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Ingrown toenails

Old 02-04-10, 07:27 PM
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nancy sv
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Ingrown toenails

I'm grasping at straws here... Some of you already know this saga, but for those that don't let me give you a brief recap...

My family and I are cycling from Alaska to Argentina. Our boys just turned 12 a couple weeks ago. Everything was find for the first 13 months of our tour, but then one son get an ingrown toenail. It isn't a "normal" ingrown toenail - a huge chunk of nail broke off way down near the base of the nail. The only way to get it out was to cut half of his nail out and go fishing.

That nail had barely started to heal when the other one did the same thing - we had surgery on that toe to have half of the nail cut out.

A few weeks later, the one that was cut out in Panama was ingrown again. As soon as the nail reached a certain point, it grew in rather than up. We had it cut out again.

By that point, we were certain we needed to have surgery done to cut off the tips of the root so the nails grow in more narrow, thus not growing into the skin. We thought we had that done 3 months ago.

Anyway, two days ago, one of Davy's toenails was ingrown yet again. We went to the emergency room in Amato, Ecuador and the doctor completely removed the nail.

Now we have NO IDEA what to do. The one nail that was removed 3 months ago is now growing back in and we are fairly certain it will be ingrown fairly soon. the other one that was just removed will most likely grow into the skin as it grows out. We have to do something, but don't know what.

One of the things that may be contributing to the problem is his toe clips. We are hesitant to get him SPDs because he spends so much time off the bike climbing trees and such, but are ordering PowerGrips to take the pressure off his toes. We'll also get shoes a size or two too big to be sure he has plenty of room.

But still - I doubt any of this will help. Do you have any suggestions? We are contemplating having his toenails permanently removed, but don't want to go t here unless we have exhausted all possibilities!
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Old 02-04-10, 07:55 PM
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Hi Nancy -

I spent most of my life fighting ingrown toenails - and most doctors and nurses who haven't dealt with them seem to be rather clueless - just passing on misinformation.

I can truly sympathize. I was on the Alaska Highway with an infected ingrown toenail years back and the owner of the hostel in Fort Nelson fibbed with the local pharmacy and got me some antibiotics. I've had scissors, tweezers, and toe in face in a tent.

When I was six, my sister showed me how to do "home surgery". It's pretty bad when siblings have a gory term for a procedure that they have to do repeatedly. Doctors always talked about a middle "V" and cotton under the edges, etc. Never worked. What did work was never allowing the corners to start growing in in the first place - so we would cut the edges down to the root and yank. Then pour on the alcohol.

I'm sure I have done this hundreds of times in my life - so much so that I can do what other people would faint from. Fortunately, a few years back, I had a doctor here in Wyoming who really DID understand the issue. In the past I had had doctors who had ripped out the toenail - only for it to grow back worse. This doctor cut down the edges and cauterized the root. I haven't had an ingrown toenail since.

Did your son have ingrown toenails before this trip? For me it has to do with the shape of my toe and the toenail - i.e. I am extremely prone to them. I do not know if the initial nail break was responsible - but then why did the other one do it, too? I have bad news - my experience is that once toenails start growing ingrown - they tend to keep doing so. So you may need another round of surgery.

Take care - Godspeed -
And I hope to hear that you get this cleared up.

John
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Old 02-04-10, 08:07 PM
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So cutting the root and cauterizing it worked? That was what they were SUPPOSED to do three months ago - and they told me they had done it. But - I suspect they simply pulled out the nail and left it at that. So now that it is growing back in, it is just growing back the same way it was. It may be that here in Ecuador they don't do the right surgery and therefore didn't understand what I wanted done. I don't know if they can do it in Peru or not, but I'm not willing to put him through another surgery unless I KNOW they are doing the right thing!

The thing is that there is NO WAY we can get the nail grown out in order to put cotton under it or whatever. It starts to grow into the skin at about 3 or 4 millimeters above the base, where it is still firmly attached to the skin. And no - he had never had a problem before 13 months ago.
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Old 02-05-10, 01:19 AM
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Originally Posted by nancy sv View Post
So cutting the root and cauterizing it worked? That was what they were SUPPOSED to do three months ago - and they told me they had done it. But - I suspect they simply pulled out the nail and left it at that. So now that it is growing back in, it is just growing back the same way it was. It may be that here in Ecuador they don't do the right surgery and therefore didn't understand what I wanted done. I don't know if they can do it in Peru or not, but I'm not willing to put him through another surgery unless I KNOW they are doing the right thing!

The thing is that there is NO WAY we can get the nail grown out in order to put cotton under it or whatever. It starts to grow into the skin at about 3 or 4 millimeters above the base, where it is still firmly attached to the skin. And no - he had never had a problem before 13 months ago.

I have been able to just keep cutting the thing with a special toe nail cutter. I got mine from spd shoes. It was pushing my toe nail inward.
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Old 02-05-10, 03:36 AM
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Nothing to do with the medical side of it, but I have problems on one foot, and all I secure it with is the strap, no powergrip, or clip. That way the foot is stabilized, and can be pulled on, but one isn't pullling on the shoe. The only danger is that I use only the strap tp the rear, and the pedal can tumble and catch the foot, still I have never had problems with it. I mostly use cycling sandals with socks. That way there isn't any down pressure on the toes. I tighten the strap on open riding for max efficiency, and leave it a little looser for city stuff, The foot comes out when pulled up and out.

I can't use the new clip-on system because my ankle is broken, and set slightly outward so one of my feet is a few degrees turned outward.
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Old 02-05-10, 05:33 AM
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Any chance it's shoe related? Something like a spd pedal and keen or similar type spd sandal help? No personal experience but it would seem to be cycling related to me.

What is your son using now?
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Old 02-05-10, 06:45 AM
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We're confused about whether it is cycling related or not. The fact that we spent a whole year on the bikes in 2006-07 and then another 13 months on the road on this trip before it started happening tells me it's not cycling related - but I really don't know. Right now he wears regular sneakers with toe clips. We're hesitant to get him SPDs because of how he likes to climb trees and such on breaks.

More and more, I'm hearing that the only solutioin is the surgery we thought we had had done 3 months ago. I now doubt they actually cauterized the root like they said they would.
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Old 02-05-10, 07:49 AM
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The process you described worked great for me. In your son's case I suspect they did a poor job of killing the portion of the nail that they supposedly cauterized.
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Old 02-05-10, 11:42 AM
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My dad had problems with ingrown (big) toe nails. His problem was that the nails would grow into the sides of the nail bed and cause infection. Eventually he underwent some sort of procedure which modified the nail roots such that the width of the nails were reduced. I'm not sure if this applies to your situation. Good luck.
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Old 02-05-10, 12:04 PM
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It's starting to look like they either didn't do the root thing at all or did a poor job of it. According you all, the process SHOULD have worked! We'll have to look for another surgeon down in Peru or Bolivia. Honestly, I don't know if the kid can handle the stress of another operation!
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Old 02-05-10, 01:47 PM
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i used to have an ingrown toenail problem. the nail is rather cool looking, its rather reminiscent of a pringles potato chip... any how the only real cure is minor surgery. i went with the full root burn. no toenail = no in grown toenail.
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Old 02-05-10, 03:19 PM
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Having the 'fix' done to my ingrown toenails was the best medical expense I ever incurred. My nails on my two big toes now have straight sides and I have never had a problem since the operation. Sorry the original operation didn't work, but try to find someone that can do it right and he will be ok.

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Old 02-05-10, 03:53 PM
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I agree with never letting them grow in the first place and grab and yank them out by the root...yes it will hurt, get over it. The toe will bleed for a while, just put a band-aid over it and off you go. I've done this for years and never seen a doctor for them. You can use alcohol...on the toe, it doesn't help to drink it unless you don't want to feel the pain...if your one of those over concerned infection guys then use the alcohol, but I never did and never got an infection.
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Old 02-05-10, 04:36 PM
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There is quite a lot of stuff on Youtube. Didn't have the guts to peruse...


Is there a good website on backcountry or self medicine?
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Old 02-05-10, 06:16 PM
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Originally Posted by freako View Post
I agree with never letting them grow in the first place and grab and yank them out by the root...yes it will hurt, get over it. The toe will bleed for a while, just put a band-aid over it and off you go. I've done this for years and never seen a doctor for them. You can use alcohol...on the toe, it doesn't help to drink it unless you don't want to feel the pain...if your one of those over concerned infection guys then use the alcohol, but I never did and never got an infection.
YOUCH!!! The problem is how to get down there while it is growing - the nail is firmly attached to the skin. It grows in so far down near the base, that I serioulsy doubt we COULD pull it out! I'm not normally freaked out about infection, but we've dealt with this thing for so long and are in the tropics where infection spreads like wildfire.
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Old 02-05-10, 07:32 PM
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Originally Posted by freako View Post
I agree with never letting them grow in the first place and grab and yank them out by the root...yes it will hurt, get over it. The toe will bleed for a while, just put a band-aid over it and off you go. I've done this for years and never seen a doctor for them. You can use alcohol...on the toe, it doesn't help to drink it unless you don't want to feel the pain...if your one of those over concerned infection guys then use the alcohol, but I never did and never got an infection.
This. 7 or 8 surgeries later, my left is finally normal, but the right continues being ********. I've had to do the above countless times. Sometimes so painful I cannot follow through and have to put it off. It's pretty awful. Cycling / running helps the problem very little, but some are just destined to have this terrible experience often.
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Old 02-06-10, 12:03 AM
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I have had a similar procedure as to jamawani, where the sides of the toenail was cut down to the root then cauterized the root of the toenail. I had this done to both big toes about 5 years ago and it hasn't been ingrown ever since. I had been suffering from ingrown toenails for about 40 years before the surgery. I went to a pediatrist for the procedure.
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Old 02-06-10, 07:19 AM
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OK - I'm convinced we are going to have to have one more surgery - to get the blasted root cauterized for sure. We are so frustrated in that we THOUGHT we had that done three months ago. Stupid doctor... If we had known all he was going to do was cut out the nail, we never would have gone to him. I asked him over and over and over again to be sure he was going to take out the root and he said, "yes, yes, yes." And now? Nothing!
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Old 02-06-10, 10:29 AM
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When I had mine done, the foot Doctor cauterized it chemically. She just put something on a Q tip, and held it in the "cut" for about 2 minutes on each side of the nail. I've never had another problem on that toe.

Good Luck!
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Old 02-06-10, 12:04 PM
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Sometimes the root has to be cauterized more than once to successfully kill it. Ask me how I know. (HTFU only worked on my toenails)
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Old 02-06-10, 12:42 PM
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I'm surprised at how many people have had the procedure done! I sincerely hope it works the next time we do it - the poor kid will crack if he has to deal with this anymore!
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Old 02-07-10, 09:22 AM
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I think you should stop using the clips and staps until the injury heals. Pressing on the ball of the foot puts a lot of pressure on the toes which maybe making the situation worse. He has to be able to use the middle of the foot to relieve the presure the clips maybe putting on the nail. You'll lose some efficiency but it does not matter at this point.
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Old 02-07-10, 10:29 AM
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We'll be taking his toe clips off and he'll go with just the pedals until we can get the PowerGrips sent down. That way he can wear his sandals if his shoes are uncomfortable and will have no pressure on the toe at all.
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Old 02-07-10, 05:23 PM
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Originally Posted by nancy sv View Post
We'll be taking his toe clips off and he'll go with just the pedals until we can get the PowerGrips sent down. That way he can wear his sandals if his shoes are uncomfortable and will have no pressure on the toe at all.
Good. The only way I could use the toe clips and straps was if I had shoes with a very hard sole and a hard toe area. If the shoe was at all soft, my toes pushed against the toe clips way too much and that was very uncomfortable ... painful. I didn't develop ingrown toenails from it ... but I didn't do as much riding as your son is.
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Old 02-07-10, 06:33 PM
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He has never complained about the toe clips at all, so I don't think they hurt him. But now that he doesn't have a toe nail, we don't want anything rubbing that area at all!
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