate shoes to prevent the nail from getting stuck. The ideal is to follow the following guidelines and consult a podiatrist for more details on the correct way to care for your nails, especially if the problem is constant:
- When cutting nails, do not round the corners or cut them too short. The ideal is to keep the square cut, finished with sandpaper and, preferably, without removing the cuticles;
- Use clean, sanitized and sharp scissors or pliers. If the nails are thick, before cutting, soak your feet or hands in warm water to soften and facilitate the cut;
- Do not wear tight shoes and play sports with appropriate shoes;
- Keep your nails clean and dry. Biting your nails can contribute to acquiring the disease.
The ingrown nail is a simple problem that can be treated at home in its early stages. However, if neglected, in addition to triggering pain and discomfort, it leaves the skin exposed to bacteria and infections, so it is essential to prevent and treat the disease correctly.
