Question

Toenail   I've had issues with my big toes for as long as I can remember.  I generally soak my feet in warm water for 1/2 hour then my wife trims both edges of my big toenails using some small scissors and pulls the nail with tweezers. She then pulls out some skin that she says is what would cause an ingrown nail.

This past Sunday I needed to trim my nails so I did, without soaking them first. I just use my clippers when I do it and it usually works fine. This time I must have squeezed to hard as I went to pull the cut corner of the nail and the nail was too short for me to pull it so my wife did then pulled out whatever skin she usually did and it bled. Now it's slightly swollen, she's seen some puss and it hurts. I spend all day on my feet. We have been putting antibiotic on it and covering with a bandage before work and before bed.

I'm concerned it may need a doctor's attention.  I attached a photo. Can you guide me on what I should do? We have no insurance and I can't afford surgery to prevent the nails from growing like they do. I soaked it in warm water last night and tonight.

Answer

How to cut toenails   Hi, James,

Sorry to hear of the difficulty you've been experiencing!  Yes, it really does look like you need to see a podiatrist for this one.  Once there's swelling and pus, it's really not good to try to fix an ingrown nail yourself, as the bone is just under and very close to the nail, and a small infection could become a very serious (and extremely expensive) problem if that infection spreads to the bone.  In general, I discourage my patients from doing what I call "bathroom surgery," as their attempt to fix a problem often makes it worse.

I'm sorry to hear of your financial situation, which is sadly all too common.  Some places can work with you to determine a payment agreement, or you can talk with them to determine the best option...for example, perhaps a temporary removal of that corner of nail instead of a permanent one.  You might want to consider one other thing.  If this is an ongoing problem that has been bothering you for years, sometimes if you're able to find enough money to do the permanent procedure (maybe by working out a payment plan that you can afford), it may be less expensive in the long run, after adding up various doctors' bills and the expense of medications, etc...not to mention the pain you wouldn't have to continue to endure.It's something to think about.

As an aside and for future reference, it's best if you cut your toenails straight across, rather than rounding the edges.  It is just way to easy to miss a tiny sliver and end up with an ingrown nail, like the problem you are dealing with now.  If the nail grows to or just past that corner of skin, it's not going to get trapped underneath to cause an ingrown nail.  Does that make sense?

I hope this helps.  Please do consider the things I said, and try to find a podiatrist who can see you on Monday, if possible.  I would hate to see anything happen to your toe because of a nail problem.

Wishing you health, happiness, and peace,
Dr. Bodart