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What are Ingrown Nails?
 An
ingrown nail is the result of a nail growing into the skin that
surrounds it. This often occurs at either edge of the big toe. Ingrown
nails may be caused by improper trimming, inherited nail deformities,
injuries, fungal infections, or pressure.
Symptoms
 Ingrown
nails may cause pain at the tip of the toe or all the way to the
base of the toe. The pain is often worse while walking. An ingrown
nail may also lead to infection or inflammation. If it’s infected,
you might see pus or redness.
Evaluation
To determine the extent of your problem, your podiatrist examines
and possibly palpates (presses) the painful area. If other problems
are suspected, blood tests, cultures, or x-rays may be done as well.
Treatment
If the nail is not infected, your podiatrist may trim the corner
of it to help relieve your symptoms. For a partially ingrown nail,
your podiatrist may need to remove one side of your nail back to
the cuticle and treat the base of the nail. Severe infections or
totally ingrown nails may require antibiotics and temporary or permanent
removal of the entire nail. To lessen pain, a local anesthetic may
be used in these procedures.
What are Thickened
Nails?
 Abnormally
thick or crumbling nails may be caused by injuries, pressure from
shoes, fungal infections, or conditions such as diabetes, psoriasis,
or vascular disease. Eventually, the nail may loosen and fall off.
Symptoms
Along with thickening, the nail may appear ridged, brittle, or yel-lowish.
The nail may also feel painful when pressure is put on it.
Evaluation
Since thickened nails may be a symptom of an underlying medical
condition, it’s important for your podiatrist to look at your
medical history for possible related problems. To check for a fungal
infection, a culture may be done. The thickness and color of the
nail are also examined carefully to determine possible infections
or other conditions.
Treatment
If the nail isn’t infected, your podiatrist may be able to
thin it by filing or grinding. If a fungal infection is present,
oral or topical antifungal medications may be needed. This can help
prevent ulcerations under the nail while keeping the fungus from
spreading to other nails. If pain is extreme, the nail can be surgically
removed.
What are Black-and-Blue
Nails?
 A
black-and-blue nail is usually caused by sudden or repetitive injury
to a toe. This might occur during sports that involve running or
stopping quickly, such as tennis or basketball. The injury may also
result from a heavy object falling on a toe.
Symptoms
The big toe is most often affected. Bruised, broken blood vessels
cause the black-and-blue colors under the nail. If the condition
is the result of a sudden injury, pain may be severe.
Evaluation
Your podiatrist talks with you about your symp-toms and physical
activities. He or she may palpate (press) the area at the end of
the toe to determine the extent of pain. Your toe and foot are examined
for any signs of infection. If a fracture or a bone spur is suspected,
x-rays may be needed. If small black spots are present under the
nail, other problems may need to be ruled out.
Treatment
If pain is severe, the nail may be removed, or a hole may be drilled
in the nail to allow drainage, which relieves the pressure. A local
anesthetic may be used. Pain may also be relieved with prescription
medications, or by soaking or icing the area. If pain is not severe,
you may not need special treatment. The nail can be thinned or left
alone to fall off. A new nail should grow to replace it.
How Can I Prevent
Nail Problems?
Many nail problems can be prevented by wearing the right shoes and
trimming your nails properly. To help avoid infection, keep your
feet clean and dry. If you have diabetes, talk with your podiatrist
before doing any foot selfcare.
The Right Shoes
Get your feet measured (your size may change as you age). Wear shoes
that are supportive and roomy enough for your toes to wiggle. Look
for shoes made of natural materials, such as leather, that allow
your feet to breathe.
Proper Trimming
To avoid possible problems, try to trim your toenails straight across
without cutting down into the corners. You can smooth the ends with
an emery board.
Consultant: Brad L. Naylor, DPM, MS With contributions
by: Stephen R. Doms, DPM, Lori J. Hillman, DPM & Richard O.
Lundeen, DPM
This information is not intended as a substitute
for professional health care.
©1994, 1999, 2000 The StayWell Company
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