Ingrown nails result
partly from the
shape of the nail
and partly from the
shoe pressure. The
pressure of the nail
margin against the
skin causes
irritation. If the
nail penetrates the
skin, an infection
called a
paronychia can
result.
The treatment is to
gently tuck a piece
of cotton between
the edge of the nail
and the skin.
Another trick is to
apply skin adhesive
and a piece of tape
to pull the skin
away from the nail.
When there is
infection, soaking
and antibiotics may
clear it up.
Sometimes minor
surgery is needed to
temporarily remove
the edge of the nail
plate and any
infected tissue.
When this is a
recurrent problem, a
permanent narrowing
of the nail can be
done by removing the
germinal matrix
(the source of nail
growth) along within
the edge of the nail
plate. This is
called a
matrixectomy,
and can be done
either surgical
methods or by
chemical application
phenol.
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Thickened nails can
be painful, but more
often are just
unsightly. They are
due to a fungus,
often the same
fungus that causes
Athlete's Foot.
Thickened nails are
also caused by
injury to the
germinal matrix and
some skin
conditions.
Treatment may
consist of topical
application of
drying agents, since
a moist environment
is needed for growth
of the fungus, or a
urea paste to
dissolve the nail.
The simplest thing
to do is to just
reduce the size of
the nail with
clippers or a
grinding instrument.
To completely
eliminate the fungal
infection, it is
necessary to remove
the nail plate under
local anesthetic,
and then treat the
nail bed with
antifungal
medication as the
nail plate grows
back. Oral
medications are not
often used for toe
nail infections.
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Black nails are
usually due to blood
under the nail, and
are caused by
injury. They are
frequently seen in
athletes, especially
runners, when the
shoe is too short or
when the toe
repeatedly hits the
end of the shoe.
The nail becomes
loose, but if there
is no infection, it
is better not to
remove the nail.
The nail can be
stabilized with a
loop of tape until
it spontaneously
separates.
Black nails can also
be caused by
infection with a
black fungus.
Black streaks in the
nail bed should be
checked; they can be
a type of malignant
tumor (melanoma).
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