Contents
What is a Nail?
Onychocriptosis, popularly known as ingrown toenail, is an inflammation that occurs in the finger when the side edge is injured by the nail. The causes range from wrong nail cuts, tight shoes and trauma to the site. The disease usually strikes the feet and causes swelling, redness, pain and pus formation.
The ingrown nail happens because the skin forms a barrier against the growth of the nail, which continues to grow and perforates the layer of the epidermis and dermis. The condition is common in the big toe and rarely affects the hands.
Ingrown toenails in babies
The ingrown nail can appear in early childhood and even in newborns. The manifestation of the disease 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 and 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. The disease 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.
Symptoms of Nailed Nail
The presence of the disease will rarely go unnoticed, as its symptoms are notable. 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
There is only pain.
Grade 2
In addition to the pain, there is swelling and redness at the edge of the nail.
Grade 3
The swelling is accentuated and signs of secondary infections are noted, with the presence of pus and / or blood.
Diagnosis
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.
How To Treat An Embedded
Even if the nail is only slightly ingrown, the individual should not cut it. In any case, it is recommended to consult a doctor, especially if the problem is more serious, such as when there is swelling or pus.
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:
Dip your nails in warm water
To relieve the pain, dip your fingers in a bowl of warm water. Treatment should be carried out for five to ten minutes, once or twice a day, to reduce inflammation. To help the healing process, you can mix the warm water with one or two tablespoons of magnesium sulfate (Epsom salt). The patient can use a hot water compress to produce similar effects.
If the inflammation is very uncomfortable, by immersing the foot in the water the patient can gently pull the damp and softened skin at the corner of the finger, to free the nail. The process must be done for at least a week.
Massage the affected area
Gently massage the inflamed area with the help of a little olive oil or almond oil . Tea tree oil has antibiotic properties and can also be applied to prevent infections.
Raise to one
The patient should raise the corner of the nail that is embedded in the skin with tweezers or dental floss and place a small piece of cotton or gauze to keep it raised, which will help the nail to grow in the correct direction. Change the cotton or gauze once a day and do not cut the nail if there is no major inflammation. The process is practically painless, however, if necessary, the doctor may prescribe an anesthetic ointment to reduce pain. If the pain is severe, cut the nail after lifting the tip.
In more severe cases, with intense inflammation and pus, the process of manipulating the skin and nail is extremely painful. Treatment will consist of antibiotics and, depending on the severity of the inflammation, surgery may be necessary.
Nails ingrown 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.
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 larger ones, on the other hand, must be treated by electrocoagulation, a surgical procedure used by dermatologists through a device that destroys the tissue injured 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.
Medications for A Nail
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.
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Home remedies
In the early stages of inflammation, it is possible to treat the disease with some home medicines, such as:
Onion juice
Blend an onion with 200 mL of water and apply twice a day to the injured nails. With each application, let the onion juice dry on the skin for a while before washing.
Water and salt
Before sleeping, apply the mixture of water with salt and cover your finger with gauze. Leave on all night.
Apple vinegar
Dip a piece of cotton in the apple cider vinegar and rub in the affected area, to nourish the skin and prevent infections. Repeat the process several times a day.
Eucalyptus oil
Eucalyptus oil relieves pain and prevents infections.
Lemon
Cut a slice of lemon, rub gently on the affected area, wrap it around your finger with a bandage and leave it overnight. The lemon acid will act directly in cases of infection.
Thyme water
Thyme is a medicinal plant with several benefits, such as fighting inflammation, infections and relieving pain. Bathe your nails in a bowl of warm water with two spoons of thyme.
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 a pyogenic granuloma, a lesion also known as 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 the 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 An Embedded
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 by the patient, 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.
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