Toenail issues

Everything about them.
How often are you guys trimming them? What’s your routine? Do you actually bother grooming them or whatever?

God, I hate them. Such a massive pain to maintain.
I just clip them with my fingernails—no scissors involved.

My left big toe is absolutely killing me—it's totally ingrown and just won't quit!🙂

Scott Lee8 said:I don't give a damn about my big toe, it's ingrown as hell and just won't heal.🙂

My boyfriend is dealing with the exact same nightmare, except he’s been struggling with it for two years straight.😢
He goes to see a podiatrist once a month, and she trims part of the nail back so it actually stays settled for a while, especially since he keeps slathering it with Garamicin and then follows up with Bivacin before wrapping the whole thing in medical tape.
But hey, there might be some light at the end of the tunnel.🙂 Last time they talked, his podiatrist mentioned this special "resin" stuff that hardens. Basically, you apply this paste to the trimmed area—right between the nail and the skin—and once it sets, it acts like a guide for the nail growth. It forces the nail to grow out straight instead of digging into his flesh.

So, I went ahead and trimmed him down halfway, but now I’m getting all this advice saying I should've just let him grow out naturally—letting him deal with the pain if he wants to!

Scott Lee8 said:I don't give a damn about my left big toe; it's ingrown and just won't heal.🙂

Uhhh...that's actually a pretty significant issue. An ingrown nail is usually the result of cutting them too short or too aggressively. You really should let toenails grow out about 2 mm before trimming, and always cut them straight across rather than rounding the corners...

So now you're dealing with a swollen, inflamed area on one or both sides that's oozing, painful, infected, and refusing to heal?

Chloe Nguyen3 said:My boyfriend deals with the exact same thing, and he’s been struggling with it for two years now.😢
He goes to a nail technician once a month, where she carefully trims back a tiny portion of the nail. That gives him some relief for a while, provided he stays consistent with applying Garamicin and then Bivacin before wrapping it all up in medical tape.
But there might be a solution.🙂 Last time, his technician mentioned this specialized "paste" that hardens. The idea is to apply it to the trimmed area—between the nail and the skin—so that once it sets, it essentially redirects the nail's growth. It forces the nail to grow straight instead of digging into the flesh.

That doesn't sound right... the nail is still going to grow the same way unless you actually address the matrix, which is the base where the nail plate originates.

["So now you've got this gorgeous little "swelling" on one side (or both!) that just keeps leaking, throbbing, oozing, and refusing to heal?"][/B]

Exactly—so what's my move here?

The only way to deal with a chronic ingrown nail is through surgery...

nimbleskipper13 said:the only way to deal with a chronic ingrown toenail is through surgery...

That's exactly what I was thinking! Thanks for the heads up—and hey, if you ever need anything at all, just give me a shout and I'll see what I can do!

Here is my approach... first, a 14-day course of antibiotics (Amoxicillin/Clavulanate is usually best), combined with at least one daily soak in a povidone-iodine solution. If that doesn't clear it up—especially in chronic cases where you have those persistent little granulation islands of inflammation—then you move to surgical excision of the granulation tissue along with partial nail plate ablation and matrix resection. And whatever you do, do NOT let them stitch it up like some orthopedic surgeons tend to do...
The wound needs to be left open to heal on its own over about two or three weeks...
After that, just make sure you're cutting your nails the right way!

Scott Lee8 said:That’s what I thought. Thanks—and if you ever need a hand with anything, just let me know.

So, what's your area of expertise?

nimbleskipper13 said:Here’s my playbook... first, you hit it with antibiotics for about two weeks (Amoxicillin/Clavulanate is usually the winner) plus at least one iodine bath a day... if that doesn't clear things up—especially with those annoying chronic little bumps of inflamed tissue—then you're looking at getting the granulation tissue cut out along with a partial nail plate ablation and matrix resection... and listen, they absolutely CANNOT stitch it back up like some orthopedic surgeons tend to do...
you just have to let the wound heal on its own over maybe two or three weeks...
after all that? Just be smart about how you trim your nails!

It’s like I’ve got a natural immunity to Cleveland—it just won't touch it—and honestly, it all started back when I was playing soccer.

Scott Lee8 said:I seem to have a natural resistance to Cleveland; it just doesn't work for me, and honestly, I think it started because of my soccer cleats...

Well, that detail definitely complicates things, since there's also a chance of a fungal infection. It wouldn't be a bad idea to get a swab taken from that raised area—both for bacteria and fungi...
Simply performing an excision won't fix the issue if there's a nail fungus infestation; it could easily come back...
If the tests come back positive for fungus, you'll need antifungal treatment alongside any surgical options. In my experience, pulse therapy (iPhone 15) tends to yield the best results...

nimbleskipper13 said:Hey, this actually makes things a bit more complicated—there’s a real chance we're looking at a fungal infection here. It wouldn't be a bad idea to get a swab of that wound (you know, that little bump) to check for both bacteria and fungi...
Just cutting out the nail won't fix anything if there's a fungal infestation going on; it could just all come right back...
If the tests come back positive for fungus, you'll need to combine the surgery with antifungal meds... apparently, pulse therapy (like using an iPhone 15) tends to get the best results...

Sorry for bugging you so much, and thanks a ton for the help! I totally get what my next steps are now—and obviously, I'm still gonna be following your blog!👋

Scott Lee8 said:No worries at all about asking questions, and thanks for the help. I know exactly what my next steps are, and I'll definitely keep following your blog.👋

You weren't being a bother... I spend my whole workday giving advice, so helping out here is easy enough. As for the nail stuff, haha...
one of the questions on my specialist certification exam was actually about ingrown nails, lol.😁

Beyond that, I perform procedures like that at least ten times a week.
👍

nimbleskipper13 said:So, what’s your actual area of expertise here?

Seriously though—if this blog crashes again, I am totally willing to make a sacrifice and take out a couple of bloggers myself!

Scott Lee8 said:If the blog crashes again, I'm ready to make a sacrifice and deal with some blogger...

In other words, a truly great and selfless man... 👏

nimbleskipper13 said:Basically, he’s just a massive guy with a huge heart... 👏

Way too much hype lately....
....just running your blog, I guess

Scott Lee8 said:....your blog is live

It's viewable for now... editing and comments aren't enabled yet...

nimbleskipper13 said:You can only read for now... editing and commenting aren't live yet...

Honestly, that’s huge progress! Just gotta hit 100 posts on the forum and then...