Picture this: standing at the bathroom counter, sharp implement that you just dipped in rubbing alcohol in hand, digging at that pesky ingrown nail. I call this bathroom surgery. While sometimes effective, it rarely results in long-term relief. You might tell yourself "If only I can dig out that last little piece.... I will fix it!" Yet here you are, a month later, in the same boat. "Epsom salt soaks helped!" They did. It helped soften the nail border and got some of the infection to clear, but it's still sore, red, and you might even have some extra 'stuff' growing from the side of the nail.
It's ok, I've been there. I once had the misfortune (chipping on a concrete block in flip flops) of smushing my big toenail. Weeks later, I developed an ingrown nail. I tried soaks, It didn't work. It started getting red, and I talked to one of my professors. (I was actually in Podiatry school at the time. Yea, flip flops working in concrete, I should have known better). Anyway, I scheduled an appointment for the next day. I already knew what to expect, but I was a little nervous nonetheless.
I shouldn't have been nervous at all. The procedure went great. Here is a breakdown:
I was brought into an exam room. I sat down and the podiatry student took my vitals, got my history and did an exam of my foot and went to talk to the attending (the doctor in charge).
Following this, I was leaned back in the chair and a numbing medication was injected into my toe. There was a little pinch, but nothing too painful. As an aside, in school, the first procedure we ever learned is called a hallux block. We learn about it extensively before hand, because, in the end, we had to practice on each other. The student numbing my toe did a good job, and the procedure was pain free. A small instrument was used to loosen up the affected portion of the toenail, and it was removed. My block lasted the rest of the day and even a little bit the next day. I never had the problem again.
An ingrown here in the office is a similar type procedure with a few exceptions. One: I will be performing your block. By my estimation, I have done it a thousand times. For you, this means comfort.
After your toe is numb, I prep your toe with antiseptic, usually Betadine. Following this, we loosen up the offending portion of the nail, and then cut and remove it. Any soft tissues that are overgrowing are removed as well. After double checking everything, we have 2 options at that point. For Chronic recurrent ingrowns, we apply a special acid to the area (once again you are numb, so you don't feel it) to kill that portion of the toenail. If it is a more acute problem, we may leave it alone and allow the nail to grow back, as in my personal case related above.
I can't tell you how many times people have told me "I wish I didn't wait as long as I did, that wasn't bad at all." For me, there are few things as satisfying as seeing someone leave the clinic with a smile on their face, happy to put their ingrown nails away for good.
If you have an ingrown toenail, or any foot or ankle problem, call us to set up an appointment today!
- Daniel Jones DPM, Diplomate, American Board of Foot and Ankle Surgery.