The Problem With Nails – About Toenails

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Gee … They Don’t Seem To Do Much … But They Can Sure Can Create Problems It is my observation that most of my patients over 70 years of age have difficulty reaching and seeing their toenails. They may not have enough strength to cut them, anyway.  Frequently, nails left uncut properly are painful and limit weight bearing activities and the choices of foot gear. Additionally, people in this age group commonly demonstrate clinical findings consistent with advancing peripheral vascular disease (poor circulation). These observations include impalpable pulses in the feet, the diminished presence of hair, textural changes in skin, such as wrinkling  and thiness, additional pigmentation of the skin as well as edema(swelling).  More serious  changes are indicated by changes in the color of the feet in which the color of the skin appears reddened or purplish. This is particularly noticeable when the feet and legs are dependent. Sitting for long periods with the legs down stresses the cardiovascular system, especially in people with these advanced vascular disease changes. There may be temperature changes as well with the toes and … Read More

‘Infected’ Toenail: It’s Almost A Rite of Passage to Have At Least One

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People of any age can have problem with how their toenails grow.  Ingrowing  nails is a common problem.  It’s almost a rite of passage to have an ingrowing nail that has to be treated by a doctor. An infected/inflamed ingrowing nail. … Paronychia … is usually something that requires definitive treatment. The frequent use of antibiotics by primary care personnel may temporarily improve but will usually not eliminate the condition that is causing the problem. Why And How Of Paronychia …… Nail ‘infection’ HERE IS WHAT IS HAPPENING.  Frequently, the shape of the nail is such that, as it grows, it presses into the nail groove skin, causing a break in the skin. This is then accompanied by increasing swelling, redness, pain, and odor. That area may become very enlarged as a result of forming granulation tissue or “proud flesh”. This is the body trying to wall off the offending nail border … as if it was a splinter … a foreign body.  This condition, paronychia, may also be caused by cutting the nails incorrectly or just tearing at them, … Read More

What Can Be Done If Your Ingrowing Nails Cause Pain Or Become Infected Regularly?

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Independent of age, patients may have chronically painful incurvated nails which commonly develop routine paronychia, ( nail infection ) in spite of appropriate attempts to appropriately cut them.   As discussed above, an infected nail border is treated by removing a small portion of the nail edge; partial avulsion. Soon after this is removed….it starts to grow back….just as it was before. If the nail border was normally shaped there will be no further problem.  However, if that edge has an abnormal incurved shape, it will predictably become re-infected. Nails are, in a evolutionary sense, a modified hair…like a claw…or a hoof.  A nail grows from a follicle like a hair…but is referred to as a nail matrix……hence the term, partial matrixectomy…which is the permanent partial removal of a nail edge.  Again, the analogy, ….pull out a hair from its follicle and it grows back…..pull out ( avulse) a nail from its matrix ( follicle )….it grows back, as well.   For example, if just the precise portion of the nail matrix that is responcible the offending ingrowing nail edge … Read More