Dr Michael Perlstein, D.A.B.P.O. Podiatrist, Talks about Ingrown Toe Nails
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Host: I am pediatrician. Lots of time we see ingrown toenails. First what is the most common reasons someone would get an ingrown toenail? Guest: The most common reason for people getting ingrown toenails, is because they usually end up cutting their nails improperly, they leave little spicules inside, they try to get adapt, they usually use dirty instruments which just gets progressively worse and then it develop infections which makes it even more difficult to treat. Sometimes it just comes from the nail, the form itself, like a fungus nail could create that particular problem. Sometimes it comes from a trauma, being either stepped on or being kicked or sometimes it even comes from just wearing very tight shoes. Those are the number of reasons that people develop in growing toenails. Host: If someone woke up and have ingrown toenails, a lot of discover, could they do anything temporarily to get through the night to make it more comfortable? Guest: Well sometimes it's just an irritation that they can think it's a true ingrown toenail, well in fact, it's just some local irritation. They can soak the area with warm water, a little bit Epsom salt inside. They can take whether a non-steroidal anti-inflammatories like a Motrin or an Advil. They could then use a little Bacitracin and try to wear shoe that doesn't press on it and I would say there is probably 25% of people that have their problems resolved very nicely with just not playing with it and just doing conservative care. Host: Should they cut the ingrown part of the nail or they should leave it alone? Guest: Generally cutting it usually makes it worse, because people have a hard time reaching it, bending over it, usually little fragments of dirt inside there and it just blows up in their faces and then they need professional care. Host: If you saw one and it was ingrown to the side, your approach would be what? Guest: It depends on how severe it is and it also depends if there is an infection along with that. If it's not infected and they just have this minor discomfort, and needs a little bit of trimming, all we simply do is just use a little tropical freeze spray, we remove that little section of nail, and usually go home with just some simple directions like soaking and putting on some topical antibiotic. If they have a little bit more advanced case, where they need some systemic antibiotics, we generally prescribed along with that and if the nail is just severely deformed and broken up and it's really digging in very deeply, then you need to have some local anesthesia performed with the nails numbed up and then that little section is removed and usually defined. If it's recurring then we could do something that's called a permanent nail resection where along with removing the nail, we just add some medication and that stops the nail from growing in permanently. Host: Many times it's slow and has a little bit of an obnoxious form and that can be caused by usually Staph infection? Guest: It's usually a gram positive organism, well because Staph or a Strep and again we need to treat it with antibiotics, to make sure it doesn't blow up and become severe and go into the bump.