You can see in this picture there is an ingrown toenail that is affecting the inside of the big toe joint.  This is very common in the office where there is some swelling and this toenail is actually stuck into the skin.  This may have been from picking at it or it may be from trimming it the wrong way, but how do you treat this? Really, what you have to do is you have to get rid of that nail that’s stuck in the skin. Otherwise, that skin is not going to calm down and reduce the swelling and the pain.  By numbing up the toe, putting Novocain in both of the sides of the toe that will help numb it up, you don’t want to inject it where it’s hurting, you want to inject it closer to where that gauze is. Once it’s injected and numbed then you can take a little sliver of skin out just to the side just to help decompress and take away the nail that’s involving the skin to make it feel better. Once this is pulled out, you can soak it a couple of times a day and then the normal nail should grow out over time and that swelling should come down. Usually with toes that just have a little bit of an infection, we don’t give antibiotics, but if it’s very, very infected we will give a short course of antibiotics to help it.  

To Your Health,
Dr. Donald Pelto