TOENAILS

Preventing InGrown Toenails
Most professional sources for personal toenail care advise trimming the toenails straight across. Many of us know this simply is not practical.

The toe is not flat at the tip and the concept of cutting the toenail straight across demands that common sense be abandoned.

Realistically the toenail should be trimmed to follow the contour of the toe. The problem arises when the edges of the toenail curve downward into the skin. Each side of the toenail becomes hard to find because it is buried in the skin.

The most effective thing you can do to prevent a painful ingrown toenail is to trim the edges out appropriately. This will prevent the hard toenail edge from pressing into the soft underlying skin.

"Appropriately" trimming the edges of the toenail can be difficult to do by yourself if the borders of the toenail curve down very much.

If you have trouble trimming your own toenails have your podiatrist trim them for you.

Who Needs Professional Toenail Care?
Even young, thin, flexible individuals can have trouble getting their feet into a position to trim their toenails properly.

Put on a few pounds, or develop some stiffness in the joints, or discover the eyes are not focusing as close as they used to and trimming your own toenails can become an even greater challenge.

The problem is seeing where to trim.

This is why most professionals and most professional publications advise the toenails be cut straight across. If you are cutting your own toenails you often can't see into the corners well enough to trim them without cutting into the skin.

The toenail should be trimmed with the contour of the toe but it can be very tricky to trim those corners out without causing skin damage because the corners can be hidden in the skin.

If, for any reason, you have trouble getting your toenails trimmed properly you should have your podiatrist trim them for you.

Periodic foot care provided by your podiatrist not only keeps you comfortable on your feet but gives you the peace of mind of knowing your feet have been examined by a foot specialist.

As we get older, it seems, our toenails just keep getting farther and farther away.

Who Provides Professional Toenail Care?
You may be able to find someone to trim your toenails if you find it difficult to do this yourself. Home care workers may choose to do this for you although many will not. Estheticians do pedicures. Some nurses provide foot care outside of the hospital.

But professional toenail care is considered medical care and should be provided by a trained health care practitioner.

Doctors are required to carry malpractice insurance to protect their patients in case problems occur as a result of the treatment the doctor has provided. Most other health care practitioners do not carry such insurance.

Serious medical complications resulting from toenail care are uncommon but they can occur.

The likelihood of complications is higher for individuals with diabetes or poor circulation. If you pay an individual to trim your toenails...For your own protection and peace of mind you should make sure the individual who trims your toenails carries malpractice insurance to protect you.

Ingrown Toenails
An ingrown toenail occurs when the edge of the hard toenail places too much pressure upon the soft skin next to it. If the toenail plate cuts through the skin a bacterial infection will usually occur.

A bacterial infection causes considerable pain and often causes the skin to produce drainage and become red and swollen. The body's primary defense against infection is the skin. If the skin is cut through by the toenail, bacteria can enter the site easily.

For individuals who have diabetes or poor blood supply to their feet a toenail infection can, in the most severe cases, result in amputation or life threatening systemic infection.

Patients often ask what they could have done differently to prevent their toenails from becoming chronically ingrown. Usually the answer is "nothing".

The shape of the toenail plate is determined genetically. If your toenails curve downward very much at the edges you have an hereditary predisposition to develop ingrown toenails.

Cutting a "V" into the end of the toenail won't change your basic toenail shape. Forcing cotton under the toenail edges can cause additional problems by causing greater pressure on the underlying soft skin. Bottled liquids found in drug stores that claim to change the shape of the toenail are ineffective.

In most instances ingrown toenails can be prevented by periodic professional foot care.

If a toenail becomes chronically ingrown and painful it may need to be permanently corrected. Permanent removal of a toenail border is a minor procedure that requires little or no time off work or out of school. This procedure can be performed in the podiatrist's office under local anesthetic.

In most cases patients experience no pain during this procedure and little or no pain after this procedure.

Thickened Toenails
Toenails usually become thickened as a result of trauma. This deformity is usually permanent. This deformity can become a medical problem if the toenail becomes so thick it presses upon the shoe which can cause pain and injury of the soft tissue underlying the toenail. If a thickened toenail becomes a problem it can be thinned at home with a rasp or file periodically. Your podiatrist can thin the toenail or remove it permanently. A toenail that has a fungal infection can also become thickened.

Fungal Toenails
A fungal infection in a toenail is not a result of poor hygiene. The feet of virtually everyone are exposed to fungus every day. Under normal circumstances our immune system will keep the fungus from making a permanent home of our toenails.

A fungal infection in a toenail usually gets started as a result of trauma to the toenail. There are many ways a toenail can become injured. Most injuries are obvious and painful. But the toenails can also become injured by microtrauma; an accumulation of minor trauma over a period of time. Wearing shoes that are too short will cause microtrauma to the toenails with each and every step.

Trauma to the toenail gives the fungus an opportunity to become a permanent resident of the toenail. Fungal toenails become discolored and can become thickened. Fungal toenails usually show a yellow and dark brown discoloration of the toenail plate, however some fungal toenail infections form a white coating over the toenail plate. A fungal toenail infection does not represent a medical threat. This is not an infection that will threaten your health. If the toenail becomes too thick it can press upon the shoe causing pain and injury to the toenail bed.

The thickened toenail can be periodically thinned at home with a rasp or file. If a fungal toenail is a concern to you your podiatrist can remove the toenail or prescribe oral medication to treat the infection.