COMMON NAIL PROBLEMS

1.  What are ingrown nails? 

An ingrown nail is result of a nail growing into the skin that surrounds it.  This often occurs at the either edge of the big toe.  Ingrown nails may be caused by improper trimming, inherited nail deformities or injuries, fungal infections, or pressure.

Symptoms:  Ingrown nails may cause pain at the tip of the toe or all the way to the base of the toe.  The pain is often worse while walking.  An ingrown nailbed may also lead to infection, inflammation, or a more serious condition.  If it is infected, you may see pus or redness.

Evaluation to determine the extent of your problem:  Dr. Honick will examine the painful area.  If other problems are suspected blood tests, cultures, or x-rays may be done as well.

Treatment:  If the nail is not infected, Dr. Honick may trim the corner of it to help relieve the symptoms.  He may need to remove one side of your nail back to the cuticle.  The base of the nail is then treated with a chemical to keep the ingrowing part from growing back.  If you have infection your ingrown nail may require antibiotics and temporary or permanent removal of the portion of the nail.  To prevent pain, a local anesthetic is used in these procedures.  This is usually done in Dr. Honick’s office.

2.  What are thickened nails?

Abnormally thick or crumbly nails may be caused by injuries, pressure from shoes, fungal infections, or conditions such as diabetes, psoriasis, or vascular disease, and should the nail may loosen and fall off.

Symptoms:  Along with the thickening, the nail may appear rigid, brittle, or yellowish.  Nail will also be painful when pressure is applied to it.  Some thickened nails may be a symptom of an underlying medical condition.  It is important for Dr. Honick to look at your medical history for possible related problems.

Treatment:  If the nail is not infected, Dr. Honick may be able to treat it by trimming, filing, or grinding.  If a fungal infection is present, oral or topical antifungal medication may be needed.  This can help prevent ulcerations under the nail or keeping this fungus spreading to other nails.  If pain is still present, the entire nail or a part of it can be surgically removed, and do not remove the nail by yourself.

3.  What are black and blue nails?

A black and blue nail is usually caused by sudden or repetitive injury to a toe.  This might occur during sports that involve running or stopping quickly.  Injury may also result from a heavy object falling on your toe.  If your toe is black and blue but not injured, see Dr. Honick immediately.

Symptoms:  The big toe is most often affected.  Bruised and broken blood vessels cause the black and blue color under the nail.  If the condition is a result of some injury, pain may be severe.

Evaluation:  Dr. Honick will talk with you regarding your symptoms and physical activities.  He may palpate the area at the end of toe to determine the extent of pain.  Your toe and foot are examined for any signs of infection.  If a fracture or a bone spur is suspected, x-rays will be needed.  If small black spots are present under the nail, other problems may need to be ruled out.

Treatment:  If the pain is severe, the nailbed may be removed or a hole may be drilled in the nail to rule out drainage, which should ease the pressure.  A local anesthetic will be used.  Pain may also be relieved with prescription medicines as well by soaking or icing the area.  If pain is not severe, you may not to need trim it.  The nail can be fitted or left alone to fall off.  The new nail should grow to replace it.

How can you prevent nail problem? 

Many nail problems can be prevented by wearing the right shoes and trimming the nails properly to avoid infection.  Keep your feet clean and dry.  If you have diabetes, talk with Dr. Honick before doing any self-foot care.

The right shoes:

  • Get your feet measured, your size may change as your age.
  • Wear shoes that are supportive and room enough for your toes to wiggle.
  • Look for shoes made of natural material, such as leather which allows your feet to breathe to avoid problems.
  • Trim your toenails straight across and not cutting down into the corners.
  • If you cannot trim own nails, ask Dr. Honick to do so for you.
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