Ingrown Toenail - How to Treat and Prevent
Ingrown toenails, medically known as onychocryptosis, usually is caused by trimming toenails too short. Specifically, the area on the sides of the big toes is most commonly seen. Another cause of ingrown toenails may also be shoe pressure. If a shoe is too tight or short pressure of skin against nail can cause the nail to ingrow. Other less common causes are injury, fungal infections, heredity, or poor foot structure.
How do I know if I have an ingrown toenail? Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. This common ailment, can be extremely painful to both adults and children. Ingrown toenails start out hard, swollen, and tender. When left untreated, the nail area may become sore, red, and infected and the skin may start to grow over the ingrown toenail, which means it’s time for a trip to your Oakhurst, NJ Foot Doctor, Dr. Allison Cheney.
When treated early, most cases are simple to treat: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. When left untreated for long periods of time the problem becomes severe. If an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. This treatment option is known as a partial nail avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.
How to Prevent Ingrown Toenail:
- Trimming toenails straight across with no rounded corners.
- Ensuring that shoes and socks are not too tight.
- Keeping feet clean at all times.
This information is not meant as medical advice. It is provided solely for education. Our Monmouth County podiatry office in Oakhurst, New Jersey would be pleased to discuss your unique circumstances and needs as they relate to these topics.
Acupuncture has been used for thousands of years to treat many diseases, chronic conditions and acute symptoms. It can be particularly beneficial for pain, as it can treat both locally and systemically. Both acute and chronic conditions have been shown to respond well to acupuncture treatments, and can even help where conventional medicine was ineffective, according to an article published in 1996 in "Acupuncture in Medicine." Be sure to discuss your condition thoroughly with your physician and acupuncturist before beginning acupuncture treatments.
Pain in Traditional Chinese Medicine
According to the Traditional Chinese Medicine Information Page, pain is considered a stagnation of qi, or energy, in traditional Chinese medicine. Qi runs in channels throughout the body. When an energy channel, or meridian, is blocked, pain can be experienced. Bruising occurs when one such meridian is blocked near the surface of the skin, while arthritis stems from qi stagnation in the joints. Acupuncture helps to break up the blockages and directly promote the smooth flow of qi.
Causes of Foot Pain
The phrase "foot pain" is not enough information for any type of practitioner to begin treatment. The foot has 38 bones, a myriad of tendons and ligaments, and is responsible for a great deal of our ability to stand, walk and run. Because of all these moving parts, many types of injuries can occur, and pain symptoms can vary greatly. The website Acupuncture Today lists improper foot posture, such as pronation, as one of the main triggers of foot pain. Improper footwear, edema, neuromas, overuse, exercise, and foot problems such as bunions and hammertoes can also cause pain in the feet. Each of these causes can be accompanied by pain in a specific area or certain type of pain. Plantar fascitis can have pain stemming from the heel and radiating toward the toes, while a bunion can cause pain and swelling in a more local area.
Several studies have found acupuncture to be an effective method for relieving different types of foot pain. In 1996, a study was published in "Acupuncture in Medicine" stating that acupuncture treatments on chronic foot pain were effective where western medical treatments were not. The journal "Medical Acupuncture" conducted a study using electroacupuncture on plantar fascitis. Electroacupuncture consists of passing an electric current through needles inserted into the patient's skin. According to this study, 82 percent of patients claimed a 50 percent or more improvement in pain reduction. They also found a correlation between the duration of disease and the number of treatments required, implying that the more chronic a condition, the more treatments will be needed.
Acupuncture Points on the Foot
Heel pain or heat in the soles of the feet, according to "A Manual of Acupuncture," can be treated by needling spleen 4, which is located on the inside of the foot, in the depression at the base of the first metatarsal bone. Spleen 5, located near the medial malleous, or inner ankle bone, can be particularly helpful in cases of ankle pain. For chronic numbness or pain, an acupuncturist may choose a point on the sole of the foot, kidney 1. There are points in between the toes on the top side of the foot, as well as along the outside edge of the foot. Your acupuncturist will decide which points are right for you, based on your specific condition.
Acupuncture and Western Medicine
According to the Traditional Chinese Medicine Information Page, acupuncture helps treat pain in a variety of ways. From a western medical perspective, acupuncture treatments help to release endorphins and enkephalins, substances needed for pain mediation. It also stimulates certain neurotransmitters, which are also important in pain perception, as well as adrenocoricotropic hormone, or ACTH. ACTH a hormone that triggers the release of cortisol from the adrenal glands. Cortisol is important in the body's inflammatory response, and it is also involved in the release of norepinephrine and epinephrine. Epinephrine is adrenaline, a potent hormone that can help decrease pain perception.
Article/Blog provided by:
Donna Zou, Licensed Acupuncturist of Traditional Acupuncture at the Jersey Shore.
For More Information on Acupuncture, please visit www.tradacu.com
Toenail Fungus Cause Treatment and Prevention
Nail Fungus (Onychomycosis)
Thickened, brittle, discolored and often painful nails are often caused by a fungal infection of the nail. This condition can occur for a variety of reasons and can be treated in a variety of ways.
Causes of Nail Fungus:
- Sweaty feet – moisture creates an environment where fungus can thrive.
- Trauma – loss or loosening of nail can allow fungus to infiltrate under the nail and with time infection can slowly overtake the whole nail or infect others.
- Compromised immune system – patient with diseases like Diabetes, HIV, or those who have compromised blood flow. Whenever the body is unable to mount an active immediate defense to an infection, the infecting organism can gain advantage.
- Overuse of nail polish – frequent nail polish use can prevent light from reaching the skin under our nails. Fungus thrives in the dark.
Topical – topical solutions applied like nail polish may be prescribed/dispensed.
Apply once daily directly to affected nail(s) surface, the skin that adjoins the nail as well as underneath free edge of the nail.
Remove medication once weekly with nail polish remover.
Best when used on mild fungal infections.
Success rate – up to 40%
Oral – The most common medication for nail fungus is called Lamisil (terbinafine).
Before therapy is initiated a sample of nail is often sent to pathologist to confirm diagnosis of fungus.
Once diagnosis has been confirmed, the patient must complete a blood test to confirm their liver is healthy as these medications are removed from the body via the liver.
Treatment consists of one daily dose of medication for 90 days.
Success rate – 70%
Laser – There are FDA approved lasers specifically designed for toenail fungus.
Toenail removal - reserved for severely infected nails, painful nails, patients with compromised immune systems, or those that have failed other treatment options.
Removal is an in office procedure performed after numbing toe with an injection.
Option 1 – nail is allowed to regrow during which time topical medication is applied to reduce risk of re-infection.
If the nail is allowed to regrow back, it takes about 8-12 months to regrow.
Success rate – approximately 90%
Option 2 – permanent removal can be performed via application of chemical after nail removal in office. A dry skin then remains once healed.
Success Rate – Approximately 95%
For your convenience our Oakhurst Podiatry office carries many of these recommended adjunctive therapies to remove fungus from your environment and prevent recurrence.
Mycomist Spray – antifungal and antibacterial spray used to sterilize shoes intermittently to prevent fungal growth.
Sterishoe – UV lamp specifically designed to eradicate 99% of pathogens that live in our shoes and cause infection and foot odor.
Topical antifungals solution/cream – these medications are designed for treatment as well as prevention of recurrence of infection as new healthy nail grows.
Biotin Pills – biotin is a vitamin that increases the health of the nail, nail growth rate, and helps some loose nail reattach to underlying skin as nail grows.
Nail Polish – nail polish formulated with naturally occurring antifungals, like tea tree oil, and removal of harmful chemicals found in regular nail polish that can lead to dryness and cracking of nails.
Nail file or buffing devices – overly thick nails can reduce effectiveness of antifungal medications. Reducing nail thickness allows for better penetration of medications.
Shoes and socks – if sweating is an issue, breathable shoes and socks may be recommended. Socks that have wool or synthetic fibers help allow moisture to evaporate off feet more quickly.
Long Term Simple Prevention You Can Do
- Avoid walking barefoot in public places.
- Use Mycomist spray or Sterishoe several times a week to reduce fungus in frequently worn shoes.
- Use a daily shower cleaner after bathing to prevent fungal growth in tub/shower.
- Replace the bath mat outside of the shower weekly.
- Change socks in the middle of the day if you sweat frequently.
Can I Wear Nail Polish With Fungus On My Nails?
You have fungus on your toe nails and all you want to do is cover it up! Nothing better than nail polish to do that, but you know enough about fungus to know that fungus thrives in moist dark places. Nail polish gives that fungus a wonderful place to grow and thrive! Oakhurst Podiatrist, Dr. Allison Cheney has some options for you.
To start it is so very important to look beyond the nail itself and look at your foot surroundings. Where do you walk? What do you wear?
We do not know exactly how you got your fungus, but we want to keep it from happening again. Keeping your surrounding as "fungus-free" as possible will help!
Let’s go over some key pointers to keeping fungus at bay:
1. Spray your shoes with an anti-fungal spray. It helps keep the fungus away!
2. Throw away your old grungy gardening shoes if they are not rubber or those old favorite canvas shoes you’ve had forever.
3. If you have sweaty feet, change your socks once during the day to keep the moisture down. The less moisture you have, the less than ideal environment a fungus has to grow.
4. Use an anti fungal powder on your feet if you tend to sweat a lot.
5. Spray "Scrubbing Bubbles" or "Lysol Tub and Tile" type stuff weekly on your shower tiles.
6. Wash your bath mats weekly. We don’t know what critters are thriving in them.
7. Shampoo your carpet if you haven’t done that in a while. We don’t know what critters are thriving in them either.
8. Give your shoes a breather! Try not to wear the same pair twice in a row.
9. Get sterile pedicures and stay away from the soaking tubs that have whirlpool effect. They can never get the tubing cleaned properly.
10. Bring your own polish and flip flops to the nail salon.
After all this, are you still thinking of the nail polish! It can matter what type of polish you use. Nail polish with Tea tree oil is becoming very popular for a reason. It has been found that tea tree oil is a natural fungal suppressant. What does this mean? It means you can have fungus and wear nail polish too! At our Jersey Shore Podiatry office, we stock nail polish with tea tree oil to offer our patients just what you have been looking for. Podiatrist, Dr. Allison Cheney is so impressed with this product that she recommends you pick up a bottle today to keep your toes looking stylish and "fungus-free"!
When To Go To Urgent Care for Foot and Ankle Problems
Understanding the differences between a visit to a specialist, urgent care and the emergency room is key to positive health outcomes. Life-threatening emergencies require a visit to the emergency department, and chronic foot and ankle problems may require a podiatrist appointment; but for everything in between, there is urgent care. Whether you have a twisted ankle or a minor sprain, knowing your options for medical care can help ease the stress of a sudden injury.
During seasonal activities and sports, minor injuries such as lacerations/cuts, sprains and fractures tend to occur at unexpected times. At Immediate Care, we are committed to assisting all patients when they are unable to reach their primary care doctor or their specialist. In cases of more serious foot and ankle injuries, following-up with a podiatry specialist may be recommended to promote a full recovery.
It is important to remember that urgent care is not a substitute for emergency care. An emergency condition is one that is time-sensitive and can permanently impair or endanger the life of the patient. Patients with these conditions should dial 911 immediately.
Urgent care provides a convenient option for patients with a non life-threatening injuries that requires prompt care. At Immediate Care, we offer x-rays, laboratory services, stitches and a variety of walk-in occupational health services. Frequent causes for urgent care visit, include the following conditions:
● Ear Infections
● Bladder Infections
● Stomach Flu
● Respiratory Illness
● Minor Burns
● Minor Rashes and Skin Infections
● Sports Injuries
● Trips and Falls
● Cuts/Minor Lacerations
● Animal/Insect Bites
● Minor Dislocations
● Back Pain
Our Immediate Care facilities are located throughout New Jersey in Hazlet, Toms River, East Windsor, Red Bank, Lacey and Edison. To learn more about urgent care, please visit immcare.com or call 1-855-Walk-Ins. We are open seven days a week, and our staff will be
happy to answer any questions you may have.
- Dr Mary Ann Yehl, Medical Director of Immediate Care Medical Walk-In of Red Bank
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