Toenails case study

Case Study

Ingrown sore toenails: Phoebe aged 17 years. Fit and healthy. No previous nail conditions.

In April 2019 Phoebe spent 4 days walking in the Peak District for her gold DofE. She walked 10-15 km per day over a range of terrains.

• Day 1 she experienced some pain, blisters started to form and the toes started to hurt. Phoebe added dressings to prevent some of the rubbing.
• Day 2 the nails ached at night and were sore (bruised).
• Day 3 she found that the toenails became very painful and sore whilst walking, and they started to show signs of bleeding. Some of the blisters had popped. 
• Day 4 the toes bled and were so painful that she had to use paracetamol to help with the ingrown sore nails.

After the expedition

Phoebe came to see us not long after she got back. The big toenails were bruised. She had cut her nails, and the wounds from the blisters were healing. We advised salt water bathing daily and to avoid any tight footwear or impact sports for the next week. We advised that she may lose the toenails, and to monitor them.

Tips for healthy toenails on expeditions

• Check that your boots fit and comfortable before your trip
• Wear appropriate socks for the weather and terrain
• Cut your toenails before leaving home
• Take dressings and blister plasters with you
• Try not to pick (or bite) your nails

6 months later

In September Phoebe came back to see us as both big toes were giving her some pain, down the sides of the nails and if any pressure was applied to them. It made sports and activities hard work. They were ingrown sore toenails.

She had not lost the nails; however they were both now growing into the skin and were causing pain. After cutting them back and monitoring for a further month, Phoebe decided to have nail surgery.

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Nail Surgery for ingrown sore toenails

Podiatrists are able to perform nail surgery. They are trained during their podiatry degree, for more information on nail surgery please check out the information on the college of podiatry website.

Nail surgery involves either part or all of the nail being removed. We always try and do part if possible (sides), and in most cases we do. Sometimes only one side is necessary. We do this whilst your toe is numb from local anaesthetic, much like the dentist with fillings in your mouth.

We cut the ingrown sore nails away, then a chemical is applied called phenol which destroys the nail bed and stops it growing back. The result is a slimmer nail, that doesn’t grow in and or cause pain. The nail takes around 3-4 weeks to heal, however the pain is normally reduced the following day. 

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Phoebe update

One month after surgery, the nails were checked and Phoebe confirms she is still in no pain from her toenails.

Nail surgery with phenol works in 97% of cases

To find out more about ingrown sore nails and nail surgery at Zest Podiatry, click here.