To paraphrase Colonel Kilgore: someday, this winter’s gonna end. And when it does, many of the patients of my NYC podiatry practice will expose their feet and toes, and by default, their toenails. And at that time, some will notice a nagging pain, some redness, and maybe even some oozing around the border of the toenails. Yes, kids, it’s the dreaded, feared, and sometimes treated ingrown toenail. As gross as it may be, it’s my living, and someone’s bad day, so let’s talk about this condition.

So what is an ingrown toenail?

The toenail is a unit of the skin comprised of keratin, the hard protein in skin and nails that gives nails their rigid structure, and the nail acts to protect the end of fingers and toes. There is a natural curve to the nail in which the borders of the nail slope down into the skin, so that much of the actual nail plate is concealed by the nail border. In some patients, especially adolescents, the flesh grows over the nail to such an extent that the nail digs into the flesh, creating a portal for bacteria to enter and produce an infection. This type of infection can also be caused by a small spike of nail, which is often created by attempting to cut the corner of the nail, but in fact leaving a small sliver to grow into the flesh (ouch and yuck). Over time, the area becomes red, swollen, painful and full of discharge.

What to do?

In an acute case of an infected ingrown toenail, the treatment is fairly straightforward. The border of the nail is removed so the infection can drain, and this procedure is usually curative without the need for oral antibiotics. In cases of recurrent ingrown nails, the above procedure can be combined with the addition of a chemical into the nail root which prevents the affected border from growing back. This is podiatry 101, a procedure that has been around longer than most of my patients and carries a 98% success rate. Don’t worry, my dear patients, this is all done with the aid of local anesthesia, as most patients would rather reveal state secrets than undergo this type of procedure without anesthesia.

So if your nail border looks a little angry after a winter of hibernation, or your 14 year old has just exposed their feet, and to your dismay, there is a sixth toe on the big toe, stop into your NYC podiatrist for some healing.

See you in the office.
Dr. Ernest L. Isaacson