To those of you that I do not already know, let me introduce myself. My name is Annie Stroze, I am one of the physicians here at Foot & Ankle Specialists of Racine, and this is my blog. When I first graduated from podiatric medical school in 2015, I instantly became the top contact for my family and friends with any hint of foot and ankle problem. These are their stories.
Chapter 1: The Case of the Ingrowing Toenail
Bright and early on a mid-September morning, I received a text message from by brother addressing “Dr. Pedhead.” This is just one of the many loving nicknames my brother has bestowed upon me. His complaint: “I have a smashed toenail giving me skin problems… I have been wearing swim fins and smooshing them in a kayak all week (we have waves).” He then sent the following picture:
My brother described that his left foot had increased redness, swelling, and pain. Unbeknownst to my brother, what he was describing was an ingrown toenail with a “paronychia”. This is an infection triggered by the ingrown nail irritating the nail margin. Various causes of ingrowing nails include wearing tight or narrowed shoe gear, trimming your nail at an angle, injuring the toe by stubbing or dropping something on it, and genetics. In my brother’s case, the tightness of his swim fins caused the nail to be forced into the skin at the nail margin.
Resolution of the infection can improve with oral antibiotics but will continue after the antibiotics unless the ingrowing portion of the nail is removed. Often our clinic will recommend that patients soak the toe in an Epsom salt- water or a betadine- water bath for 20 minutes, twice a day. Patients should also promptly schedule an appointment to have the toe evaluated, likely requiring a partial nail excision procedure. (See our YouTube video attached: https://www.youtube.com/watch?v=CuSIaHkJRiI) Sometimes, if an infection is present, an antibiotic will also be prescribed. For recurring issues, it may be recommended to undergo a chemical matrixectomy, a permanent nail procedure. This is simply applying a chemical to the nail margin in order to destroy the nail matrix and prevent the nail from growing within the “ingrown” corner of the nail.
Aftercare of the affected toe includes a two-week process of foot soaks. In the case of my brother, I received text messages, twice a day, with photos updating me on his progress. What I looked for is resolving signs of infection, which includes: decreased redness, warmth, swelling, drainage, and pain.
If you think you have an ingrown toenail or believe you may have an infection, call Foot & Ankle Specialists of Racine to have it evaluated. Waiting can result in worsening infection, formation of a granuloma or even an infection of the underlying bone.