Total Care Podiatry

What is it?

Onychomycosis is a fungal infection of the nail. Fungi grow in all warm, moist places. The fungus usually commences growth at the end of the nail plate and continues to spread under the nail. Sometimes chalky, white plaques form on the nail surface and as the infection progresses yellowish, brownish discolouration may be seen. Cell damage by the fungus to the foot of the nail can cause the nail to thicken and change shape. Often callus (dead skin) is broken down and builds up beneath the nail plate. Of all fungal infections that occur on the body, nail infections are most difficult to prevent and treat.

How is it treated?

Fungal infections of the nail are treated in two ways:

1. Conservatively
2. Surgically

Conservative treatment involves a visit to the podiatrist for cutting and thinning of the nails; use of an anti-fungal topical medicament can be used if indicated by the symptoms. Consult your podiatrist for appropriate recommendations. Prevention of reinfection is very important. If this is not carried out, treatment will fail. If skin has been infected then advice on management of tinea pedis will be needed. Your podiatrist will advise you on this. In most cases conservative treatment successfully alleviates discomfort. However, some cases will require specific oral medication and surgery. Surgery is only considered when conservative treatment fails and oral medications are contraindicated due to potentially nasty side effects. Should the need arise these two options can be discussed with your podiatrist.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

What is an ingrown toenail?

An ingrown toenail is where the edge, or corner, of the toenail grows into the adjacent skin (the skin next to the edge of the nail) and pieces the skin, causing the toe to become red, swollen and tender (inflamed).

Ingrown toenails are common, with the big toe most likely to be affected on one, or sometimes, on both sides. The toenail curves and cuts into the skin, causing the toe to become tender and painful, particularly when you walk on it. If left untreated, the toe can become infected.

What causes them?

Ingrown toenails can be caused by a number of things:

• The most common causes of ingrown toenails are badly cut toenails and toenails that are picked, leaving jagged and sharp edges.
• Tight fitting shoes – wearing shoes that are too narrow, or too short,, can crowd your toes and cause your toenails to curve into your skin.
• Excessive sweating or poor foot hygeine – if the skin on your toes and feet is warm and moist, you are more likely to develop an ingrown toenail as the soft skin is easily peirced by the nail edge.
• Injury – such as stubbing the toe, or dropping something on it, can cause an ingrowing toenail to develop.
• Genetic factors – your risk of developing an ingrown nail can be increased by genetic factors, such as the way that you stand, the way that you walk, or having a naturally curved, or fan-shaped toenail.

How can it be treated?

It is best to treat an ingrown toenail as soon as you notice the symptoms. If caught early enough, your podiatrist may recommend the self-care advice listed below to prevent it from getting worse.

Soak your foot in warm water 3-4 times a day.
Use a cotton bud to gently push the skin away from your toenail.

Wear comfortable shoes with enough space around your toes.

Take painkillers, such as paracetamol, or ibuprofen, to relieve any pain. Children who are under 16 years of age should not take aspirin.
If your symptoms persist, your podiatrist will be able to remove the small part of the nail that is digging into your skin. As your toenail grows back, a piece of cotton wool or foam can be placed under your nail in order to prevent it from growing back into your skin. The cotton wool should be changed daily.

If your nail is infected, you may be prescribed a course of antibiotics.

Nail surgery

If your toenail does not improve your podiatrist may recommend that you have part, or all, of or your toenail surgically removed.

The most common surgical procedure for treating ingrown toenails involves only removing part of the toenail. This is called partial toenail avulsion. The edges of your toenail are cut away to make the toenail narrower.

Once the anaesthetic wears off, your toe may be very tender. You may need to take a painkiller, such as paracetamol or ibruprofen, and wear soft or open-toed sandals for about a week or so.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.