Ingrown toenail: causes, symptoms, treatment methods

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Deformation of the nail plate “bumps” appears even in completely healthy people. Women are upset by the appearance of tubercles on their nails and for good reason, because they spoil the aesthetic beauty of the nail plate.

The bumps on the nails are located either horizontally or vertically. The tubercles are especially visible if you paint the nail plate with bright or dark varnish. There may be many tubercles, several or just one.

The tubercles can be deep, and in their advanced form they are accompanied by small cracks (in the recess of the nail), yellowness, and lamination of the nail plate.

Causes of ingrown toenails

The main causes of ingrown nail plates include:

· valgus deformity (curvature of the big toe at the joint level) associated with flat feet, and other anatomical changes in the foot: improper placement of the toes, their pressing on each other inside the shoe can lead to ingrown toenails

genetic predisposition: hereditary deformation of the nail plate and lateral periungual skin ridges

· circulatory disorders caused by diseases such as varicose veins, diabetes mellitus and other endocrine disorders: diseases are accompanied by swelling of the legs, feet, fingers, which leads to ingrown nails

· inflammatory processes - fungal and bacterial diseases: the nail becomes thicker, may lose its previous shape, crumble, thereby damaging the nail fold and causing inflammation

· incorrectly selected shoes: narrow or smaller, squeezing the toes; without a backdrop, leading to the toes resting on the toe of the shoe when walking; high heels, increasing the load on the fingers; on a hard sole, leading to a lack of softening while walking

· incorrectly performed pedicure: trimming nails too short, cutting off the corners of the nail plates

· injury to the toes: bruises leading to damage to the nail and its further abnormal growth

· high load on the legs: physical activity, excess weight, pregnancy, hormonal changes

Ingrown nail

- a problem that causes pain and discomfort, and inaction leads to more severe consequences. Constant pain, the inability to wear any shoes, purulent formations and inflammation around the nail plate are only part of the unpleasant complications associated with onychocryptosis. If you notice the first signs of an ingrown toenail, be sure to schedule a consultation with a specialist.

Can a person have no nails at all?

Fingers without nails are obviously an unusual occurrence. Human nail plates are susceptible to a huge number of diseases, among which infectious diseases take pride of place. We are talking about candidiasis, pyoderma, etc.

Pathological changes in the nail can also be caused by nervous, mental, endocrine and other systemic ailments. It is impossible not to note the frequency of traumatic and occupational injuries to the horny plate. However, if the fingers are without nails at all, we are talking exclusively about a hereditary pathology - anonychia.

Symptoms of onychocryptosis

With onychocryptosis, the lateral part of the nail abuts the periungual fold and continues to grow inside it. At first, the patient feels general discomfort, redness of the skin around the nail is observed. It is also possible to change the shape of the nail. Preferences in shoes are gradually changing, the choice is given to open options, wearing tight, narrow, and over time, any closed shoes becomes difficult. In case of inaction, the symptoms of the disease become more pronounced, complications appear, and over time, surgical intervention becomes inevitable.

The main symptoms of an ingrown toenail include:

Painful sensations in the toe area resulting from injury, after wearing shoes, or for no apparent reason

· swelling and hyperemia (overflow of blood vessels of the circulatory system of any area of ​​the body) of the periungual fold

formation of pus in the area of ​​the nail plate

formation of excess connective tissue protruding from the wound, visually reminiscent of raw meat

In medicine, the development of onychocryptosis is characterized by three main stages - mild, moderate and severe.

Stages of onychocryptosis

First (mild) stage

characterized by redness of the periungual fold and moderate swelling. At this stage, the nail plate has no visual changes, and painful symptoms usually appear while walking in shoes.

Second (moderate) stage

accompanied by signs of inflammatory processes: the periungual fold becomes red, purulent discharge appears, and in some cases painful pulsation is observed. The nail becomes denser and dull.

Third (severe) stage

caused by hyperemia (increased blood supply) of the periungual ridges, the formation of hypergranulation (tissue growth in areas of inflammation), an increase in the volume of the phalanx, and the presence of purulent discharge. The nail becomes brittle and mobile, the skin around it visually resembles raw meat (this symptom is called “wild meat” in medicine).

Complications of onychocryptosis

Prolongation of the disease leads to the development of infections, which certainly aggravates the situation. Wounds that are open for a long time and do not heal are an excellent breeding ground for bacteria. An infected wound heals slowly as the body tries to heal the affected area, resulting in bright red granulation tissue forming at the site of the ingrown nail. If you do not start treatment or start the wrong treatment, the granulation becomes dense, the phalanx changes shape, and it becomes impossible to solve the problem with conservative methods. In addition, inflammation of the soft tissues of not only the fingers, but also the entire foot is likely to develop, which, if left untreated, can spread to the bones and lead to osteomyelitis.

Complications of onychocryptosis are associated mainly with the development of infectious and inflammatory processes and include:

· abscess

(limited inflammatory purulent focus causing intoxication) fingers. It is characterized by the presence of pronounced swelling and redness of the skin. Surgery required.

· lymphangitis

(acute or chronic inflammation of the lymphatic trunks and capillaries, occurring secondarily against the background of purulent-inflammatory processes). It is characterized by the spread of infection throughout the lymphatic system, affecting blood vessels. Complex treatment is required, including anti-inflammatory and antibacterial therapy.

· gangrene

(death of living tissue) of the finger. Characterized by processes leading to irreversible necrosis of soft tissues. Amputation of the affected phalanx or the entire finger is required.

· osteomyelitis

(purulent - inflammatory process that develops in the bones, bone marrow and surrounding soft tissues) of the finger. The infection affects the bones. Drug therapy is required. Amputation of the phalanx of the finger is possible if the patient comes too late.

The risk of complications increases in the presence of concomitant diseases associated with disruption of blood vessels, for example, diabetes mellitus and atherosclerosis. The risk group also includes people who are overweight and over the age of 60.

What is the norm

The nails of a healthy person are smooth, shiny, pale pink in color, with a pronounced whitish hole at the base.
At the same time, the nail plate is constantly renewed, growing by about one millimeter in a week. irecommend.ru

With age, the nail plate thickens and becomes more brittle. This is part of the body's natural aging process. Fragility is also characteristic of the nails of pregnant women. But within six months after giving birth, everything usually returns to normal.

It is acceptable if nails break due to a lack of vitamins or turn yellow due to poor-quality varnish. Sometimes the nail plate can even turn black and fall off if the finger is pinched or hit.

In a healthy person, fingernails are completely restored within 4-6 months, and toenails - within 6-8 months.

But there are persistent pathologies that we often don’t even pay attention to. But in vain. Some changes in the shape, color and texture of nails, as well as the skin around them, may indicate disturbances in the functioning of internal organs and the presence of a variety of, sometimes serious, diseases.

Diagnosis of the disease

First of all, a visual examination and history taking are necessary. It is important to identify the presence of concomitant diseases - to exclude or confirm fungal infections and diseases that are associated with disruption of blood vessels (diabetes mellitus, atherosclerosis).

Diagnosis of onychocryptosis includes

:

· collecting anamnesis (full collection of data about the patient and his diseases): identifying the causes of the disease, collecting complaints

· visual examination of the patient (diagnosing the stage of the disease and identifying complications): the condition of the nails, periungual ridges, skin of the fingers and feet; the presence of deformation of the fingers, swelling, purulent inflammation, granulation; comparison of two limbs

· general blood test (if complications are detected): carried out to identify or exclude a general inflammatory process. A blood glucose test is also performed to confirm or rule out diabetes.

· bacteriological examination of discharge from wounds (analysis of purulent discharge): the study is carried out to determine the type of pathogen and the severity of the inflammatory process

· X-ray examination (study of the internal structure of the foot): carried out to study the anatomical changes in the structure of the foot and to identify or exclude the transition of inflammatory processes to the bones

What is a healthy person’s nail like?

A healthy nail is smooth to the touch, has no color, and is slightly convex. Numerous capillaries are visible through the plate - it takes on a pink tint.

The area and thickness of the horny plate depends on the gender, age of the person, his genetic characteristics and type of activity. The pattern on the nail is individual and is formed from protrusions and depressions. Each person has their own rate of nail growth. Over the course of a day, the plate increases by an average of 0.1 mm. The process of complete nail regeneration takes about 170 days.

Treatment of ingrown toenails

The tools for treating onychocryptosis are conservative methods

in the initial stages (load reduction, compression treatment, foot hygiene, etc.) and
surgical methods
in later stages (nail resection, complete removal of the nail plate, laser techniques).
There are also modern non-surgical methods
that involve the use of various plates, staples and springs (orthonyxia methods).

Which doctor should I contact?

A podiatrist is the doctor you should contact when the first signs of an ingrown toenail appear. In certain cases, treatment requires the participation of a surgeon (in late stages, when conservative treatment is ineffective), a dermatologist (in the presence of fungal and other infectious diseases) and a laser therapist (when treating the disease with methods associated with the use of laser therapy).

It is very important to prescribe competent, most effective treatment to restore pain-free mobility to the patient.

Treatment methods for onychocryptosis

This or that method depends on the stage of onychocryptosis, as well as the presence of complications and concomitant diseases. At the initial stage, the problem can be solved using conservative methods. When a patient presents at a late stage of the disease, there is a high probability of surgery.

Non-surgical methods:

· medical hardware pedicure (a treatment procedure that is performed by a pedicurist with a higher medical education and is aimed not only at the aesthetic beauty of the feet and toes, but also at their health)

· tamponing (installation of a special thin gasket between the nail and the periungual ridge, which prevents contact of the nail with the ridge; therefore, the process of ingrowth is impossible)

· installation of corrective systems: staples, plates (the device is placed on the nail plate in various ways depending on the type of problem and helps to lift the nail, thereby reducing pressure on the roller and preventing ingrowth)

A positive effect can only be achieved if the treatment is prescribed by an experienced doctor - a podologist with higher education. Contact only professional specialists in trusted clinics with extensive experience and a good reputation.

Surgical methods for treating onychocryptosis:

· resection of the nail plate. Resection is a surgical operation aimed at removing part of an organ.

· complete nail removal

Today, classical surgical methods of nail removal are inferior to modern methods that involve the use of laser.

Laser therapy has a number of advantages - it is low in trauma, short recovery time and reduces the risk of re-ingrowing (relapse) of the nail. Using a laser, it is possible to painlessly remove: the nail fold, nail plate, part of the nail, hypergranulations, inflammatory and purulent formations.

Laser treatment is painless, safe and most effective; the procedure is carried out by experienced specialists using modern high-tech equipment.

Why do you need to remove the nail plate?

First of all, the fungus (onychomycosis) attacks the big toe. The reason is simple: the main part of the nail is often found in shoes. Bacteria that get on the plate begin to actively spread and cause harm. The nail may become curled and the finger may swell. Usually a person seeks medical help at this stage: unsuccessful self-medication leads to the neglect of the condition. When a fungus appears, the attending physician carries out therapy, prescribing various ointments and drops. They are designed to destroy the root of the disease. If the stage is late, then the medications cannot reach their target. Advanced cases require long-term therapy. Factors such as excessive sweating of the feet or certain features of shoes can complicate treatment. In order for drugs to access the source of infection, it is necessary to remove the affected area. This is the fastest way to get rid of onychomycosis. Removal of the plate is prescribed in the following cases:

• at least 70% of the nail is infected;
• the affected plate structure and finger swelling make it difficult to walk;
• the infection caused an ingrown nail;
• the root of the nail plate is infected;
• relapses.

Since the nail has a protective function, removing it completely is dangerous. This can provoke additional infection and cause severe discomfort during the recovery period. In some cases, only the top layer or a certain part of the nail plate requires removal. If previously the fungus was gotten rid of only with the help of medications or surgery, today more effective and painless methods have appeared.

Is there a difference between gel nail prosthetics and extensions?

These two procedures are completely different, since each of them uses different substances.

A nail plate that is infected with a fungus and has lost its functionality as a result cannot be extended. During prosthetics, special mixtures with plasticizers are used, which make it possible to create both a durable and plastic nail. In addition, these components have an antifungal effect, which facilitates treatment of fungus after the update. It is worth noting that the technique for carrying out these two procedures is also different.

As you know, human feet are the part of the body that carries a large number of pathogens. That is why during prosthetics, specialists use exclusively disposable devices (spatulas, etc.). This helps prevent fungus or pathogenic bacteria from spreading.

Prevention

The following list of simple rules will help you prevent many possible diseases of the toenails and fingernails.

• You can't bite your nails.
• File your nails with a glass or cardboard file.
• Manicure should be done on steamed hands, this reduces the risk of microtrauma and, as a result, infection of the wound.
• If you use the services of a salon to care for your nails, make sure that the technician disinfects the tools before use.
• Dry your hands and feet.
• Your diet should include enough foods containing vitamins and minerals.

And most importantly, do not be lazy to contact doctors and undergo additional examinations by specialists. The earlier the disease is detected, the greater the chances of defeating it.

Preparing for prosthetic nails on a toe or hand

1. An examination is carried out, during which the condition of the nail, the degree of its damage are assessed, and material for prosthetics is selected.
2. Treatment begins with treating the finger with a spray or solution with an antiseptic effect.
3. Using sterile instruments, all affected areas of the plate are removed, leaving only healthy and strong tissue. This is done to ensure that the prosthesis fits better.
4. The rough layer is removed from the rollers to avoid ingrowth of the natural nail under the artificial one.
5. The plate and open bed are re-treated with antiseptic agents. This is necessary in order to destroy bacteria that cause inflammation, as well as remove the fatty layer that interferes with the quality fixation of the prosthesis.
6. After completing the above stages, prosthetics are performed, the type of which depends on which of the three types of prosthesis was chosen.

It is not so important what material was used to create the artificial nail. Any of them contains strong antifungal components that help prevent the development of fungal infection under the plate.

Basic techniques used in nail prosthetics

• Nail prosthetics with “Ungisan” (filling method).

This prosthetic technique was developed in 1953 by Josef Greppmeier. It involved mixing two components (polymer in powder form and Unguisan (liquid)) to obtain a mass from which a durable and plastic prosthesis was subsequently formed.

In this case, the mixture is poured onto the prepared nail bed and a plate is formed that is as close as possible in appearance to the natural one. In addition, the prosthesis can be made separately for a specific patient, after which it is installed in place.

It is worth noting that this prosthetic technique is only possible if the person has at least a small part of a healthy nail left.

• Nail prosthetics with “Ungisan” using a plate prosthesis.

Using scissors, a blank is cut out of transparent material PG-190/Greppmayr, after which it is fixed to the remaining part of the natural plate using the same mass as in the case of cast-in prosthetics. The prosthesis, which is formed in advance, is placed vertically on the nail fold and then slowly pressed.

Before the material begins to harden, the excess protruding from the sides is removed with a spatula. The artificial nail should not move throughout the entire time until it is completely fixed, that is, until the mass has completely hardened, which usually occurs after five minutes. Before installing the prosthesis, the open bed, which is located below the nail plate, is tamponed, as with the pouring method.

The main advantage of a prosthesis made from a finished plate is that it can be used repeatedly. For example, if it is separated from the rest, the remaining polymer material is removed from the inside by grinding, after which the installation procedure is repeated according to the same scheme described above.

The main condition for prosthetics using Ungisan is the presence of at least three millimeters of a healthy natural nail.

A combined technique can also be used to prevent moisture or dirt from getting under the prosthesis.

• Nail prosthetics using nail mass.

This method of prosthetics is one of the most complex, since during its implementation, conoline (a natural breathable material) and glue are alternately applied. The number of layers depends on the thickness of the nail plate. Finally, the surface is sanded and polished.

After this, the prosthesis is no different in appearance from a natural plate.

As a result, the nail is strong and natural. This is the optimal method of prosthetics for the lower extremities, as well as in case of infection of the plates with a fungus, since the glue used during the procedure contains antifungal drugs.

• Nail prosthetics "Gevolem".

This method involves the use of Gevol gel, which is a hardening polymerization composition containing a light-curing substance. The process is very simple: a soft nail prosthetic agent should be applied to the damaged bed, after which it hardens and a thin elastic surface is formed. At the end, the master can only give the artificial material the desired shape.

The main advantage of this method is its simplicity, which distinguishes it from previous methods.

Gewol gel is available in three colors, namely: pink, transparent and opal. By mixing them, it is possible to obtain a natural shade of a natural plate. Another advantage of this composition is the content of antifungal components. Indications for toenail prosthetics with gel are deformed, broken and delaminated plates.

It is worth noting that the prostheses obtained in this way can be easily painted with decorative varnish, since the material is not afraid of the components it contains, as well as acetone. In addition, when the nails grow, the place where the artificial plate transitions to the natural one is not at all noticeable.

It should be borne in mind that this type of prosthetics is recommended for use if the damage to the fingers is minor, since the material is very elastic.

• Nail prosthetics with acrylic (acrylate).

Nail prosthetics with polygel allows you to grow a plate of a physiologically correct shape. This type of plastic is a new generation invention and is used to create removable dentures. It ensures fixation of the artificial material in such a way that a certain pressure is applied to it. Thanks to this, the distal roller is pressed, and the nail passes freely without resting against it. Only after the plate has grown to the required length is the prosthesis removed.

Is it possible to speed up nail recovery after removal?

In order for the nail plate to recover as quickly as possible, it is necessary to ensure blood flow to the damaged area. As a rule, complete renewal occurs in 3-4 months, and the nail on the working hand grows much faster. If an operation was performed to remove the entire nail plate, the process will take much longer.

The main rule that should be followed is to follow all the doctor’s instructions and not to overload the sore leg or arm. In addition, bathhouses and saunas are prohibited for some time. To restore the nail, both traditional medicine and cosmetic products are used.

If we talk about the latter, many of them have contraindications and side effects. As for traditional medicine, it is absolutely safe, but the result of its use will have to wait quite a long time. Which method to choose to restore a damaged nail plate should be discussed with your doctor.

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You can purchase cosmetic products both in a store and in a pharmacy. As a rule, they help restore the plate within two weeks. The IBX series of preparations and the “Smart Enamel” varnish, which contains vitamin A and some fruit acids, are very popular. It can be used both to activate the growth of a new nail plate and for prevention.

The drugs included in the IBX series restore the nail, penetrating into the deeper layers, as a result of which the plate grows faster and becomes more durable. However, it must be remembered that for each patient the remedy is selected separately together with the attending physician.

No less popular are folk recipes that have virtually no side effects. In addition, the components for them are inexpensive, but are considered very effective.

Good remedies are masks, rubs and baths:

• Using sea salt.

Sea salt has a positive effect on the nail plates, so you can take a bath with it. It is enough to add 1 tsp. in a glass of water and immerse your toes or hands in the solution for 15 minutes. This procedure must be done every other day for two weeks. However, you should not increase the time, otherwise you may dry out your nails.

• With added oils.

In order for recovery to occur faster, you can rub a few drops of oil (sea buckthorn, olive or peach) into the skin around the nail plates every day. You can also add it to hand cream and treat your hands or feet with it, especially in those places that require it most. Rub it in thoroughly until completely absorbed. The benefits of this product will be considerable if you use it for care every day.

• Oil baths.

Take vegetable oil (one glass), heat it in a water bath and add castor oil (a few drops). Dip your toenails or fingernails into the resulting mixture and wait a little. This procedure is quite effective.

• With the addition of lemon juice.

Another good remedy is lemon baths once a week, but only if you are not allergic to citrus fruits. To prepare, you need to take boiled water (one glass) and add fruit juice. The fingers of the lower or upper extremities are dipped into this solution for 25 minutes. You cannot wash off the product immediately after the procedure; you need to wait until your hands or feet are air-dried, and only then rinse them with warm water.

• Potato masks.

It is enough to take one boiled vegetable, peel it and put it through a blender. Spread the resulting warm paste over the nails, cover with plastic and wrap in a towel. The duration of the procedure is as long as the potatoes cool down. After the paste has become cold, the mask can be washed off and a rich cream applied to the nail plates. It is recommended to do this procedure twice a week.

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• Masks with vitamins.

To restore a nail after prosthetics, you need to buy vitamins A and E in capsules at the pharmacy and make masks based on them. Take one piece of each and add to them vegetable oil (1 tsp), water (1 tsp) and lemon juice (six drops). Mix everything thoroughly, apply to the nail plates of the upper or lower extremities for 20 minutes, then rinse with warm water.

• Gelatin mask.

Gelatin contains a large amount of keratin, so it is an excellent remedy for restoring damaged nails. In order to prepare the mask, you need to take one glass of warm water and add gelatin (1 tbsp.). Then fingers greased with rich cream should be dipped into the resulting mass for 20 minutes.

The main thing is to remember that any product has contraindications, so before using it, you need to make sure that they are absent. In addition, it is necessary to check for allergies to the components contained in the mask. If you have neither one nor the other, then using traditional methods just twice a week, you can achieve very significant results.

In order for nail restoration to occur much faster, you should follow the advice given by leading dermatologists:

1. You need to follow a proper diet, because this is the key to the rapid recovery of nails affected by fungus. Regeneration occurs due to the presence of vitamins and microelements in the products, which ensure rapid growth of the plates.
2. The menu must contain products containing vitamins A and B, which are found in carrots, brewer's yeast, eggs, liver and butter. No less important are vitamins C (gooseberries, bell peppers, citrus fruits, currants) and E (greens and olive oil). If they all enter the body in sufficient quantities, the regeneration process accelerates, blood circulation improves, nails are saturated with oxygen, which means they grow faster.
3. Be sure to include apples, bananas, fermented milk products, buckwheat and goat milk in your diet. They will help make the plates stronger and provide a basis for nail formation.
4. Contact with aggressive substances must be avoided, which means that cleaning agents and detergents should only be used with gloves.
5. Constantly apply oils (olive, peach, grape) to moisturize the plate and the skin located around it.

How to care for your nails after prosthetics

1. The prosthesis can last about one to three months. The plate can grow back up to one year if the damage to the infected area is strong enough.
2. Since the attachment is carried out to the remainder of the natural nail, a place is formed between the artificial material and the bed where fungus can form and bacteria can multiply. That is why it is necessary to carry out regular treatment with sprays with an antifungal effect (Triclosan, Clotrimazole, tea tree oil).
3. It is worth avoiding frequent wearing of narrow shoes, otherwise compression of the prosthesis may occur and, as a result, injury and deformation of the bed.
4. Every day you should massage the base of the nail. Manipulation is necessary in order to improve blood circulation at the site of injury. To do this, apply cream, rub and massage each finger, more precisely, the base of the nail, focusing on the injured one. If required, a similar procedure should be done with the lower limbs.
5. We must try to exclude situations where there is moisture between the prosthesis and the natural plate for a long time.
6. Prosthetics should only be performed by a specialist.
7. If the artificial nail is too long, it can lead to problems with the development of the natural plate, namely onychodystrophy.
8. You should definitely consult a qualified specialist first.

What to do to prevent curvature?

To prevent curvature of the nail plate, it is important to follow preventive measures . These include:

• Normalization of diet. The menu should include products containing microelements necessary for the normal functioning of the body. The following substances are required: phosphorus, zinc, iron, magnesium and calcium.
• Vitamin therapy. For vitamin deficiency, complexes containing vitamins B1, E, H, and A are prescribed.
• Gentle care. It involves using only high-quality care and cosmetic products, proper trimming of nails and cuticles.
• Use rubber gloves when working with soil or products containing aggressive chemicals.
• Maintaining a healthy lifestyle. Involves proper sleep and rest, physical education. Activities aimed at strengthening the immune system will also be important.
• Wearing comfortable, quality shoes. It is strictly forbidden to wear someone else's shoes, as this increases the risk of contracting fungal infections.
• Periodically give your nails a “rest” from decorative varnish and use medicinal varnish instead.
• If your feet sweat excessively, it is recommended to use special drying agents. For example, talc.

It is important to remember that timely seeking medical help when the nail plate grows upward will help get rid of this problem without a trace. And compliance with preventive measures will protect against relapse of the disease.