Category: Ingrown Toenails

Does Your Ingrown Toenail Have A Fungal Nail Infection?

We treat a lot of ingrown toenails here at the Auckland Ingrown Toenail Clinic. So, with approximately 10% or more of the adult population harbouring a fungal nail infection, it’s not uncommon that we see many ingrown toenails where a stubborn nail fungus has also infiltrated the nail. So how can you tell, what can you do, and what complications can arise in terms of treatment when you have both an ingrown toenail and nail fungus? Here’s the low-down from Remuera’s leading podiatry team. 

How Can You Tell If You Have A Fungal Nail Infection?

A few key giveaways show you that you may have a fungal nail infection. These include:

Spots on the nails

In the initial stages of a fungal nail infection, you’ll see changes to the free nail edge (at the tip of the nail), cuticle damage, or changes to the sides of the nail. It’s common to notice white or yellow spots or streaks down the nail. This is usually where most people will wonder why their nail has changed and what could be going on, but are hoping that it will go away on its own just like it appeared, so don’t take any action to treat it (yet).

Unfortunately, it is uncommon for fungal nail infections to clear up without treatment. This is because the fungus has everything it needs to continue growing and thriving on the toenails – it has a big nail to invade paired with warm and moist temperatures when enclosed in footwear. As a fungal nail infection is at its early stages here, it’s actually the simplest to treat, before the damage becomes more extensive.

Changes to the nail colour (discolouration)

As the infection progresses, the colour of the nail tends to change. You may see more yellow, white, or sometimes even brown areas. These are all signs of the very real damage that the fungus is inflicting on your nails, and these changes tend to be irreversible – aside from treating the fungus and letting the nail grow out healthy and clear. 

Crumbly, brittle, thick or moth-eaten-looking toenails

As the fungus infects the area beneath the nail, thick nodules are produced, and the nail-thickening process begins. Soft keratin (which has a nail-like texture) can build up between the nail plate and nail bed, ‘islands’ on the nail surface can form, and the nails develop a moth-eaten appearance. These nails are prone to crumbling and splitting and can have jagged edges that catch on socks.

Thickened nails can be tricky to trim without the right tools. They can also cause ingrown toenails! The thickness may create pressure in shoes that can cause pain and discomfort to the toes. This is the stage where we see many of our patients for fungal nail treatment, and ingrown toenails if they have them. 

Loose, distorted nails

As the fungus causes the nail to thicken, the shape of the nail may become distorted as it separates from the nail bed. You may find yourself with bumpy, curly and oddly shaped nails that have partially or fully separated from the nail bed. This can create a ‘cave’ beneath the nail, where the fungus can continue growing and where traditional creams cannot reach.

At this stage, most patients we’ve treated tend to hide their nails in enclosed shoes and socks. They may have the thickness or the ridges of their nails reduced by a podiatrist (this can help with the appearance temporarily!), but this does not restore the appearance of their nails, it only makes the nails more comfortable until they grow further. 

Fungal Nail Infection Treatment Options

So how are fungal nail infections treated safely and effectively? The thing with fungal nail infections is that, traditionally, they’ve been challenging to treat. When working with living fungal cells and applying the standard creams to the nails daily, it’s easy for things to go wrong – whether that’s forgetting to use the creams or lacquers, or them not penetrating the nail enough or getting under that ‘nail cave’ we described above.

This is why we highly recommend PACT treatment for toenail fungus – a safe and effective treatment that produces the best results for nail fungus that we’ve seen in our years of practice. PACT stands for Photodynamic Antimicrobial Therapy and uses a high-powered LED light paired with a unique gel sensitive to the LED light. Together, they produce antifungal effects that kill the nail fungus (and fungal spores that spread the infection). Better yet, they do so without causing any damage or harm to your toenail or the surrounding skin. 

Research on the effects of PACT has found success rates of up to 100% for mild to moderate infections and 63.5% for severe infections. This is significantly better than the range of traditional treatments currently on the market (which can be as low as 7% in some cases).

We love that PACT:

  • Is effective against a wide range of fungal species, and has shown to be effective against fungal strains that are resistant to conventional antifungal drugs. This means you have a higher chance of success even if you’re battling a tricky fungus or traditional treatments haven’t worked in the past.
  • Is not invasive, only involving the application of a photosensitising agent followed by exposure to light. This keeps you maximally comfortable and safe.
  • Only targets the infected area instead of risking the tissues surrounding the nail.
  • Has a lower risk of side effects compared to oral antifungal medications, meaning it’s more suitable for a greater range of people. As it’s not medication you ingest, there’s also no risk of drug interactions from other medicines that you’re taking.
  • Leads to the rapid destruction of fungal cells, providing quicker relief from symptoms. This makes it suitable for even severe fungal infections.
  • Is effective against a wide range of fungal species, making it a versatile treatment option for various types of fungal infections.
  • Involves the physical destruction of fungal cells, which reduces the likelihood of resistance development compared to conventional antifungal drugs that often face resistance issues.
  • Can be used in combination with other antifungal treatments to enhance overall efficacy
  • Makes a genuine difference in improving the quality of life (and comfort) of our patients

Want to learn more about PACT? Visit our treatment page here.

 

How Does Nail Fungus Affect Ingrown Toenail Treatment?

In some cases, having your ingrown nail infiltrated by fungus may complicate ingrown nail treatment as toenail fungus weakens the nail structure, making it more susceptible to further damage and infection. A nail with changes to its appearance and texture, such as when it is thickened and ridgy, can make the ingrown toenail more painful and difficult to treat. With this said, as Auckland’s leading ingrown nail clinic, our podiatrists have you covered.

We are confident in treating ingrown toenails and fungal nail infections, together or separately, with great results. At your assessment, we’ll discuss all of your options and any complication risks so you stay fully informed. Most people have no issues enjoying a life free of ingrown toenails after their PNA procedure—as well as healthy and clear nails with PACT.

 

Book your appointment online with our team here, or call us on (09) 523 2333.

 

 

References

https://www.aafp.org/pubs/afp/issues/2013/1201/p762.html

Signs Your Ingrown Toenail Needs Help From Your Podiatrist

If you consider ingrown toenails to be the most debilitatingly painful problem given that it involves such a seemingly small nail, you’re not alone. These are the exact same thoughts shared by most people who come into our ingrown toenail clinic to have their ingrown nails professionally cared for – and often to get rid of them for good. But how do you know if your ingrown nail is fine to manage at home, or if you should come in for professional treatment? 

Ingrown Toenail: The Basics

First thing first: an ingrown toenail occurs when the edge of a toenail grows into the surrounding skin rather than over it. Think of a small but sharp dagger piercing through healthy skin and staying embedded there – it’s actually very similar! This can result in pain, redness, swelling, and potential infection. Ingrown toenails most commonly affect the big toe, but any toe can be affected.

Identifying An Ingrown Toenail

To spot an ingrown toenail, look for:

  • Pain and discomfort: one of the earliest signs is tenderness or pain along the edge of the affected toenail. Ingrown toenails can also affect both edges of the same toenail.
  • Redness and swelling: the skin around the ingrown toenail may become red, swollen, and painful to the touch.
  • Inflammation: as your ingrown toenail grows deeper into the surrounding skin, you may notice the surrounding area become red and inflamed. Sometimes, there may be pus or clear fluid leaking from the area, which may also be a sign of infection.
  • Difficulty wearing shoes: ingrown toenails can make wearing shoes uncomfortable, and pressure from footwear may worsen the condition.
  • Overlapping skin: you may see the edge of the nail curling into the surrounding skin or observe overlapping of the skin onto the nail.

Home Care For Mild Cases

If your ingrown toenail is mild, you may try managing your symptoms at home by:

  • Soaking your feet in warm, soapy water for 15-20 minutes, 2-3 times a day. This can help soften the nail and reduce inflammation.
  • After soaking, use a clean, disinfected tool, such as a dental floss pick, to gently lift the ingrown edge of the nail away from the skin. Do not force it. This should be easy if the ingrown nail is mild so that it is only pressing against the side of the skin as opposed to already growing deep inside. If the nail has already significantly pierced into the skin, it’s time to see a podiatrist. 
  • Continue to keep the area clean and dry, avoiding tight footwear that puts pressure on the toe.
  • You can try to place a sterile bandage or a piece of cotton under the lifted nail edge to encourage it to grow above the skin. Again, this will not be suitable if your nail has already notably pierced into the skin.

When To Get Help For Your Ingrown Nail

While home care can help with mild cases, you should consult a podiatrist if you experience the following:

  • If ingrown toenails repeatedly affect the same toenail, a professional evaluation is essential to address the root cause.
  • If there are signs of infection, such as increasing redness, pus, or discharge, it’s crucial to book in with your podiatrist
  • Those with diabetes or circulation problems should not attempt self-treatment for ingrown toenails. These conditions can lead to complications and delayed wound healing.
  • A painful abscess (collection of pus) or the presence of a draining sinus warrants immediate attention.
  • If your symptoms worsen or fail to improve within a few days of home care, consult a podiatrist.

Final Tip

Ingrown toenails can be simple for a health professional to manage – but only if they have the right tools, experience and knowledge. As a clinic that sees ingrown toenails day in and day out, we have refined our protocols and processes to ensure you get the very best care for your ingrown nail every time.

Each person’s treatment plan is uniquely tailored to their symptoms and circumstances to help you get the best long-term results. Our podiatrists take the time to discuss every step of the process, alongside all of your treatment options, and are here to help you or your child have the very best experience with their toenail treatment. We’re based in Remuera, in the One Health medical building, close to Newmarket. Call us on 09 523 2333 or book online here.

Is It An Ingrown Nail, Or A Corn? A Case Study

While most of the time our patients are confident about an ingrown toenail diagnosis, we thought we’d share the case of a recent patient who thought she had a very painful ingrown toenail – only to discover that she actually had a corn in the area where an ingrown toenail would normally be found.

The Symptoms

Jess* has had several ingrown toenails in the past, treated by another provider, prior to coming to see us, so she knew the symptoms she was looking out for. Aside from knowing that her work shoes that she spent 8-10 hours in per day weren’t there best for her feet and made her toes feel cramped, she also experienced:
  • Pain and tenderness at one edge of her right big toenail
  • Redness that was isolated to one side of the toenail
  • Mild swelling around the area
  • Pain when pushing down on the side of the nail from the toe
She didn’t have any bleeding or discharge, and she didn’t normally have that with her previous ingrown toenails. There were no signs of infection or indications of anything sinister. It just felt like another ingrown toenail.  Jess had always had her nails “temporarily” managed where the offending nail edge was removed, but nothing was done to stop it from coming back. She found us through our reputation of being Auckland’s leading providers of ingrown toenail treatments, including permanent solutions that would keep the ingrown toenail gone.

What Was Found

During Jess’ exam with our podiatrist, we uncovered that she didn’t actually have an ingrown toenail. The ridge that her toenail naturally followed as it grew out (on the painful side of the nail) looked like it had been rubbing against the skin (likely contributed to by her footwear) and it had actually formed a small, hard corn down the side of the nail. As corns are firm, dead skin that often blend into the appearance of the surrounding skin, Jess never even saw it until we pointed it out. The thing with corns – and you’ll know if you’ve had one in the past – is that despite their small size, they can be incredibly painful.  When present on the bottom of the foot, many of our patients describe them as constantly walking on a painful pebble. All her symptoms made sense – especially if the nail kept pressing against the corn, leading to her pain and redness.

Treatment

The best part for Jess was that her treatment was very simple and straightforward. All we had to do was use a fine surgical scalpel to remove the corn – a procedure that is painless given that corns do not have any living tissue. Once the corn was removed and the toenail was no longer pressing against anything, she felt immediate relief, and was completely pain-free by the following evening.

Did She Have Ingrown Toenails Previously?

The biggest question that was left for us is whether Jess really did have ingrown toenails in the same spot previously, or if she had had that corn for quite some time and it was misdiagnosed as an ingrown toenail given the symptoms were the same. As she previously had a small part of the nail removed to relieve her symptoms, it would make sense that once the part of the nail that would otherwise rub against the corn was removed, that her symptoms would stop too, so it would appear that her ingrown nail was ‘treated’ – without ever treating the true cause of her problem, meaning that it would be bound to continue recurring as the nail grew out. Interestingly, that’s something that’s almost impossible to determine now – but what we do know is that Jess won’t be having any more pain related to that particular corn.

Ingrown Toenail Facts

  • Aside from wearing shoes that are too tight or narrow, the biggest cause of ingrown toenails that we see and treat is a person’s nail-trimming technique – especially if they pick at or pull of the nail
  • Ingrown toenails do not usually get better without treatment – a true ingrown toenail means that part of a toenail has embedded itself down in the skin of your toe (like a sharp dagger) and it must be removed
  • You don’t have to suffer with repeated ingrown nails – permanent treatments that get rid of the issue once and for all are available. This involves removing a small section of the nail and then applying a chemical that destroys the nail growing cells so they don’t grow back.
  • We see just as many children (often adolescents) with ingrown nails as adults. We have also successfully treated ingrown nails on young toddlers. They can occur at any age
  • Having an ingrown nail where the nail has pierced your skin means that you are vulnerable to infection as long as the nail is in there and you have an open wound.
For safe and effective treatment of ingrown nails by Auckland’s leading podiatry specialists, book in at our clinic in Remuera. You can call us on 09 523 2333 or book online here.

Is Your Ingrown Toenail Oozing Clear or Yellow Pus? It’s Probably Infected

Ingrown toenails are painful and frustrating enough, so the last thing you want is to add an infection to the mix. Unfortunately, in our experience, a large number of ingrown toenails will get infected if proper treatment is undertaken – and it makes sense when you think about it. Today, our ingrown toenail specialists will be sharing:
  • Why the risk of developing an infection once you have an ingrown toenail is high
  • What you can do to prevent an infection before it develops
  • How you can treat your ingrown toenail and infection once it has occurred

You Have A Significant Risk Of Developing An Infection. Here’s Why

Let’s clear something up: ingrown toenails and infections are not a case of the chicken and the egg – the ingrown toenail comes first.  What classifies a sore toe as an ‘ingrown toenail’ is the moment that the sharp piece of nail goes from merely pushing against the surrounding skin, to actually piercing it and penetrating it. Think about that for a second – you have a piece of nail that is now constantly inside the skin through a cut down the side of the nail. Every time you walk and move, it’ll move slightly with vibrations of pressures from shoes and socks. Ouch! This also means that while a normal cut occurs and then can heal, this cut can’t – because the ingrown toenail is still constantly piercing it and so keeping the cut open.  An infection occurs when bacteria and other nasties enter the body. Usually, our skin is a fantastic barrier, so while there may be many nasties around us regularly, they never have an ‘in’. Until now. And especially at the ground where you may walk barefooted. And when you give it a perfectly placed entrance – there’s a strong chance that the infection will take hold and start to develop. Once the infection takes hold, it means increased swelling, pain and oozy discharge (and maybe blood) that is yellow/green/clear in nature and may ‘crust over’. 

Preventing An Infection From Your Ingrown Toenail Before It Develops

So how, then, can we prevent – or at least reduce the risk – of developing an infection? It’s quite simple, really. And no – no Epsom salts required just yet! As the cut from ingrown toenail creates an ‘in’ for the bacteria to take hold, the way to prevent an infection is to remove this ‘in’. This means removing the penetrating nail edge so that the cut can heal, close, and no longer be vulnerable to the infection. Simple, right? – Absolutely.

So How Do I Treat My Ingrown Toenail – And The Infection If I Already Have One?

The best way to ensure the proper care of your ingrown toenail is to see your Podiatrist. Our team here at the Ingrown Toenail Clinic are Podiatrists that are trained in simple and painless ingrown toenail surgeries, as well as conservative care where we safely remove that small, pesky nail edge in a matter of minutes. You’ll feel the relief almost instantly! We don’t recommend trying to cut back the nail at home because often the nail runs much deeper than you can see, so most people will miss removing the complete penetrating edge and their pain will only continue to worsen. You also won’t have the right tools for the job – whereas we have everything needed to do it quickly and easily – even anaesthetic if you need or want it! (though most people don’t). Once the sliver of nail is removed, the body will be able to effectively heal the wound and fight the infection – and of course, we’ll help it along by dressing it with betadine (antiseptic). You’re welcome to soak it in some Epsom salts too – but once the nail is out, it should be relatively simple and straightforward for it to heal and the infection to subside. No more painful, swollen discharge – hooray!

Auckland’s Ingrown Toenail Experts

Perform Podiatry are proud to be home to the Auckland Ingrown Toenail Clinic – specialising in the safe and effective care of ingrown toenails – and we do a really good job of it! From simple and easy care to quickly remove the small nail edge, to minor nail surgery to permanently correct ingrown toenails, we’ve got you covered.   You can book online here or give us a call on (09) 523 2333.