Many of my patients in Worcester, MA who come into the office I put them into two classes: the quick actors and the slow actors. So let me tell you about the quick actors. The quick actors tend to be pro-active about their health care and they tend to be female, especially when dealing with ingrown toenails. So they come in when they have an ingrown toenail. It is painful on the side, it may be a little bit red, but it is not infected, it is not pussing, it is nothing like that, and they will come in within a couple of weeks to get it treated. These are very easy to trim back after numbing up the toe and then there is no problem. I can teach them how to massage the side of the toe so that it does not come back and if it does we can treat with a permanent procedure called a phenol and alcohol matrixectomy. The second type of people that come in tend to be men because they wait longer than the women and they have had it either one time and treated it themselves or a couple of times and treated it themselves, but this time they just cannot get that little piece out. They now come in and the toe is very swollen, they may have extra tissue on the side called hypergranular tissue, as well as they may have an infection or pus coming out of the area. These are the very infected ones that should be seen immediately whether it be in the emergency room or in the doctor’s office. I tend to go to the specialist right away. In my opinion when you go to a generalist they may know how to treat it, but for the most part they put you on an antibiotic and then send you to see us. So it is just easier to see a podiatrist who will numb the toe, remove that section of the toenail, give you some dressing changes to do, and it should resolve it. Now if it does come back, we still may need to do the phenol and alcohol matrixectomy to help it. If you would like more information, visit my Foot Pain Toolkit found at www.drpelto.com.