Pix of ingrown toenail

Ingrown nail problems are commonly caused by improper and aggressive trimming, minor injuries or repeated trauma, or a thickening of the plate, causing pressure against the nail and eventual abrasion or cut into the skin. Some nail disorders can also be congenital. Toe injuries that change the nail's contour also can lead to an ingrown toenail. Toe deformities (such as a bunion that forces the big toe to lean toward the second toe), high-heeled or narrow, pointed shoes can put pressure between the nail and soft tissues, eventually forcing the nail to grow into the skin. Ingrown nails ran be accompanied by other toe disorders, such as excessive skin growth, granuloma, surrounding tissue or an outgrowth of bone beneath the nail.
Bacteria enter the skin after an abrasion occurs. If the cut remains open due to pressure from the nail, an infection can develop. Unless the nail is cut back from the open wound, treatment with antibiotics will not offer long-term benefit.

TREATMENT
Surgery is often necessary to ease the pain and remove the offending portion of the nail. Only the border portion of the nail is removed permanently and the rest of the nail will grow normally without the offending portion. No stitches are used. If the entire nail is affected or there is a severe nail deformity, the nail plate and matrix (the cells that grow the nail) may be completely removed. If the nail is not infected, your podiatrist can trim the corner to relieve the pain without anesthesia required.

Picture of fungal nail

Various types of fungi, mold, are present everywhere in the environment. The dark, moist surroundings created by shoes and stockings make the feet especially susceptible. Fungus can grow on and between toes and well as the bottom of the feet and they penetrate the skin. A fungus can invade through minor cuts, or after injury or repeated irritation to the toes. Fungal infections of the nail plate and nail matrix are quite common and easily recognized.

SYMPTOMS
Nails attacked by fungus, thicken, and become yellow or brownish, and may separate from the nail bed or even crumble away. Pressure from a thickened nail or the build-up of debris make the toe painful. The nail infection can also spread to the skin.

TREATMENT
Treatment is best begun at the early stages of infection. The accumulation of debris under the nail plate can lead to an ingrown nail, or to a more serious bacterial infection. The surgeon may reduce its thickness by filing the nail plate down with a surgical burr. Filing will not, however, prevent the infection from spreading. Oral antifungal nail treatments, Sporonox and Lamisil, are also now available.

SURGERY
If the problem is severe or chronic, surgery is indicated. Surgical removal of the all of the nail, or a portion of the nail is recommended. Most nail surgery is performed in the office under local anesthesia and the patient can walk in his own shoes when completed. The result after surgery, to remove the entire nail plate, is a layer of skin on top of your toe where the nail once was. There is no loss of balance or sensitivity.