Foot Care from A to Z

Thomas P. Lyman, BS; Tracey C. Vlahovic, DPM, FAPWCA


Dermatology Nursing 

In This Article

Ingrown Nails

Ingrown nails often present as paronychia which is a red, swollen, painful, and infected lateral nail border (see Figure 2). The nail is forced under the skin as a result of tight shoes and/or nail shape. Once the nail is under the skin and causing pain, patients will often attempt "bathroom surgery" which can introduce bacteria and cause an inflammatory reaction or paronychia. Either an oral antibiotic or soaking in Epsom® salt is not sufficient to treat paronychia. The signs and symptoms require the offending nail border to be removed either by trimming the painful corner (slantback procedure) or minor nail surgery (partial nail avulsion). It is imperative the patient has sufficient blood supply to the foot to undergo a partial nail avulsion. After the introduction of local anesthesia to the digit, the practitioner will sharply remove the painful, infected nail border. In recurrent cases, phenol may be applied to the area of the nail matrix to discourage that corner of the nail from regrowing (Banks et al., 2001).

Figure 2.

A grossly hypertrophied and chronically infected ingrown lateral border of the hallux toenail.