By: Michael Zapf, D.P.M., M.P.H., F.A.C.F.O.
In my eleven years in Acorn Country I have seen almost every conceivable
treatment for ingrown nails; except one. I knew it was bound to happen but I was still
surprised when I saw it. I have seen patients push cotton into the border of the nail. I
have seen patients attack it with kitchen and bathroom implements. One of the latest waves
is the application of tea tree oil to the nail border. Tea tree oil comes from a tree of
the same name found down under and a few believe it to have almost miraculous
curative powers. But until last week I have not anybody use the tool of choice for
millions of weekend handy persons: duct tape.
My young patient was David. He has suffered with an ingrown nail on his
big toe for months. He showed me in careful detail how he took a one by eight inch strip
of duct tape and wrapped it around his toe. He would start by placing the end of the tape
next to the nail on the ingrown side and pull it taught as he wrapped it under the toe and
across the bottom of the foot. It would have been a great treatment -- except that it did
not work. He still had a very painful and swollen ingrown nail.
David’s nail was simply too wide for the nail bed. While this may not
be a problem for those who do not wear shoes, it clearly is for those who do. Shoes put
pressure on the side of the toe next to the nail. The nail, in turn, penetrates the skin
and creates an inflammation that is usually (and often incorrectly) called an infected
ingrown nail. Because the underlying problem in the penetration of the nail and not an
infection, the use of topical or oral antibiotics is often fruitless. The cure involves
the gentle removal of a thin edge of the nail, usually under local anesthesia. This can be
done permanently by the application of a chemical to the nail root that prevents the edge
from growing back. Both the temporary solution and the permanent cure are done in the
office under local anesthesia. Because of his long history of ingrown nails, David chose
the permanent correction. David found the local anesthesia to be almost painless. The rest
of the procedure was done in the office in just a few minutes. While he left the office
with his toe wrapped in gauze, David only needed a Band-aid the next day.
David returned to the office last week for a follow-up examination. He was
doing great and his toe had healed without problems. He was also happy that he did not
have to use any more duct tape on his toe. He said he had a big home repair job coming up
on Saturday and he had just the right amount of duct tape to complete the task.
Dr. Michael Zapf is a board certified podiatrist with offices in Agoura
and Thousand Oaks. For more information you can call his office at (818) 707-3668.
