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Ingrown toenails

1,644 Views | 17 Replies | Last: 3 yr ago by bigtruckguy3500
TXTransplant
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Yes, a gross topic I know, but my almost 16 year old son is suffering from them. I know it's genetic because his dad had them so bad that the toenails on both of his big toes were surgically removed.

I don't want to go to that extreme, but my son has injured (maybe broken?) a couple of his toes, and he complains about them, one in particular, all of the time.

I will look into getting an appt with a podiatrist, but are there any reasonable home treatments? He tries to keep the affected toenails trimmed before they grow down into the nail bed, but he's not having a lot of success. One toe appears to have a second nail growing down into the side of his toe, and it has to get to a pretty large size for him to even be able to pull it out.
rebag00
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AG
I suffered from this also when I was a teenager. Big toes only. Only thing that finally stopped them was surgical removal of that part of the toenail. I still cut them off straight with a small notch in the middle. Good luck!
O.G.
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I had them years ago, big toes mostly. Best thing (for me) was to go to CVS/Walgreens and buy the kit to do it yourself. I had gone to the doctor twice about it, didn't get it right either time.

Buy the clippers with the straight edge, look like a pair of wire cutters. There should also be a tool in there to help you "lift" the edge of the toenail.

As was posted above, cut them straight and leave a small notch in the middle. I haven't had an issue in years now.
TXTransplant
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Thanks for the suggestions! What does the notch in the middle do?

His worst toe is actually not his big toe, but his third. Since it's smaller, it's harder for him to manipulate it.
Shiner Bock
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AG
Doc here, foot and ankle big part of my practice

For adolescent IGT there's not alot of home remedies to cure. To make feel better and prevent paronychia (infection of the nail fold from the nail penetrating skin) epsom salt soaks twice daily can alleviate some. In general if developing IGT at a young age, it is generally genetic with either the skin growing over the nail, excessively wide toenails, or pincer shape nails.

My recommendation is to have partial nail ablations from the ingrowing affected borders with phenol application to prevent regrowth of those sides. Of course when you get to the lesser toes the nail is not as large and sometimes folks will elect to have the entirety of the nail removed. Recurrence rate after phenol ablation of either a side or the entirety of the nail is roughly 5%.

Generally patients are extremely pleased with results, because they no longer have the constant aching pain associated with painful ingrowing nails.

hope this helps.
O.G.
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Shiner Bock said:

podiatrist here.

For adolescent IGT there's not alot of home remedies to cure. To make feel better and prevent paronychia (infection of the nail fold from the nail penetrating skin) epsom salt soaks twice daily can alleviate some. In general if developing IGT at a young age, it is generally genetic with either the skin growing over the nail, excessively wide toenails, or pincer shape nails.

My recommendation is to have partial nail ablations from the ingrowing affected borders with phenol application to prevent regrowth of those sides. Of course when you get to the lesser toes the nail is not as large and sometimes folks will elect to have the entirety of the nail removed. Recurrence rate after phenol ablation of either a side or the entirety of the nail is roughly 5%.

Generally patients are extremely pleased with results, because they no longer have the constant aching pain associated with painful ingrowing nails.

hope this helps.
Good user name....
TXTransplant
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Thanks! We have an appt on Monday, so that information gives me a frame of reference for what to expect.

Phenol treatment sounds reasonable compared to removing the entire toenail. Although, your point about the smaller toes is noted. Having a missing toenail on a small toe will probably not be as strange looking as having the entire nail on the big toe removed (his dad has some gnarly looking feet thanks to this).
Shiner Bock
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AG
thanks?
Max Power
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AG
Had issues with my big toes back in high school, would happen if I trimmed them too short. Would normally just soak them and eventually they'd grow back out, but one time it didn't. Had to have the inside edge cut out of my right big toe. To this day, the worst pain I've ever endured was the doctor sticking the needle into the infected tissue and injecting it, as close as I've ever come to passing out. And to numb the toe there was a total of 4 injections, 2 on each side. No issues since, but they killed that side of my toe nail and I'm much more cautious about trimming my nails now. Don't want to deal with that again, no thank you.
harrierdoc
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AG
Shiner Bock said:

Doc here, foot and ankle big part of my practice

For adolescent IGT there's not alot of home remedies to cure. To make feel better and prevent paronychia (infection of the nail fold from the nail penetrating skin) epsom salt soaks twice daily can alleviate some. In general if developing IGT at a young age, it is generally genetic with either the skin growing over the nail, excessively wide toenails, or pincer shape nails.

My recommendation is to have partial nail ablations from the ingrowing affected borders with phenol application to prevent regrowth of those sides. Of course when you get to the lesser toes the nail is not as large and sometimes folks will elect to have the entirety of the nail removed. Recurrence rate after phenol ablation of either a side or the entirety of the nail is roughly 5%.

Generally patients are extremely pleased with results, because they no longer have the constant aching pain associated with painful ingrowing nails.

hope this helps.


I did this to myself back when I was active duty, after my surgery internship. Hurt like heck giving myself the blocks, but no problems ever again.
bigtruckguy3500
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Flight doc with a VMA?

Also, Shiner Bock, thoughts on phenol vs silver nitrate?
harrierdoc
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AG
311 back in mid 90s
aTm2004
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AG
Quote:

My recommendation is to have partial nail ablations from the ingrowing affected borders with phenol application to prevent regrowth of those sides. Of course when you get to the lesser toes the nail is not as large and sometimes folks will elect to have the entirety of the nail removed. Recurrence rate after phenol ablation of either a side or the entirety of the nail is roughly 5%.
I think this is what I had on both sides of both of my big toes when I was a teen. I constantly had ingrown nails (actually born with one) and the podiatrist cut the nail and then killed the root. He had to go back on each toe and redo it on a side as it grew back on one side and had another ingrown nail. The worst part about it is the shot to numb the toe.
TXTransplant
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Had an appointment today. Doctor removed the excess nail and applied phenol on the worst toe. When we go back in two weeks for a follow up, he's going to do the same to the same toe on the other foot, since it's showing signs of problems.

Kid was nervous about the shot but wound up saying he didn't feel a thing (even the shot didn't hurt).

Dr said silver nitrate doesn't work.

Cost was just over $400. I'm hoping I get some kind of buy one, get one half off deal on the second toe, but I'm not counting on it.
Shiner Bock
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AG
Glad to hear it went well.

In regards to chemical ablations, really only two are routinely used, phenol and sodium hydroxide. Silver nitrate has inconsistent results.
bigtruckguy3500
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Cool. I'm with an HMLA. This life, thanks to COVID, and probably also due to the personality of skid pilots, has not been as cush as I thought it would be.
Smokedraw01
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Max Power said:

Had issues with my big toes back in high school, would happen if I trimmed them too short. Would normally just soak them and eventually they'd grow back out, but one time it didn't. Had to have the inside edge cut out of my right big toe. To this day, the worst pain I've ever endured was the doctor sticking the needle into the infected tissue and injecting it, as close as I've ever come to passing out. And to numb the toe there was a total of 4 injections, 2 on each side. No issues since, but they killed that side of my toe nail and I'm much more cautious about trimming my nails now. Don't want to deal with that again, no thank you.


Same but I had to have 8 injections due to the toe being so infected. After the doc cut the nail on both sides and then used the acid to kill the nail bed, I finally had relief. I forgot what it was like to walk without worry about someone hitting my toe. Real relief.
harrierdoc
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AG
enjoy your time with those guys. it will be some of your best memories.

what do you do for the squadron?
bigtruckguy3500
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Probably a lot of what you did. Mostly admin (physicals, LIMDU, argue with NAMI, etc) with a little medicine sprinkled in, and fly when I can.

Should be heading back to GME soon.
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