Lyndon Johansen DPM

Ingrown Toenails

What are ingrown toenails?

Ingrown toenails happen when the side of your toenail grows into the flesh. Your toe will typically appear red and swollen and be painful to the touch. It's a common condition that occurs when toenails are trimmed tapered instead of straight across. Although it looks nice, this type of trimming may encourage your toenail to grow into the soft flesh on the side of your toe. And like many other foot-related conditions, ingrown toenails can be the byproduct of improper footwear.

What causes an ingrown toenail?
Many things can encourage ingrown toenails, including some health issues like diabetes, but these are the most common causes.

• Heredity. Sometimes genetics plays a factor in having repeated ingrown toenails.
• Trauma. Such as stubbing your toe, toe injuries, or activities that put repeated pressure on the toes.
• Trimming Incorrectly. Cutting your toenails too short and tapered encourages the skin to grow over the nail.
• Wearing the wrong footwear. Wearing socks or shoes that are too small pushes the toenail into the skin and promoting an ingrown nail.
• Nail conditions. Untreated fungal infections or repeated toenail loss
• Nail Maintenance: Aggressive pedicures or nail picking can likely cause ingrown toenails.
• Sweaty feet: Feet with constant sweat can cause the nail to be soft and split, leading to an ingrown toenail.
• Foot or toe deformities: People with bunions, hammertoes, and flat feet.
Complications

An ingrown toenail can infect the bone underneath and lead to a severe bone infection when left untreated. This type of infection begins at the nail border and spreads into a deeper soft-tissue infection called cellulitis, ultimately leading to a bone infection. Some common complications are scarring of the skin surrounding the nail borders, thickened fungal toenails, and enlarged soft tissue at the nail fold that easily bleeds.

How do I care for an ingrown toenail?

These options may help you heal quickly if you have an ingrown toenail.

1. Castile foot soak: You can soak your foot up to 3 times a day for 20 minutes in a Castile soap warm water soak. For added relief, add Epsom salt to your soak.
2. Shoes: Wear comfortable shoes that give the toe enough room to move. You might consider wearing open-toed shoes while the toe heals.
3. Pain Relievers: Take an oral over-the-counter anti-inflammatory medication. It will help your swelling diminish while providing some pain relief.
4. Antibiotic: If your toe is swollen and painful, you may have an infection requiring an antibiotic. Schedule an exam with your doctor for a prescription.
5. Nail Removal: If your podiatrist thinks the problem is severe enough, they might suggest a partial toenail removal to alleviate the pain. Your podiatrist will perform this procedure on an outpatient basis by applying a local anesthetic. The result is a narrower toenail on the affected toe.

When to seek treatment?

Minor foot problems like ingrown toenails can cause severe complications in people with diabetes, a compromised immune system, or poor circulation.

If at-home remedies aren't providing relief within a week or so, or if there is persistent pain or signs of infection, you should schedule a podiatric medical examination.

See your doctor right away if you are experiencing any of the following:
• Swelling
• Redness
• Streaking (redness spreading from the toe to middle of the foot)
• Pain
• Drainage that may be yellow, green, or white and purulent (containing pus)

If you have questions or concerns about an ingrown toenail, contact our office to schedule an examination.

Hammer Toes

What is hammer toe?

Hammer toe occurs when an abnormal bend in the middle joint of one of your toes forms. Although hammer toe can happen in any of your toes, they usually develop in the second, third, or fourth toe.

When hammer toes are first forming, they are generally flexible and easily corrected with exercises or stretches for the toe. But if left untreated, they will likely become fixed and require surgery.

Hammer toe usually develops over time and may be caused by arthritis or wearing shoes that are too tight in the toe box, like high heels. That's why there is a high percentage of women who develop this deformity. In most cases, a hammer toe is treatable when caught early.

What causes hammer toe?

Hammer toe results from continual pressure on your toe tendons and joints due to muscle imbalance.

Since your muscles work together to straighten and bend the toes, when the toe is bent in a single position for an extended time, the muscles and joints tighten and lose their ability to stretch. And when the top part of your toe is continually forced in a downward position, it becomes difficult to move your toe, even after taking your shoes off.

As mentioned above, the most common cause of hammer toe is wearing short, narrow shoes that are too tight. These types of shoes cause the toe to bend upward. When your toes are bent like this repeatedly for long periods, the muscles and tendons in your toe tighten and become shorter, making one or more of your toes stay in the bent position.

People born with long toes, children who wear shoes they have outgrown, and people who wear very narrow or high-heeled shoes are also more likely to develop a hammer toe. Sometimes, pressure from a bunion or rheumatoid arthritis also can increase your risk of developing this deformity.

What are the symptoms of hammer toe?

One of the most common symptoms of a hammer toe is a bent toe upward at the middle joint. Although you may be able to straighten out your toe at first, it will become painful and more challenging to do so over time.

Hammer toes are extremely painful, especially when moving the toe or wearing shoes. Unless caused by trauma, hammer toe symptoms start slowly. Initially, you'll notice your toe begin to bend downward. As your joint becomes stiffer, you'll find it difficult to move your toe without pain. It's also important to note that you may also find shoes no longer fit comfortably in the toe box and begin to develop calluses or blisters. However, if you've developed a hammer toe due to injury, your toe may instantly appear bent at the joint.

A hammer toe will cause discomfort or even acute pain when walking, moving, or stretching the affected toe. If you notice that your toe is bending downward, you may want to get checked by a podiatrist.

Here are some of the most common symptoms of hammer toe:
• Your toe is angling upward at the joint
• Corns formed at the top of the affected toe
• Toe pain when wearing footwear
• Bending, swelling, and redness of the affected toe
• Restricted motion of the toe
• Your toe is unable to lie flat
• Foot pain at the ball of the foot under the affected toe

Can hammer toe be treated?
Non-invasive treatment starts with new shoes that have soft, roomy toe boxes. You'll want to stop wearing tight, narrow, or high-heeled shoes. If you can, find a shoe with a deep toe box made for hammer toe. Or, have your local shoe repair shop stretch the toe box to provide room for the affected toe.

Your doctor may also prescribe toe exercises you can do at home to stretch and strengthen the muscles, like stretching your toes manually or using your toes to pick things up off the floor. You may also receive a recommendation to use over-the-counter remedies to ease symptoms.

If conventional measures are unhelpful, surgery is an option and is typically performed with outpatient treatment. For up to 4 to 6 weeks after surgery, you may experience stiffness, swelling, and redness in your toe. Even though you can put pressure on your foot immediately after surgery, you should limit your movement while the toe heals. And you'll want to be sure to elevate your foot as much as possible to help speed up the healing and reduce the pain. After you've healed, your toe may be somewhat longer or shorter than before surgery.

If you have questions about or think you may have hammer toe, don't hesitate to get in touch with us to schedule an evaluation.

Painful Bunions? Dr. Johansen can help with a patented new treatment option.

Learn more at https://lyndonjohansendpm.com/lapiplasty/

What Your Feet Tell You About Your Health | Skinny Mom Experiencing weird foot symptoms or pain? You may want to consider calling up your doctor! Check out what your feet are telling you about your health.