NAIL CARE

The three most common toenail related problems patients complain about are fungus infestation, ingrown/infected nail margins, and trauma. Diabetic nailcare is also brought up often but is covered in the "Diabetes" section.

Fungal nails

Fungal Nails are usually thick, yellowed and in advanced cases, abnormally shaped. Regular nails debridement with nippers and burs, curettement of the under and side margin debris (which we affectionately call a crapectomy) and treatment with an anti-fungal medication is a good treatment regimen. We do not recommend oral medicines with systemic side affects choosing instead a more system-friendly approach such as topicals with more natural ingredients like tea tree oil, grapefuit seed oil and oakin. In addition, we use a special vacuum system when doing electric nail debridement making treatment safer for doctor, patient and staff alike by removing fungal and nail dust from the air and storing it in a filter. Our instruments are of the highest quality and remain in cold sterilize solution.

Ingrown/infected nails

Ingrown/infected nails present to the office, mildly/moderately as incurvated borders with soft tissue/margin changes or holes and severely as infected spikes with puss, blood and/or proud flesh. Anti-biotics may be important but nothing helps like removal of the offending area. After treatment, we often recommend soaking in a diluted anti-bacterial solution in warm water, washing the area with a saline-like solution, blotting and finally the application of an anti-biotic/anti-fungal topical and covering with a bandage or dry sterile dressing. If this is not related to a trauma and the nail shape is truely a problem, we recommend regular nail retaining until the nail is grown out.

Nail Trauma

With nail trauma, one needs to evaluate each situation on a case by case
basis. Certainly, infection and pressure under the nail plate are the prime
concerns. The care is often similar to ingrown nails as stated above but
the consideration of draining bloody fluid from under the nail maybe
important as well. Limiting weightbearing and x-rays to rule out fracture
maybe additional considerations.