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Ingrown toenail
contents
The toenail: structure and function
definition
Causes and symptoms
treatment options
Ingrown toenail OP
Naturopathy with ingrown toenail
The toenail: structure and function
The toenail or toenail is usually referred to as the domed, translucent to whitish keratin plate located on the top of the toe tips. The nails are so-called "horn formations" because they are formed from the hard, keratinized (i.e., keratin-filled) cells of the epidermis (in technical terms, "skin appendages"). The strength of the nails usually varies from 0.05 mm (baby) to 0.75 mm (adult) - although the thickness of the nail can vary greatly from person to person. Accordingly, the growth of the nail is not always the same, but a nail grows on average in healthy people about 0.5 to 1.2 mm per week, in the elderly and due to certain diseases and injuries but also significantly less.
The structure of the toenails is complex: The skin-anchored area of the nail is called the "nail root", which is located at the bottom of the so-called "nail pouch". Here, the nails from the described horn plates, the substance of the nail plate of the so-called "matrix" is provided, which is often recognizable at the lower edge of the nail as a bright, crescent-shaped part, which is therefore referred to as "nail moon" or "Lunula". The nail plate is the visible part of the nail, which in itself is transparent - the color of healthy nails, which is typically light pink, only arises when the blood vessels of the underlying nail bed shine through the transparent plate. The connective tissue nail bed is firmly attached to the periosteum of the underlying toe bone (phalanx distalis). The toenail is framed on the side by a skin fold (nail wall or nail fold), which surrounds the non-visible parts of the toenail and thus provides support on the one hand and protection against lateral tears on the other hand. The term "cuticle" (perionychium) refers to the visible part of the skin that directly adjoins the nail wall, which rests on top of the fingernail.
Since the nail itself consists mainly of keratinized or keratin-filled, dead skin cells, this is in itself not sensitive to pain - the skin on the tip of the toes, however, because in this special sensory cells are for touch stimuli (Merkel cells), through which the nails can fulfill their function as a "touch tool". In addition to toenails but have other important tasks, on the one hand protect the top of the extremely sensitive toes and also ensure that pathogens can not penetrate into the underlying nail bed.
definition
In an "ingrown toenail" (medical "Unguis incarnatus"), the nail grows laterally in the nail fold (also called "nail wall"), which refers to the skin fold, which covers the edges of the nail plate on fingers and toes. As a result, the nail wall presses on the nail, in many cases it comes through this irritation in addition to inflammation and proliferation of the tissue, the so-called "wild flesh". This grows to protect the wound on the nail edge, which in turn causes the toenail grows even further into the nail bed.
The "big toe" is usually affected by this problem, but the little toes and fingernails are rarely affected. Typical of an ingrown nail are sharp pains that can be so severe that even walking or walking is hardly possible. Even in rest position sufferers often experience that the foot hurts and throbs badly, also it often comes with an accompanying nail bed inflammation to other symptoms such as pus, swelling and redness on the affected nail. If a suppuration wanders into the deep, it can also spread to the nearby bones in an emergency.
Causes and symptoms
Wrong cutting technique
In most cases, incorrect cutting of the nails is the cause of an ingrown toenail. This is fast, because with toenails, it is important that they are cut straight or filed to prevent the edge of the nail pushes into the nail bed. Frequently, however, the toenails are - like fingernails - incorrectly cut round, with the result that the nail by the pressure in the shoe quickly grows into the nail wall and thereby causes severe pain. In addition to the toenails are often cut too low at the corners, which reduces the nail bed and no longer has enough space for the renewable nail. The result: The newly grown nail corners grow into the surrounding flesh, causing severe pain. In addition, it often comes to an inflammation, because the skin is injured by the ingrowing nail, at this point bacteria (usually streptococci or staphylococci) can penetrate into the tissue and multiply. The inflammation then causes redness and swelling of the tissue, which is often very painful. In addition, pus forms after some time.
Other causes
In addition, an ingrown toenail on the foot can also have other reasons - in many cases, tight shoes are the cause. These can quickly become a problem, as the nail and nail bed are strongly pressed against each other and the nail - especially if it was cut incorrectly - is pushed into the nail wall. This is especially true if shoes and socks are too tight at the toes at the front and they are "depressed" from the front as well as from the side.
Even people who sweat on the feet quickly or heavily, have a generally higher risk. Because of the increased perspiration it can happen in airtight shoes or sports shoes quickly that the skin on the nail softens and pushes the nail under pressure more easily in the nail fold. In addition to the softened skin and bacteria, the penetration into the tissue, which additionally an increased risk of inflammation. Inheritance can also be the cause of chronic ingrowing toenails, as well as vascular diseases, nail fungus or diabetes. Malformations of the toe bones may also be the cause, for example after an operation in this area or in the case of "hallux valgus", which is a deformation of the big toe.
treatment options
If the toenail has grown, you should always consult a doctor or a medical podiatrist, because only a specialist can ultimately decide which treatment is most appropriate for the individual case or whether surgery is necessary. It is important here that the visit to the doctor takes place immediately and does not first try to "fiddle" on the nail on his own, because this increases the risk of inflammation and even worse discomfort.
If the nail has not grown too deeply into the nail wall or not yet inflamed, this can be treated by the specialist, for example, with a so-called "tamponade". In this case, a narrow strip of cotton or fleece between the nail and nail wall is introduced, whereby the nail pressure immediately reduced significantly and the pain can be alleviated or at best even completely eliminated. Alternatively, the pressure relief can also be done by a spacer ("butterfly technique"), a one-sided slit plastic tube, which is inserted by the podiatrist with a special instrument in the Nagelwall.
Another non-surgical treatment technique is the so-called "nail correction clasp" (also called Orthonyxie). This is used especially when a nail is rounder than normal ("Rollnagel") and thereby - even after treatment - again and again Waxing. The clasp is placed on top of the toenail by the podiatrist, which immediately reduces the pressure on the nail fold, relieves the pain and, as a rule, quickly relieves an inflammation caused by the pressure. In addition, the nail is corrected by the nail correction clasp in its growth by this successively pulled up and the curvature is thereby reduced. There are different techniques, but in most cases the treatment usually takes a few months, sometimes even up to a year. The treatment with the podiatrist, however, usually has to be paid for itself and usually costs around 30 and 35 euros.
Ingrown toenail OP
However, if the treatment is late, the nail is often already deeply embedded in the nail bed and the inflammation has progressed so far that the pain becomes unbearable and surgery becomes inevitable. Again, there are various surgical procedures, one possibility is the so-called "wedge resection" (also called "wedge resection"), in which the family doctor or surgeon as part of a mini-surgery as small a part of the toe plate removed to much of the nail to obtain. Although this procedure provides an immediate relief of the symptoms - but this is usually only a short-lived, since the cause of ingrowth can not be eliminated in this way. Accordingly, the standard surgical procedure, especially for chronically ingrown toenails, is the so-called "Emmert-plasty", in which a part of the nail root as well as the inflamed, thickened nail wall are removed to avoid further relapses.
After surgery, the affected foot must first be spared for about two weeks. Therefore, should be omitted during this time on sport and the foot to be washed only with clear water without any addition, and the application of ointments should be avoided, as it inhibits the outflow of secretions. In addition, it makes sense to go to full recovery regularly for medical foot care, to prevent new foot problems. In contrast to surgery, however, this must in principle be paid for itself - as a podiatric treatment is normally only taken over by the health insurances in the case of severe diabetes.
Naturopathy with ingrown toenail
With an ingrown toenail, the only option is to visit the doctor or podiatrist, because "tinkering" or possibly even cutting the injured toe can massively increase discomfort and quickly lead to a chronic problem with severe disability. Accordingly, in the case of an already existing condition, a specialist should be consulted immediately in order to clarify the cause and initiate appropriate treatment steps. In addition, an attempt should always be made to prevent ingress of the nails as much as possible by taking appropriate measures. Accordingly, it is important to avoid tight, unsuitable shoes in general and to make sure that the nails are cut straight and the corners are not too short during foot care. Therefore, it is advisable to have regular appointments with a pedicure especially for sensitive feet, where the nails are professionally cleaned and cut. In addition, misalignments of the feet should be taken seriously and corrected (for example, by deposits).
Proof: Astrid Borower