Ingrown Toenails & In-Clinic GP Treatment

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Ingrown toenails seem to come out of nowhere.

The condition occurs when the width of your nail bed is mismatched to the space in which your toenail grows. This can result in your toenail digging into the fleshy bits next to your nail, usually one of your big toes.

ON THIS PAGE

• Common causes of ingrown toenails
• Treatment options available to you
• DOs and DON’Ts of toenail care
• When to visit your GP
• About Dr Jeanne North

Typical symptoms include tenderness, swelling, and redness on one or both sides of your toe.

If left untreated, the area can become infected and seep pus. A course of antibiotics should clear it up, but you’ll need a doctor to treat your ingrown toenail.

Treatment may be as simple as providing advice on proper nail trimming and which footwear to avoid. However, a surgical procedure is often required to remove the offending part of the nail embedded in your toe.

In more severe cases, a doctor must remove your toenail for good.

It can be surprisingly tricky to find a GP who can treat an ingrown toenail – most will refer you to a podiatrist.

Luckily for my patients, I’ve had some additional surgical training and can perform most procedures at the clinic using local anaesthetic.

I aim to permanently fix your ingrown toenail.

Common Causes

Anyone can get an ingrown toenail, though I see it affect teenagers and young adults more than others.

Causes include injuring your toe, which can result from poor-fitting footwear, and cutting your toenails incorrectly.

However, if your toenail is too big for your nailbed, bad luck and genetics could be to blame. Thanks, Mum and Dad!

If this is your diagnosis, we can work on reversible causes such as:

• Avoiding tight or inappropriate footwear, including high heels
• Addressing poor foot hygiene and treating fungal infections
• Improving poor foot posture, possibly requiring alignment with the help of orthotic inserts

Ingrown Toenail Treatment Options

As with most nail and skin problems, the best treatment option depends on how severe or advanced your ingrown toenail is.

Treatment starts with assessing the underlying cause. During your appointment, I’ll also treat any underlying infection.

We can then weigh up the benefits and risks of surgery to permanently fix the problem.

Non-Surgical Treatments

If your toe isn’t in pain or showing signs of inflammation, and you don’t have a fever, chances are you don’t require surgery.

Getting a GP to check it out is still a good idea. We can talk about at-home treatments, including:

• Soaking your foot in warm, salty water for 20 minutes a few times a day to help reduce pain and swelling. Repeat until your toenail grows out properly – anywhere from 2 to 12 weeks.
• If you can easily access the ingrown edge of your toenail, carefully clip the offending part of the nail.
• Cover your ingrown toenail with antiseptic cream to reduce skin bugs, then bandage it to keep it clean and dry. If there’s no infection, you can also use petroleum jelly.
• Take over-the-counter pain medication as needed.

Depending on the condition of your affected toe, your GP may use tape to pull your nail away from the skin edge.

Infected Ingrown Toenail Surgery

If your toe is painfully swollen, red and seeping pus, or if you have a fever, you’ll likely need infected ingrown toenail surgery.

Various surgical treatments are available to remove the offending part of your toenail. I offer a straightforward, 30-minute procedure.

What’s Involved?

Assisted by our lovely nurses in the clinic’s treatment room, I’ll first numb your toe with a local anaesthetic.

I’ll carefully cut a thin strip, or wedge, from the edge of your ingrown toenail down to its base before removing it completely.

I’ll then destroy (or ablate) the small section of tissue from which this nail wedge has grown, known as the germinal matrix or growth plate.

Next, I apply a diluted acid called phenol to the growth plate to stop your nail’s edge section from growing back.

The aim here is to ensure the problem never returns.

The procedure is known as a partial nail avulsion. It narrows the toenail and makes it less prone to further irritation.

After the surgery, one of our nurses will bandage your toe, and we’ll give you clear at-home care instructions.

Depending on how infected your toe was before the procedure, treatment may include a course of antibiotics and regular soaking in salted water.

It’s best to take some time off work and wear open-toed shoes. If you have a desk job, returning to the office should be fine after a few days.

If you work on your feet or wear protective footwear, you must wait at least a fortnight to recover.

Take a short break from sports and exercise as well.

I’ll need to see you again soon to check on your toe’s recovery.

DOs & DON’Ts of Toenail Care

Follow these simple tips for toenail care to give yourself the best chance of preventing an ingrown toenail from returning.

DO

• Cut your toenail straight across
• Maintain good foot hygiene – including immediately treating fungal infections (aka tinea or athlete’s foot)
• Wear separate, sport-specific shoes
• Ensure nail clippers or scissors are clean

DON’T

• Cut the corners of your toenail
• Cut your toenails too short
• Wear poor-fitting shoes – too loose or tight
• Pick at your ingrown toenail or try to fix it yourself
• Bite your toenails – you’d be surprised how many people do this!

When to Visit your GP

If at-home remedies aren’t working, your toe becomes infected (with pus, redness, or swelling), you develop a fever, or you have diabetes, hotfoot it to your GP.

Diabetics with foot problems require specialised monitoring and care due to associated nerve and circulation problems.

Your GP should be able to diagnose the severity of your ingrown toenail easily and determine the next steps.

For my patients, if your toenail requires surgery, I’ll very likely be able to treat you at the clinic over a couple of appointments, saving you a trip to a podiatrist.

Dr Jeanne North is a local GP at Doctors of South Melbourne.

She has special interests in skin health, minor surgical procedures, and chronic disease management.

You can make an appointment with Jeanne online or call us on 8579 6838.