Foot doctor explains common problems

Ingrown Nail Pain

Even after 20 years of practice I still get the same two questions: why did you choose podiatry and what is the most common foot problem.

Let me start with the second question.

By far the most common reason people come to my office is ingrown toenails. It is the bread and butter of podiatry, like taxes to an accountant or colds to a doctor. Fortunately we, as podiatrists, have developed some marvelous ways to treat ingrown nails.

Ingrown nails come in two varieties: the acute, red, infected kind usually found in teenagers, and the chronic type in adults.

Acute ingrown nails are easy to diagnose; in fact, they diagnose themselves. They are also easy to treat.

If the toe is being aggravated by the edge of the nail, a simple removal of the edge of the nail under a little local anesthesia solves the problem. The relief is instant and complete.

Some family doctors like to try a course of antibiotics before sending the patient over for the procedure. I have no problem with this since sometimes the toe is infected.

But often the problem is akin to a foreign body reaction where the toe is fighting off the nail. As soon as a thin edge of the nail is removed the problem goes away. Often with nail removal the antibiotics are not (or no longer) needed.

If your teenager has a recurrent ingrown nail, that can be fixed, too.

After the edge of the nail is removed, a chemical is placed at the base of the nail to keep the edge from ingrowing, usually permanently.

I have done this countless times on athletes, dancers and other active teens, often the day before a competition. Tyler is an example of this. He was a high school basketball player who was in near agony with his ingrown nail.

He, in fact, missed part of two games due to his pain. His pediatrician sent him to my office on a Thursday afternoon. I performed a permanent correction of his ingrown nail and he was able to play Friday night.

Claire is the other extreme. She is an active, 60-something business woman who dreads wearing her size 4 shoes. It is not that her feet are too big for her shoes—they are not. What bothered her was the pain in her large toes with shoe pressure.

Her toes never got to the point where they were red or swollen, but they hurt every day in her dress shoes. Claire had chronic ingrown nails.

It was easy to make her happy again by permanently removing the edges of her big toe nails. I did this for her on a Thursday and she was back to dress shoes the following week.

She was pleased both with the pain relief and with the fact that neither she nor her pedicurist can tell that anything was done to the nail. She may still dread the Monday morning alarm clock, but at least her toe is no longer part of the problem.

Now for the number one question asked of a podiatrist: why did we ever choose to work on feet? I promise the answer in next month’s Acorn.

Dr. Michael Zapf, along with Dr. Darren Payne, has a podiatry practice with offices in Agoura Hills and Thousand Oaks. For a copy of their booklet on ingrown nails, call (818) 707-36689 or (805) 497-6979.