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Ingrown Toenail

Allie writes:

I am a type 1 diabetic, and for 16 years I have had problems with ingrown toenails. As I age, this will only continue to become more of a problem.  I have hardly gone 2 weeks without having to go digging for pieces of nail or packed skin that looks like a crumpled newspaper once it’s pulled out. I usually go into a physician’s office once every other month or so for a surgical removal. I have had the nail removed and burned with Phyenol, but the nail still grows back and in. I have had enough.

A friend of mine accidentally ran over her foot while she was mowing the yard in flip-flops and cut the end of her big toe off. I fantasize about “accidentally” doing this to myself. Is there an option to remove the end half of the big toe, including the bone? I need a permanent, drastic and final resolution to this problem. Cosmetic appearance is not an issue.

Dr. Nirenberg replies:

Please don’t cut off your toe! Many solutions exist to help solve your ingrown toenail woes.

Podiatrists love nails. I am not talking about rusty nails in your garage, but ingrown toenails.  Ingrown toenails (or in medical-speak onychocryptosis) occur when the edge of the nail grows deep into the flesh of the toe. These are painful and can become swollen and infected. Fortunately, a brief, in-office technique can alleviate painful ingrown toenails, often permanently. Unfortunately, this simple procedure did not work for you!

The next step would be another small—though slightly more involved—procedure, where the podiatrist will use a scalpel to remove the ingrown nail border and some of the skin around the edge of the nail. This procedure is called a Winograd procedure and is a well-known cure for ingrown toenails (onychocryptosis). The procedure takes a few minutes to perform and is often successful. Good luck. Let us know how you do!

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