TOENAIL PROBLEMS

Your toenails grow 1.6mm to 3mm per month and protect the ends of your toes and the bones and nerves lying underneath. Toenail problems tend to be more common as you get older.

Toenails can suffer a variety of disorders as a result of trauma, disease, ill-fitting shoes, poor hygiene, infection and poor circulation. These problems include bruises, ingrown nails, fungus discolouration, brittleness and curved growth. Professional care from your podiatrist can help improve health of your toenails.

Fungal Infections

Fingernails and toenails are particularly vulnerable to fungal infections. These occur when fungi (microscopic plants) take up residence in the keratin of your nails. Fungus breeds in dark, damp, warm environments, so avoid walking barefoot in changing rooms or through mud. This affinity for damp, dark places - such as in shoes and socks - is why toenails are more prone to fungal infections than fingernails. Nails that are brittle, discoloured, dull, abnormally thick, distorted, crumbling, loose, or subject to unusual debris under the nail are a medical rather than a cosmetic problem. They demand the expertise of a dermatologist, podiatrist or medical practitioner.

Fungal infections are extremely contagious and can be spread through direct contact with contaminated towels, shower and pool surfaces, and nail implements like clippers, orange sticks and cuticle pushers. People most likely to develop toenail infections include those who frequent public swimming pools, gyms or shower rooms; those who perspire a lot; and those who wear tight shoes.

Symptoms of a nail with fungal infection include discolouration and thickening of the nail, and the separation of the nail from the nail bed. There may be a white, cheesy discharge. Without treatment, the nail bed itself can become infected. Treatment options include antifungal or antibacterial cream, and professional trimming, shaping and care of the nail by your podiatrist. An infection can take as long as seven months to cure, as it must grow out with the nail.

Nail infections do not always respond to topical treatments; if severe, you may need to use oral antibacterial medication.










Cut or clip toenails straight across to prevent painful ingrown nails.



Ingrown Toenails

The most common problem treated by podiatrists is ingrown toenails (or onychocryptosis). The big toe is particularly prone to this painful condition, which occurs when one or two corners of a nail grow into and become embedded in the surrounding skin. It feels like a splinter and can be very painful. In severe cases, it may even cause pus and bleeding.

Most ingrown toenails are self-inflicted as a result of incorrect trimming technique, trauma (such as stubbing your toe), or from wearing tight-fitting shoes, socks or tights that push your toe against the nail so that it pierces the skin.

Try these tips to prevent this painful affliction from recurring:

• Cut toenails straight across so they are even with the tip of the toe. Do not cut too short, too low at the edge or down the side. File any pointed edges smooth with an emery board.
• Avoid using nail cutters as the curved cutting edge may cut the flesh. Nail scissors can also slip so it is best to use nail nippers. These have a smaller cutting blade but a longer handle for ease of use.
• Cut nails after a bath/shower when softer and easier to cut.
• Keep toenails square in shape. Rounding the corners may be prettier, but this only encourages nail to grow into the surrounding skin. File sharp edges slightly to smooth any roughness.
• Avoid toe-pinching shoes. Cramming toes into tight shoes often leads to nail problems.
• Do not be vain; wear a larger shoe size.
• Practice good hygiene. Rotate your footwear so that each pair of shoes has a chance to dry out thoroughly before you wear them again. Opt for breathable materials and wear natural-fibre socks. In summer, wear open-toed sandals when ever possible.

The treatment of ingrown toenails depends on the severity of the condition.

• If you have a mildly ingrown nail, try to remedy it yourself. Fill a basin with warm water, add a tablespoon of salt and soak your feet for 15 to 20 minutes. Dry thoroughly. Next, gently wedge a tiny bit of cotton wool under the corner of the nail. Repeat this nightly for two or three weeks until the nail has grown out.

Push cotton wool under an ingrown nail each night to alleviate pressure and encourage correct growth.

• If strong pain, swelling, redness, pus or infection develops around an ingrown toenail, visit your doctor or podiatrist immediately. Remember, never start digging yourself. Apply a sterile dressing if you have a discharge.
• For the most painful and irritable ingrown toenail, your podiatrist will remove the offending spike of nail and over it with an antiseptic dressing. If it is too painful to touch, he or she may inject a local anaesthetic before removing the offending portion of the nail. If you have bleeding or discharge from an infection, or even excessive healing flesh around the nail, you will also need antibiotics if you are to get better of the infection.
• See a foot specialist immediately if you are diabetic.
• If an ingrown toenail is a recurrent problem your doctor may perform a matrixectomy (removal of the matrix, the source of the nail growth, along with the edge of the nail). This will result in permanent narrowing of the toenail.