Ingrown Toenail

An ‘ingrown’ nail is defined as a nail that grows by bending into the skin and penetrating the lateral soft tissue. This disorder, more correctly known as Onychocryptosis, afflicts at least 1 in 5 people. The initial clinical symptom is pain in the affected part: the hands (the so-called ‘gyrioditis’) or more frequently the feet and in particular the toes. Subsequently, redness and swelling appear near the nail, clear indicators of infection. The presence of bacteria generates, in turn, pus and bad odours. Among the most common causes of Onychocryptosis are hereditary factors, unsuitable footwear, improper cutting of the nail edge (too short nails that grow poorly), biomechanical pathologies of the big toe or other toes (hallux valgus), but also sports injuries or accidental injuries such as dropping an object on the foot. Onychocryptosis is a phenomenon that affects people of all age groups and in most cases affects the big toe.

Treatment
The only treatment provided is surgery. It lasts about 20 minutes and takes place on an outpatient basis under local anaesthesia (and possibly after taking antibiotics). The doctor may decide to remove the entire nail or only a part and also the soft tissue. The nail will grow back in three to four months.
In podiatry, when biomechanical causes are identified, this conservative treatment is complemented by digital and/or plantar orthotics (interdigital or plantar spacers). In the last decade, there has been a move to advanced techniques, such as selective lateral onychectomy with onychoplasty. Dr Savoia removes the lateral matrix of the nail that grows vertically a few millimetres away from the lateral fingertip, so that it no longer grows back. The operation leaves no visible marks, but results in a slight restriction of the nail width.

Maintenance and healing time
Healing times can vary. The average is about 10 days. Afterwards, it will be necessary to follow Dr. Tommaso Savoia’s instructions and observe a few small precautions, avoiding cutting the nails too much (thus leaving them free to grow) and using comfortable shoes that are not too tight at the toe and laced correctly. Those who have suffered from the problem of ingrown toenails know that, unfortunately, recurrences are always lurking. Better, therefore, to protect yourself.