Vrot Toenail

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Q: I have a toe problem that is not really a sports injury, but is aggravated by my running. My toenail is vrot. I think it is an ingrown nail that looks infected, hurts and is starting to smell. – Mia, Stellenbosch

Dr. Rehbok answers:

You have an ingrown toenail that is infected. There are a few possible causes. Shoe pressure may be the common one in runners, while incorrect cutting of the nail can also be a cause. Some inherit a wider nail that develops into an ingrown.

The first part of treatment is to keep the area clean with some type of antiseptic cream and a dressing. Do not try to go in there and cut out the nail. This would be painful and would probably not make it any better.

Secondly, see a podiatrist to treat the toe. We inject some local anaesthetic around the base of the toe to numb it. We then remove the offending piece of nail and chemically destroy the base of it, permanently. When this heals, the ingrown nail will be gone forever.

The nail does not have to be pulled out. If this is done, it will reoccur and grow inwards again in a few months. If the nail is pulled out permanently, it cures the ingrown nail, BUT leaves the toe without a nail for protection.

Prevention is a good idea. Make sure the toe box of your running shoe is wide and deep enough to fit your forefoot and toes, and cut your toenails straight across and not down the sides.

Dennis Rehbok is a qualified podiatrist practising in Johannesburg. Visit his website www.footdoctor.co.za.

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