Dealing with Toenail Issues: Pain and Treatment Options Explained

Problems with toenails?

I previously had surgery on my left big toe because the nail was growing into the flesh, and the doctor removed the entire nail.
However, I'm not sure if the procedure was done correctly, as the nail that grew back is thicker than the one on my right foot.
When I trim my nails, it seems like I cut too deep.
Now, the outer side of my left big toe hurts a bit when touched, but there is no pus.
Should I consider having the nail removed again, or are there other treatment options available?

Shane, 10~19 year old female. Ask Date: 2004/07/27

Dr. Huang Zhihui reply Surgery

Based on your description, it may be a case of ingrown toenail, where the nail grows inward and puts pressure on the nail bed, causing pain and increasing the risk of bacterial infection, leading to paronychia.
The general treatment method involves partial or complete nail removal.
The newly grown nail may initially appear thicker, but it will return to normal after some time.
However, it is important to monitor for onychomycosis (fungal infection).
If pain persists, it is advisable to return to the physician for an examination, as it may be necessary to trim the edges of the nail slightly.
Additionally, be cautious not to wear overly tight shoes.
If, despite treatment, the newly grown nail continues to exhibit ingrowth, one might consider destroying the nail matrix to prevent further nail regrowth.

Reply Date: 2004/07/27

More Info

Dealing with toenail issues, especially after a surgical procedure, can be quite challenging and painful. It sounds like you have experienced an ingrown toenail that required surgical intervention, and now you are facing complications with the regrowth of your toenail. Here’s a comprehensive overview of your situation and potential treatment options.

Understanding Your Condition
After a toenail is surgically removed, it is common for the nail to grow back differently than before. In your case, it seems that the regrown toenail is thicker than the one on your right foot, and you are experiencing pain when the outer side of the toenail comes into contact with shoes or other surfaces. This could be due to several factors:
1. Nail Growth Abnormalities: Sometimes, after a nail is removed, the nail matrix (the tissue under the base of the nail) can be affected, leading to abnormal nail growth. A thicker nail may indicate that the nail matrix is producing more keratin than usual.

2. Nail Bed Issues: If the nail bed was not properly treated during the surgery, it could lead to complications such as pain or discomfort as the nail grows back.

3. Ingrown Toenail Recurrence: If the nail is growing into the surrounding skin again, it can cause pain and inflammation, even without visible pus or infection.

Treatment Options
1. Observation: If the pain is mild and manageable, you might consider monitoring the situation for a short period. Sometimes, nails can adjust over time, and the discomfort may decrease as the nail continues to grow.

2. Proper Nail Care: Ensure that you are trimming your toenails straight across and not too short. Avoid rounding the edges, as this can lead to ingrown toenails. Keeping the toenails clean and dry is also essential to prevent infections.

3. Soaking and Pain Relief: Soaking your foot in warm, soapy water can help reduce discomfort and soften the nail. Over-the-counter pain relief medications like ibuprofen or acetaminophen can help manage pain and inflammation.

4. Consulting a Podiatrist: Given that you are experiencing persistent pain, it would be wise to consult a podiatrist. They can assess the situation more thoroughly and determine if there are any underlying issues that need to be addressed. They may suggest:
- Partial Nail Avulsion: If the nail is ingrown or causing significant pain, a podiatrist may recommend a partial nail avulsion, where only a portion of the nail is removed to relieve pressure and pain.

- Nail Matrix Phenomenon: In some cases, if the nail continues to grow abnormally, a procedure to destroy the nail matrix may be considered to prevent the nail from growing back altogether.

5. Orthotic Solutions: If the pain is exacerbated by footwear, consider using orthotic inserts or shoes that provide more space for your toes. This can help alleviate pressure on the affected area.

6. Follow-Up Care: Regular follow-ups with your healthcare provider can help monitor the situation and make adjustments to your treatment plan as necessary.

Conclusion
In summary, while it is possible that your toenail may require further intervention, there are several options available to manage your pain and improve the condition of your toenail. It is crucial to seek professional advice from a podiatrist who can provide a tailored treatment plan based on your specific situation. Remember, early intervention can often prevent more severe complications down the line, so don’t hesitate to reach out for help.

Similar Q&A

How to Manage Nail Pterygium Pain and Its Impact on Daily Activities

A family member is experiencing a problem with ingrown toenails, which is causing significant pain and affecting their work situation. What should be done to address this issue? (Does the nature of their job, which involves lifting heavy objects, exacerbate the pain?) Thank you, ...

Dr. Li Yufen reply Dermatology
Hello: If the condition does not improve or worsens, it is recommended to consult a nearby dermatologist for diagnosis and to assess whether further examination and treatment are necessary. Thank you!

Managing Toenail Fungus and Ingrown Nails: Expert Guidance Needed

I have been suffering from onychomycosis and ingrown toenails for several months, possibly due to improper nail trimming techniques. If accidentally touched, it causes significant pain, and I have been limited to wearing sandals for an extended period. I have to be very careful i...

Dr. Huang Ruiyun reply Dermatology
Hello! To address the issue of painful ingrown toenails, you can seek orthopedic surgery, which will require local anesthesia. As for the treatment of onychomycosis (fungal nail infection), it takes a long time and does not provide immediate relief for pain. Additionally, your li...

Effective Solutions for Ingrown Toenails: A Guide for Treatment

My sister, who is 23 years old, has an ingrown toenail on her big toe due to its inward curvature, which causes significant pain as the nail grows into the flesh. Although she frequently trims the nail, this does not address the underlying issue. Could you please advise on any me...

Dr. Zheng Lizhen reply Dermatology
Hello, Your sister is suffering from ingrown toenails, which can be very painful and often accompanied by granulomas. Our department has extensive experience with this condition. If you live near Taoyuan, we would be very happy to assist your sister. The treatment is very quick...

Dealing with Toenail Issues: Causes, Symptoms, and Treatment Options

Hello Doctor, I would like to ask about an issue I have been experiencing. About 3.4 years ago, I stubbed my little toe against the foot of my bed. At that moment, there was bruising under the nail. After a few days, since the toe was still painful, I went to see a doctor. I wasn...

Dr. Li Zhonghuai reply Surgery
Hello! If you have an irregular toenail growth due to an injury to the nail bed, and you are concerned about it, it is advisable to seek medical attention for toenail removal. Proper trimming of the nail bed can lead to a more aesthetically pleasing nail growth. Take care! Changh...