Nail Problems

What are toenail problems?

Ingrown Toenails
Ingrown toenailsIngrown nails, the most common nail impairment, are nails whose corners or sides dig into the soft tissue of nail grooves, often leading to irritation, redness, swelling and pain. The big toe is usually the victim of this condition, but other toes can be affected.

How a podiatric physician can help...

A podiatrist will remove the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent them  by removing the troublesome corner of the nail  along with the matrix or root of that piece of nail, using  a chemical, a laser, or by other methods.

Fungal Nails  

Fungal infection of the nail is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

The condition is caused by an infection beneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate and the infection can spread  to other toenails, the skin, or even the fingernails.

What you can do...

  • Washing the feet with soap and water, and drying them thoroughly is the best way to prevent an infection.
  • Shower shoes should be worn when possible in public areas.
  • Shoes, socks, or hosiery should be changed more than once daily.
  • Toenails should be clipped straight across so that the nail does not extend beyond the tip of the toe.
  • Wear shoes that fit well and are made of materials that breathe.
  • Avoid wearing excessively tight hosiery, which promote moisture.
  • Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks.
  • Disinfect instruments used to cut nails.
  • Disinfect home pedicure tools.
  • Don't apply polish to nails suspected of infection—those that are red, discolored, or swollen, for example.

How a podiatric physician can help...

A podiatric physician can detect a fungal infection early, culture the nail, determine the cause, and form a treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Newer oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Podiatrists may also prescribe a topical treatment.

In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.
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Source: American Podiatric Medical Association