The ABC’s of Ingrown Toenail Surgery : Part A The Anatomy

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Part A – Anatomy of an Ingrown Toenail

 

Of the various afflictions, your toes may endure, an ingrown toenail may seem to be in the lesser category — unless it is ignored. There are a few home remedies to try, but if symptoms of redness, swelling, and P-A-I-N persist then infection, disease and even sepsis can occur. The good news is: if you’re suffering from an out of control ingrown toenail, one quick and effective office procedure will do the trick. Honestly.

Let’s take a look at the ingrown toenail, and the way it reveals itself. The condition isn’t as much of a mystery when you understand a little more about the composition and function of your toenails.

Anatomical Structure

The nail plate is a protective outgrowth from the proximal nail fold (and cushioned by the cuticle as it grows out from the nail root). As the nail plate extends to the outer tip (distal fold), it is bordered on either side by the paronychium (lateral nail folds). The nail plate rests on top of the nail bed and protects the nail matrix beneath it, which contains the nerves and blood vessels and is where new nail cells are produced.

The visible part of the nail matrix is called the lunula which contains active nuclei cells — appearing as a white half-moon shaped arc — and sits below the nail plate; becoming translucent as the cells push the nail plate forward. The cells appear pink in color at this point because they are back-lit by the nail bed capillaries below them. The lunula has a unique microscopic anatomy which can be an important determinate of disease.

Anatomical Context 

Though ingrown toenails can be classified in terms of congenital or acquired causes, their appearance is generally the result of wearing ill-fitting shoes, failing to lace your sneakers for maximum support, improper grooming, inappropriate pedicures, or stubbing your toes. Athletes are especially susceptible, as are older persons with thick or curved toenails.

The ingrown toenail manifests itself when the skin on either side of the nail (paronychium) grows over the edge of the nail plate. The skin adjacent to the nail plate will become hardened, tender, swollen and even painful.

Conversely, an ingrown toenail can also present when the nail plate burrows into the paronychium. This sets off a cascade of foreign body intrusion, inflammation, infective and curative processes. A painful discharge may follow, with a foul odor (malodor) emanating from the lesion.

Cautionary Symptoms

For patients with arterial insufficiency or an autoimmune disease such as diabetes or rheumatoid arthritis, an ingrown toenail may lead to severe complications. Septic shock can occur if left untreated, and patients with chronic conditions can also run the risk of losing a limb.

Toenails can be an overall important diagnostic tool. Vitamin deficiency, fungal infections, problematical circulation as well as autoimmune morbidities can be visible from examining the toenail.

Home Remedy Trial

As the ingrown toenail first presents as swollen, red, and somewhat painful you can try this remedy at home. Soak your foot in warm water three or four times a day for 15 minutes, finishing up with a topical antibiotic cream. Try letting the toenail grow out, do not cut it.

If the condition advances and the nail enters the paronychium border, symptoms can now increase to consistent pain, skin overgrowth, bleeding, and oozing of green or yellow pus. These signs definitely suggest that it’s time to seek medical attention from your local podiatrist!

Elizabeth E. Auger, DM has been a practicing holistic podiatrist in Salt Lake City for nearly two decades, and as an athlete herself, Dr. Auger is especially knowledgeable in the area of sports injuries. She takes all new patients, offering personalized foot care solutions for those with a sedentary lifestyle or in a rehabilitative state, from infants to senior citizens.