Ouch! Do I Have An Ingrown Toenail?
When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.
Why did I get an ingrown nail? Some causes of ingrown toenails include:
· Heredity - In many people, the tendency for ingrown toenails is inherited.
· Trauma - Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.
· Improper trimming - The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.
· Improperly sized footwear - Ingrown toenails can result from wearing socks and shoes that are tight or short.
· Nail Conditions - Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected, or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot, or poor circulation. If you don’t have an infection or any of the above medical conditions, you can soak your foot in room-temperature water with Epsom’s salt and gently massage the side of the nail fold to help reduce the inflammation. Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to call Foot & Ankle Centers to make an appointment with Dr. Cohen at our Nashville office.
What You Should Know About Home Treatment
Don’t cut a notch in the nail - Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.
Don’t repeatedly trim nail borders - Repeated trimming does not change the way the nail grows, and can make the condition worse.
Don’t place cotton under the nail - Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.
Over-the-counter medications are ineffective - Topical medications may mask the pain, but they don’t correct the underlying problem.
After examining the toe, Dr. Cohen will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed. Sometimes a minor surgical procedure, often performed in the office on the same day, will ease the pain and remove the offending nail. After applying a local anesthetic, Dr. Cohen removes part of the nail’s side border. If this has been a persistent problem Dr. Cohen will likely permanently remove the nail root. Following the nail procedure, a light bandage will be applied. Most people experience minor pain after surgery and you may resume normal activity the next day. If Dr. Cohen has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.
Preventing Ingrown Toenails
Many cases of ingrown toenails may be prevented by:
Proper trimming - Cut toenails in a fairly straight line, and don’t cut them too short. You should be able to get your fingernail under the sides and end of the nail.
Well-fitted shoes and socks - Don’t wear shoes that are short or tight in the toe area. Avoid shoes that are loose, because they too cause pressure on the toes, especially when running or walking briskly.
Remember, there is no need to suffer unnecessarily. If your ingrown toenail doesn’t go away quickly call Foot & Ankle Centers for an appointment at our Saint Thomas Hospital office at 662-6676 to get relief from your foot pain.
With summer around the corner many women are getting pedicures. Here are some helpful dos and don'ts to keep your feet healthy.
Bring your own pedicure utensils to thesalon. Why? Because bacteria and fungus can move easily from one person to the next if the salon doesn’t use proper sterilization techniques. Yuck!
Use a pumice stone, foot file or exfoliating scrub when eliminating thick, dead skin build-up, also known as calluses, on the heel, balland sides of the feet. Be sure to soak your feet in warm water for at least five minutes and then use the stone, scrub, or foot file.
Gently run a wooden or rubber manicure stick under your nails. This helps keep your nails clean and removes the dirt, glitter, and other types of build-up you may not be able to see.
Shave your legs before receiving a pedicure. Resist the urge to have smooth legs, at least until afterward. Freshly shaven legs or small cuts on your legs may allow bacteria to enter your body.
Allow salons to use a foot razor to remove dead skin. Using a razor can result in permanent damage if used incorrectly and can easily cause infection if too much skin is removed.
Apply nail polish to cover up discolored nails. Thick and discolored toenails could be a sign of a fungal infection. Nail polish locks out moisture and doesn’t allow the nail bed to “breathe.” If you think you have a toenail infection, schedule an appointment with Foot & Ankle Centers immediately to get it checked out.
People with foot pain are often extra careful about the shoes they buy (and with good reason!). A common question about shoes is how long do they last? Unfortunately, shoes have no expiration date noted on the bottom. How long your shoes will last depends on several factors, including how often you wear them, where you run or walk, how your foot functions, and your workout conditions and mileage. Contrary to popular opinion, however, you cannot always tell whether a shoe is worn out by visual inspection. With the technologies available today, the outer sole can hold up and not show deterioration even after the shock absorption and stability capacities of the shoe are gone. Wearing old athletic shoes, specifically for running, or wearing the wrong type of shoes for your foot or for a specific sport can lead to injuries. For example, running in a shoe that no longer provides traction, support, and cushioning can lead to a number of musculoskeletal complaints, among them heel pain, shin splints, and stress fractures. A basic rule of thumb for runners is to replace shoes every 300-500 miles.
Some things to consider are:
• Type of shoe/type of foot: Go to a high quality shoe store with well-trained staff. They will know how to evaluate your feet and place you in the proper shoe. Do not just go by brand. Even top name brand shoes make different levels of shoes. Remember the old saying – you get what you pay for.
• Environment: A humid climate can contribute to a shoe’s rapid
breakdown because running in a wet shoe will overstretch the upper part of the shoe while over-compressing the lower part.
• Body type: Your body weight is a big factor in determining which shoe is best for you. In general, the more you weigh, the more cushioning your feet will need to withstand the impact.
• Usage: The amount you wear your shoe and how many miles you log can also affect the life of your shoe. Runners and walkers can easily track their mileage. Shoes used outside will break down more rapidly than those in the gym.
About half-way through the life of your shoes, buy a second pair to rotate in during workouts. Having a newer pair as a point of reference will also help you identify the feel of shoes that have run their course. Additionally, by rotating your shoes you give each pair adequate time to allow the sweat to dry inside.
Sources: Orly Cohen, Certified Pedorthist & the American Podiatric Medical Association
What does Diabetes have to do with my feet?
People with diabetes can develop many different foot problems. Foot problems can occur when there is nerve damage also called neuropathy, which can lead to loss of feeling in your feet. Neuropathy can lead to an inability to feel pain, heat or cold. You may develop a foot injury and not even know it. Dr Cohen has had patients come into the office with thumb tacks in their shoes and not know it! The skin on your feet may also change become dry and crack and peel. The nerves in your feet that control oil and moisture may no longer work. You may develop corns and callusesthat if left untreated could result in ulcerations. Circulation is key to good foot health. If you develop poor circulation, you lose the ability to fight infection and to heal.
How can Foot & Ankle Centers Help?
Dr. Cohen will schedule routine diabetic foot examinations allowing him to check your feet thoroughly to check for any unusual signs. He may do testing on your feet to check your circulation and nerve function. He will check the feet and toes for any redness, swelling and sores. The best way to effectively maintain your foot health is to see the doctor. Do not hesitate to call for an appointment and let the doctor check your feet! Below are some things you should do regularly:
Diabetic Footcare Guidelines:
¨ Do not smoke
¨ Inspect your feet daily for blisters, cuts, scratches, bleeding and lesions between toes. Using a mirror can aid in seeing the bottom of your foot
¨ Do not soak your feet
¨ Avoid temperature extremes-do not use hot water bottles or heating pads on your feet. Test water before bathing
¨ Wash feet daily with warm, soapy water, and dry them well, especially between the toes
¨ Use a moisturizing cream or lotion daily, but avoid between the toes
¨ Make sure that shoes are comfortable at the time of purchase. Do not depend on them to stretch out. Break in new shoes gradually
¨ Do not use acids or chemical corn removers
¨ Do not perform “bathroom surgery” on corns, calluses, or ingrown toenails
¨ Trim your toenails carefully and file them gently. Have a podiatrist treat you regularly if you cannot trim them yourself. Contact your podiatric surgeon immediately if your foot becomes swollen, painful, or if redness occurs
¨ Learn all you can about diabetes and how it can affect your feet
We've all seen someone with a bunion but did you know this condition also can affect children? Juvenile Hallux Abducto Valgus (HAV) is the scientific name for a bunion of the big toe. The word Hallux refers to the big toe and Abducto Valgus refers to the angulation that develops within the big toe joint. A bunion consists of a hard bony bulge at the joint of the big toe, and often the big toe will lean in towards the smaller toes. Though bunions are more common in adults than children, Juvenile HAV can present in children as young as six years old, and can affect anyone.
The signs and symptoms of Juvenile HAV begin with the physical signs; the area around the big toe joint may become swollen, large and prominent. The big toe may also lean in towards the smaller toes. Other symptoms generally include pain in the area, limitation or more difficulty walking and problems can arise with wearing normal footwear. If left untreated Juvenile HAV can cause problems for your child later in life when they become adults.
Treatment options range from buying wider shoes to custom made orthotics to surgery. The main objective is to control excessive abnormal pronation to reduce the medial forces acting upon the bunion. Reducing this force and stress will assist in proper weight redistribution away from the bunion. Symptoms will often improve within a few days. Orthotics help control this motion by supporting the arch of the foot and reducing excessive pronation (flattening of the foot) redistributing weight away from the bunion at toe off.
If you have any concerns or questions about your child’s feet, it’s best to consult with one of the Podiatrists at Foot & Ankle Centers in Nashville, Smyrna, or Carthage
More information is available at childrenspodiatry.com
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