2024-01-11 04:49:00
life
If your big toenail looks like this… Pus, bad smell, and risk of osteomyelitis
Reporter Lee Hae-na | Intern reporter Jeong Jun-yeop
Entered 2024/01/11 13:49
If your toes hurt when you walk or the skin around the toenail is red and swollen, you should suspect an ingrown toenail. Ingrown toenails are also called ‘nail incision’, as the toenails dig into the flesh on both sides. Ingrown toenails not only limit your shoe choices, but also affect your ability to walk. This is because toenails embedded deep into the flesh cause severe pain. If an ingrown toenail is left untreated, it can lead to secondary infection, such as inflammation spreading to the bone, so it is important to treat it on time.
◇ Mainly occurs on the big toe, risk of secondary infection if not treated early
Ingrown toenails most often occur on the big toe. The big toenail is the thickest and hardest of the toenails, and has a high risk of digging into the flesh. When walking or running, the pressure or friction exerted on the toes is greatest on the big toe.
Symptoms caused by ingrown toenails include erythema and heat in addition to pain, and may also be accompanied by pus and foul odor. If inflammation becomes severe, granulomas may form. A granuloma is when the blood vessels and body tissues on both sides of the toenail protrude like flesh when inflammation becomes severe. This can lead to secondary infection. Choi Jun-ha, director of 210 Orthopedics, said, “If secondary infection occurs, pus may form and a foul odor may develop. In severe cases, it may progress to cellulitis, toenail fungus, or, in rare cases, osteomyelitis where the inflammation spreads to the bone.” Therefore, it is best to visit a dermatologist or orthopedic surgeon as soon as possible before it leads to secondary infection.
Risk groups for ingrown toenails include people who are overweight, people who exercise a lot with their feet, people who wear shoes that do not fit their feet, and people who sweat a lot. If you are overweight, the space between your feet decreases, which increases the risk of developing ingrown toenails. If you wear shoes that do not fit your foot size, a lot of friction and pressure is applied to the toes, which increases the incidence of ingrown toenails. If your feet sweat a lot, the skin becomes brittle, making your toenails vulnerable to irritation.
◇The more severe the symptoms, the greater the possibility of surgery… Toenails should be cut straight
Treatment is divided into three stages depending on the severity of symptoms.
▷Level 1 = There is no pain normally, but it hurts when walking or pressing. At this time, steroid/antibiotic ointment is applied topically and a dressing is applied. Additionally, self-treatment is possible in the early stages after consulting a doctor. Director Choi Jun-ha said, “In the early inflammation stage, it is good to lift the area where the toenail is digging into the skin with dental floss, cotton swabs, or tape and apply antibiotic ointment.”
▷Step 2 = If the skin around the toenail continues to be red and painful even without pressure or stimulation, the treatment method will vary. The procedure is performed to create space between the toenail and the skin around the toenail to prevent the tip of the toenail from irritating the skin. If infection occurs, oral antibiotics and anti-inflammatory/painkillers may be taken.
▷Stage 3 = This refers to when the granuloma is severe, and in this case, surgery is necessary. Since not only the toenail but also the granuloma must be removed, a method of removing part of the toenail is used. Professor Joo Min-sook of the Department of Dermatology at Hanyang University Hospital said, “It is appropriate to remove the ‘toenail matrix’ that is responsible for the growth of the toenail, thereby allowing the toenail to grow narrowly.” Sometimes, toenails are pulled out, but it is not recommended because there are cases where the newly grown toenails recur as ingrown toenails just like the old toenails.
To prevent ingrown toenails, the most important thing is to cut your toenails straight rather than round. When cutting your toenails, the length should be longer than the area where both sides of the toenail contact the flesh. However, if you cut your toenails round and short, you will not be able to achieve the proper length of both ends of the toenail due to the nail structure, and as the toenails grow, they will irritate the surrounding flesh.
If you have athlete’s foot, you need to treat it. Professor Joo Min-sook said, “If you have athlete’s foot, your toenails will bend more easily and there is a risk of irritating the surrounding area.” It is also important to wear shoes that fit your foot size. In particular, you should avoid wearing tight shoes because they put pressure on your feet.
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