Nail (anatomy) Archives - Jeffrey Sterling, MD

Straight, No Chaser: Find Something Better to Chew On! Ingrown Toenails

The overwhelming majority of cases of ingrown toenails I see come from people chewing on their toenails. So the really, really Quick Tip is keep your feet out of your mouth. If only it was that simple.

Ingrown toenails themselves aren’t the problem. The resulting skin infection and pain are what bring you in to see me. Remember that the ingrown toenail is caused by the nail burrowing into the skin of the toe instead of growing out and over it. I’ve always found it interesting that people wait so long for such things, but in this instance, if you are going to wait, there actually are things you can do to potentially make it better. You’ll know you need to do this if you have a red, swollen, painful toe and especially short toenails.

Soak your feet two-three times a day for 15 minutes at a time.
Attempt to lift the nail by placing cotton or dental floss under the toenail after you soak. The goal is to get that nail corner above the skin.
Wear open-toed shoes. This is not the time when you’d want to have any pressure on your toes.
Place a topical antibiotic on the area.

Have you ever seen a bad ingrown toenail get removed? If you have, you’ll likely agree that it’s a deterrent to having another one. Treatment usually involves lots of local anesthesia (i.e. needles) and partial manual removal of the toenail. It’s not a good day when this has to happen.

So, you can avoid this fate. Just follow a few simple steps to avoid it in the first place.

Don’t bite your nails. As discussed in the human bites blog post, you’ve just added really bad bacterial to the mix for when the infection occurs.
Don’t cut your toenail so short that you can’t see some of the white tips. Be sure to let the corners extend past the skin.
Don’t wear excessively tight shoes that literally smash your toes onto themselves.

Here’s a final note: if you’re diabetic or otherwise immunocompromised, these infections can spread rapidly and extend into the bone – these infections are very serious. In some cases this has led to amputated toes. If an ingrown toenail happens to you, I’d suggest getting seen sooner rather than later.

Straight, No Chaser: Trauma Quick (Finger)Tips – Give Me the Finger!

What you’re seeing is not a five-finger salute gone bad. It’s an all too often occurrence: amputated fingers. Believe it or not, 90% of reattached fingers are done so successfully, although many end up with decreased motion and sensation. Today’s tips are to tell you how to handle the time between when the amputation occurs and when you get to the hospital. It’s actually pretty important to be meticulous in how you handle the finger prior to reattachment.

Wrap the amputated part of the finger in moist, clean gauze. Moist – not wet, not dripping.
The gauze should be placed in a sealed plastic bag or sterile container.
Take the plastic bag and place in another sealed plastic bag or container, with the second containing ice or cold water. The finger never should touch the ice!

It’s actually more important to support the person than the finger. We can survive without a finger. Fingers are worthless without a live person. To that end, calling an ambulance should be the very first thing you do, and don’t forget to place a clean dressing or the cleanest towel you can over the bleeding part of the hand.
You should be aware that not all amputations are reattached, particularly when a poor outcome is likely. However, don’t make any assumptions, and make the effort to give yourself the best possible chance for the best possible outcome.