A Big Ask: Anyone Know A Pedicurist Who Knows How To Prevent Ingrown Toenails?

[Jingthing]

Here's the deal.

I have a genetic tendency towards ingrown toenails.

Mostly the classic problem: the BIG toes.

Anyway knowing this and living in the tropics with sandal wearing etc. I have been using pedicurists for years now.

Also I am uncoordinated and think a specialist could do a better job technically than I can.

Long story still long, I have been using the SAME pedicurist for years now. She seemed competent enough.

Over time under her "care" my genetic tendency has emerged more.

I know it. She knows it. She has being doing what she knows to reduce the problem and she helps in the short term but its clear to me she doesn't understand anything about tactics for PREVENTION.

Now I realize I'm asking a lot. She's not a doctor. Speaking of doctors. Are there any podiatrists in Pattaya? I don't think so. If you get to the point of needing toenail surgery, you can find a surgeon for that though but am trying to prevent that. The feet are so low here, what doctor would want to specialize in that.

So my big ask, very long odds, is if any forum people have a lead on an unusually competent pedicurist who has understanding in PREVENTION of ingrown toenail problems?

I think I need to fire my current lady, sad to say.

Edited January 23, 2013 by Jingthing

[4.real]

When 'winklepickers' became fashionable in London I got ingrowing toenails.

My doctor advised me to cut a' V ' in the middle of my big toenail and lever some cotton wool under the ingrown side.

Takes time but it works.Must do every time you cut your nails

The nail will grown to the centre to close the V.

[BlackPuddingBertha]

My doctor advised me to cut a' V ' in the middle of my big toenail ...

I read that this is exactly what you shouldn't do. I read that you should cut the nail absolutely straight across and not even follow the contour of the toe.

[tropo]

My doctor advised me to cut a' V ' in the middle of my big toenail ...

I read that this is exactly what you shouldn't do. I read that you should cut the nail absolutely straight across and not even follow the contour of the toe.

That doesn't work. A V cut in the centre takes no pressure off the sides as the nail is fixed to the nail bed. It's not loose.

There's only one cure. Nail bed ablation. They use chemicals to kill the cells where the ingrown side edges of the nails grow from. It reduces the width of your toe nail by about 1/8 inch on each side.

I very much doubt you'll find any surgeons in Thailand who can do this. All podiatrists in Australia can do this. They probably do it in the US too.

I had it done in Australia just over a year ago. It cost me AUD $550 to do 4 sides and it was the best money I've ever spent. I even got a follow up check up done a year later for free.

I used to have a lady here cut the sides out every 6 weeks or so. I did that for about 10 years here and in the Philippines. Sometimes it worked, sometimes it didn't, but it sure was painful. The ladies here make the ingrown toenails worse by always cutting out the sides, but once they've started doing it there's no return - it'll always be a problem.

If I was you (Jingthing) I'd have it done next time you visit the US. I've heard about movie stars in the Philippines flying to Australia just to have this done.

Edited January 23, 2013 by tropo

[Jingthing]

Yes, I am sure the "V" idea is completely the wrong thing to do.

Anyway, yes I'm sure using my Thai pedicurist I've made the situation worse with the side cutting and yes also removing the cuticles.

I recently had an acute situation, worse ever, and did use the cotton under the side successfully to redirect the nail. It's amazing what you can learn on the internet! If I hadn't been able to fix it I would have needed whatever crude surgery they can do here, but I did prevent that need so far.

The generally accepted tactic is to let the nails GROW OUT. I understand that but I think that needs to be managed as well, cleaned up, etc.

I may just try that myself and stay away from these local pros for awhile, maybe forever.

Or I might just keep using the same lady and telling her just to let me grow out the big toes and just file the tops for me. I know how to manage the sides now with cotton as they grow out. It seems worth a try anyway.

Edited January 23, 2013 by Jingthing

[tropo]

The generally accepted tactic is to let the nails GROW OUT.

They grow sideways at the base, so they will likely never grow out. I never cut the sides for 40 years but they still grew sideways.

Just have the surgery and be done with it.

http://www.ingrowntoenailcentre.com.au/?page_id=76

[yoslim]

we used to treat it at the military dispensary.. any real doc should be able to fix it

[marstons]

I had the problem for years, I had toe nails removed here in pattaya inter just over 3000 baht, problem solved. Did the same thing in Samui 8 years ago and no problems for 8 years. with proper care should not be a problem again. I wore tight fitting trainers for the gym and the problem came back

[Jingthing]

I had the problem for years, I had toe nails removed here in pattaya inter just over 3000 baht, problem solved. Did the same thing in Samui 8 years ago and no problems for 8 years. with proper care should not be a problem again. I wore tight fitting trainers for the gym and the problem came back

Reading about this I find that with limited surgery the problem quite often surfaces again. Then the next step is complete removal of the toenail which I think is permanent but not sure about that. Of course no toenail is cosmetically not so nice. As recently I really had my first rather serious flare up ever (before only minor discomfort), I think a more conservative approach is worth a try and what most good foot doctors would probably suggest to try first. I was able to completely reverse the pain and irritation within a few days with very hot water soaking, antiseptic, antiobiotic cream, and wedging cotton at the edge to lift up the nail at the bad side. No pain at all now. So it seems irrational to go for surgery at this point. I think I have identified some good reasons why this developed. I mentioned sandals before but in the last years I have switched to shoes for outdoors for better foot support. So my shoes are putting pressure on my nails. Also, letting my Thai pedicurist remove my cuticles was a huge mistake. So I think I can possibly reverse these problems naturally now. Switch back to sandals almost always, let all my cuticles grow back, and use cotton wedging if any acute problems start to pop up. Its more unlikely if wearing sandals all the time that it will even happen again. My total confusion now is how to care for my nails now. I have little confidence in any Thai pedicurist I have ever met and I probably lack the technical skills to do this well myself IF I even understood exactly how to cut my nails for this issue. I've read conflicting things ... let them grow out, cut them often, it's totally contradictory. One pretty consistent message is try to cut them very straight, not curved, NOT TOO SHORT and OVER the area where they could even have a chance to go into skin, and file them. Now that I have fixed the pain in the bad area and guided the nail away from the skin, I really don't know whether I should touch that part of the nail now or not. To the point that nails don't grow OUT how can that be? Haven't we all seen people with super long nails?!? Again, if you happen to know an unusually smart pedicurist who has a clue about foot health as opposed to foot beauty, please let me know.

I know this is really a health forum item now, but the reason I put it here was to hope someone could point me to a better LOCAL pedicurist.

For the benefit of people reading this for whatever reason, I do have some advice. Do NOT let pedicurists remove your cuticles. If you tell them not to they will usually fight you. Sometimes they might forget you asked and do it anyway.

Edited January 24, 2013 by Jingthing

[JohnC]

I have heard some favourable reports from this clinic but do not have specifics, might e worth a visit!

http://www.footclinic.asia/treatment.html

[Jingthing]

I have heard some favourable reports from this clinic but do not have specifics, might e worth a visit!

http://www.footclini.../treatment.html

I'm aware of that place but their focus is clearly about selling therapeutic shoes to deal with foot structural problems. I get the impression they are pushing that kind of therapy when I am just interested in my nails right now. Anyway, thanks. Edited January 24, 2013 by Jingthing

[tropo]

I know this is really a health forum item now, but the reason I put it here was to hope someone could point me to a better LOCAL pedicurist.

You can try Nong at Star Nails. It's a little shop just up from Sindarella Wedding nearly opposite MK on Soi 2 on the north side of Big C on 2nd Road.

She did mine for about 4 years. She did a pretty good job, but this involved cutting out the ingrown nails on each side. It took me a long time to find her so consider this privileged information.

This is the only way to treat your problem. They will never grow out so you're wasting your time even attempting that.

This is exactly what podiatrists do if you don't go for the surgery - they cut out the ingrown nails. The only difference is they offer local anesthetic.

[Jingthing]

Thanks for that. But I have seen sources on the net reporting their foot doctors said they MUST grow out the nails (also redirecting the problem areas with cotton or floss) for a real non-surgical solution and reports that if you're very patient this works. So you see conflicting information -- confusing. Saying nails can't grow long just seems totally wrong to me. Haven't you ever seen LONG nails? They don't really need to very long, just LONGER than where they can grow into the skin on the sides.

This acute thing I just had which a few days ago seemed and looked really bad, I did manage to move the nail away from the skin without ANY cutting and now the area feels and likes fine. That makes me think there is really something to this more natural approach. The cutting out the sides, again and again, is obviously not a long term solution.

Bottom line, if I want to try this growing out idea including cuticles which you say isn't possible but I don't really accept that yet, I'll probably have to do it myself. Asking a Thai pedicurist not to cut things out may make their head explode. Maybe correctly, what am I paying them to do? It's interesting that people who never wear shoes don't get ingrown toenails, according to what I've read.

Edited January 24, 2013 by Jingthing

[tropo]

You don't understand what an ingrown toenail is. It's a nail with a piece at the base which grows sideways. It's like a hook. I've had a proper podiatrist cut them out - big chunks of nail about 1/4 inch long growing sideways.

If you can grow yours out, then you don't have ingrown toenails. I had these long before the girls here started cutting them out. I had them when I never touched the side of the nail. I had one on each side of both big toes.

Most of what you've been reading is nonsense. I've discussed this a number of times with very experienced podiatrists in Australia.

Of course nails grow very slowly, so it will take you quite a while to discover than I'm right.

Edited January 24, 2013 by tropo

[Jingthing]

You don't understand what an ingrown toenail is. It's a nail with a piece at the base which grows sideways. It's like a hook. I've had a proper podiatrist cut them out - big chunks of nail about 1/4 inch long growing sideways.

If you can grow yours out, then you don't have ingrown toenails. I had these long before the girls here started cutting them out. I had them when I never touched the side of the nail. I had one on each side of both big toes.

Most of what you've been reading is nonsense. I've discussed this a number of times with very experienced podiatrists in Australia.

Of course nails grow very slowly, so it will take you quite a while to discover than I'm right.

Yes I have seen pictures of extreme hooks. Mine don't seem dramatic that way. I am not sure I really had this problem before I started using pedicurists here. I was just worried about my feet based on my Dad's experience which I don't really remember so well but I know he suffered with them, so figured I needed a pro to do the cutting. I really think I created this problem myself letting them cut out my cuticles and also wearing poorly fitting shoes. I understand what you are saying and think I may indeed fail with my Mr. Natural approach for whatever reasons. One big reason is that is very high maintenance to put in the cotton wedges all the time for maybe months Who wants to pay that much attention to their feet? That said, I think the home therapy of hot soak and cotton wedge is a legitimate medical practice for many acute cases. I just don't know about going forward.

Anyway, I have a few questions about when you did the side cutting pedicures.

1. How often did you go?

2. Did she cut out the cuticles or leave them? (assuming she cut them)

The reason I ask if that if my natural methods fail I will probably try more aggressive side cutting. BUT. I think you are supposed to do that quite often if that's your solution. Otherwise it leaves too much time for the nails to go too far into the skin. My current lady was probably doing this but I was not going often enough for that "therapy" to work without an incident like I just had. I have read go every two or three weeks to cut the sides if that's what you're doing. I was waiting much longer. One might be cynical and suggest that the practice of cutting cuticles here is a crafty way to create pedicure addicts!

I respect your opinion and experience about this, but I guess I need to figure this all out for myself with my own feet to my own satisfaction. But thanks.

BTW: This is from the bloody Mayo Clinic, so there really is something medically based to trying cotton guiding:

http://www.mayoclini...ments-and-drugs

Lifting the nail. For a slightly ingrown nail (redness and pain but no discharge), your doctor may place cotton, dental floss or a splint under the edge of the nail to separate the nail from the overlying skin. This helps the nail eventually grow above the skin edge.

Also WebMD:

http://www.webmd.com...ingrown-toenail

You are right that the important thing is the SIDE growth. If you can achieve SIDE growth that goes above the skin, you've solved it.

BTW, even though I'm still pretty confused, I think I now know more about toenails than I ever cared to know before!

Edited January 24, 2013 by Jingthing

[tropo]

You don't understand what an ingrown toenail is. It's a nail with a piece at the base which grows sideways. It's like a hook. I've had a proper podiatrist cut them out - big chunks of nail about 1/4 inch long growing sideways.

If you can grow yours out, then you don't have ingrown toenails. I had these long before the girls here started cutting them out. I had them when I never touched the side of the nail. I had one on each side of both big toes.

Most of what you've been reading is nonsense. I've discussed this a number of times with very experienced podiatrists in Australia.

Of course nails grow very slowly, so it will take you quite a while to discover than I'm right.

Yes I have seen pictures of extreme hooks. Mine don't seem dramatic that way. I am not sure I really had this problem before I started using pedicurists here. I was just worried about my feet based on my Dad's experience which I don't really remember so well but I know he suffered with them, so figured I needed a pro to do the cutting. I really think I created this problem myself letting them cut out my cuticles and also wearing poorly fitting shoes. I understand what you are saying and think I may indeed fail with my Mr. Natural approach for whatever reasons. One big reason is that is very high maintenance to put in the cotton wedges all the time for maybe months Who wants to pay that much attention to their feet? That said, I think the home therapy of hot soak and cotton wedge is a legitimate medical practice for many acute cases. I just don't know about going forward.

Anyway, I have a few questions about when you did the side cutting pedicures.

1. How often did you go?

2. Did she cut out the cuticles or leave them? (assuming she cut them)

The reason I ask if that if my natural methods fail I will probably try more aggressive side cutting. BUT. I think you are supposed to do that quite often if that's your solution. Otherwise it leaves too much time for the nails to go too far into the skin. My current lady was probably doing this but I was not going often enough for that "therapy" to work without an incident like I just had. I have read go every two or three weeks to cut the sides if that's what you're doing. I was waiting much longer. One might be cynical and suggest that the practice of cutting cuticles here is a crafty way to create pedicure addicts!

I respect your opinion and experience about this, but I guess I need to figure this all out for myself with my own feet to my own satisfaction. But thanks.

BTW: This is from the bloody Mayo Clinic, so there really is something medically based to trying cotton guiding:

http://www.mayoclini...ments-and-drugs

Lifting the nail. For a slightly ingrown nail (redness and pain but no discharge), your doctor may place cotton, dental floss or a splint under the edge of the nail to separate the nail from the overlying skin. This helps the nail eventually grow above the skin edge.

Also WebMD:

http://www.webmd.com...ingrown-toenail

You are right that the important thing is the SIDE growth. If you can achieve SIDE growth that goes above the skin, you've solved it.

If you haven't suffered this problem before, then maybe you don't have true ingrown toenails and just a problem caused by bad pedicuring. If they pull the skin attached to the nail bed that could cause problems, but if they just tidy up the loose skin and trim the cuticle, I wouldn't think that would cause ingrown toenails.

With the type of ingrowns I had it would have been impossible to put cotton under the nail because the ingrown nails were growing deep at the base of the nail bed.

Perhaps you just have rough edges causing a build up of thickened skin on the sides of the nail.

I could keep my ingrown nails under control by having them cut out every 4 - 6 weeks, but as you say, if you're slack and leave it too long then the problem gets worse and much harder to fix. There were times when I had to go back again in a week but it was my fault for leaving it too long.

The lady I mentioned is very good with nails. It's hard to find a lady who can cut out deep ingrowns and she has the skill to do it...however, you could tell her how you want to proceed and tell her not to cut the side edges. She had a lot of guys with ingrowns going there to see her regularly.

[Jingthing]

Thanks again. I'm feeling hopeful.

[Scully]

I have ingrown toenails passed to me by my mother who had her nails removed. Please don't laugh but I let my ex girlfriends mum do mine which was passed on from her mum.

What she did was cut the nail out at the sides and as short as she could at the front. She cut them so short that in many places she drew blood, it hurt like hell and to add to it she then dripped hot wax down the sides.

I just thought she disliked me but sure enough I have not had any problems 4 years on. All I do now is cut short, straight across and cut often.

Good luck, I have a sneaking suspicion you won't use this method though

[Jingthing]

I have ingrown toenails passed to me by my mother who had her nails removed. Please don't laugh but I let my ex girlfriends mum do mine which was passed on from her mum.

What she did was cut the nail out at the sides and as short as she could at the front. She cut them so short that in many places she drew blood, it hurt like hell and to add to it she then dripped hot wax down the sides.

I just thought she disliked me but sure enough I have not had any problems 4 years on. All I do now is cut short, straight across and cut often.

Good luck, I have a sneaking suspicion you won't use this method though

You're right. But it is a very interesting method. As they say, there are many ways to skin a chicken.

[tropo]

I have ingrown toenails passed to me by my mother who had her nails removed. Please don't laugh but I let my ex girlfriends mum do mine which was passed on from her mum.

What she did was cut the nail out at the sides and as short as she could at the front. She cut them so short that in many places she drew blood, it hurt like hell and to add to it she then dripped hot wax down the sides.

I just thought she disliked me but sure enough I have not had any problems 4 years on. All I do now is cut short, straight across and cut often.

Good luck, I have a sneaking suspicion you won't use this method though

You're right. But it is a very interesting method. As they say, there are many ways to skin a chicken.

It doesn't make any sense. He says his ingrown nails are genetic, yet he doesn't have them anymore after having them cut short one time. Real ingrown toenails grow in from the very base of the nail, so no cutting at the top has any influence.

[Scully]

I have ingrown toenails passed to me by my mother who had her nails removed. Please don't laugh but I let my ex girlfriends mum do mine which was passed on from her mum.

What she did was cut the nail out at the sides and as short as she could at the front. She cut them so short that in many places she drew blood, it hurt like hell and to add to it she then dripped hot wax down the sides.

I just thought she disliked me but sure enough I have not had any problems 4 years on. All I do now is cut short, straight across and cut often.

Good luck, I have a sneaking suspicion you won't use this method though

You're right. But it is a very interesting method. As they say, there are many ways to skin a chicken.

It doesn't make any sense. He says his ingrown nails are genetic, yet he doesn't have them anymore after having them cut short one time. Real ingrown toenails grow in from the very base of the nail, so no cutting at the top has any influence.

The genetic reference was because my big toe nails are very curved. They grow into the skin at either sides where they curl over. They were cut either side under where the nail grows into the skin then cutting up the sides.

The reason it hasn't returned is probably mainly due to they way I cut them now.

Edit to add there are different levels of severity and it sounds like tropo had it bad.

Edited January 24, 2013 by Scully

[marstons]

I had the problem for years, I had toe nails removed here in pattaya inter just over 3000 baht, problem solved. Did the same thing in Samui 8 years ago and no problems for 8 years. with proper care should not be a problem again. I wore tight fitting trainers for the gym and the problem came back

Reading about this I find that with limited surgery the problem quite often surfaces again. Then the next step is complete removal of the toenail which I think is permanent but not sure about that. Of course no toenail is cosmetically not so nice. As recently I really had my first rather serious flare up ever (before only minor discomfort), I think a more conservative approach is worth a try and what most good foot doctors would probably suggest to try first. I was able to completely reverse the pain and irritation within a few days with very hot water soaking, antiseptic, antiobiotic cream, and wedging cotton at the edge to lift up the nail at the bad side. No pain at all now. So it seems irrational to go for surgery at this point. I think I have identified some good reasons why this developed. I mentioned sandals before but in the last years I have switched to shoes for outdoors for better foot support. So my shoes are putting pressure on my nails. Also, letting my Thai pedicurist remove my cuticles was a huge mistake. So I think I can possibly reverse these problems naturally now. Switch back to sandals almost always, let all my cuticles grow back, and use cotton wedging if any acute problems start to pop up. Its more unlikely if wearing sandals all the time that it will even happen again. My total confusion now is how to care for my nails now. I have little confidence in any Thai pedicurist I have ever met and I probably lack the technical skills to do this well myself IF I even understood exactly how to cut my nails for this issue. I've read conflicting things ... let them grow out, cut them often, it's totally contradictory. One pretty consistent message is try to cut them very straight, not curved, NOT TOO SHORT and OVER the area where they could even have a chance to go into skin, and file them. Now that I have fixed the pain in the bad area and guided the nail away from the skin, I really don't know whether I should touch that part of the nail now or not. To the point that nails don't grow OUT how can that be? Haven't we all seen people with super long nails?!? Again, if you happen to know an unusually smart pedicurist who has a clue about foot health as opposed to foot beauty, please let me know.

I know this is really a health forum item now, but the reason I put it here was to hope someone could point me to a better LOCAL pedicurist.

For the benefit of people reading this for whatever reason, I do have some advice. Do NOT let pedicurists remove your cuticles. If you tell them not to they will usually fight you. Sometimes they might forget you asked and do it anyway.

Both toe nails completely off, cleaning hurt like hell and brought tears to my eyes, I had it done before as 1 got infected, but came back ingrowing after wearing tight gym shoes. Now healed and I cut toes out of gym shoes. 12 years not wearing shoes my feet have spread.

Edited January 24, 2013 by marstons

[tropo]

This guy is my hero.

That's what I was dealing with. A huge hook growing sideways at the base. If this is what you've got there's only one way - cutting it out.

I had 4 of these to deal with....

As I said, $550 and I'll never have another problem.

[tropo]

Here's another video were you can clearly see what the ingrown toenail looks like after it has been extracted. (can be seen at exactly 7:10 on the video)

This guy is another hero. This kind of surgery causes a terrific amount of pain.

Obviously these ingrown nails cannot be grown out. This guy had one toe operated on and it grew back.

http://www.youtube.com/watch?v=3kRFCoZ-9a4

[BlackPuddingBertha]

This guy is my hero.

He looks like an idiot to me. There are doctors and hospitals and anaesthetics for this sort of thing.

Is he into DIY brain surgery also? Maybe he tried that before he started on his feet?

[tropo]

This guy is my hero.

He looks like an idiot to me. There are doctors and hospitals and anaesthetics for this sort of thing.

Is he into DIY brain surgery also? Maybe he tried that before he started on his feet?

On the contrary. The guy in the second video seems pretty smart and does a very good job.

You should applaud these guys for the ability to handle the pain. It is extremely painful let me tell you. I love the way the guy in the second video just talks his way through all 4 sides of extraction.

I basically had the same done every 6 weeks, but my girl here in Pattaya was missing the forceps.

Why would you want to pay a podiatrist to do the same every couple of months if you can do it yourself? There are plenty of YouTube videos of podiatrists doing exactly the same thing. If you don't have the surgery, then this is the only option.

[robblok]

This guy is my hero.

He looks like an idiot to me. There are doctors and hospitals and anaesthetics for this sort of thing.

Is he into DIY brain surgery also? Maybe he tried that before he started on his feet?

Some things you can do yourself and of course not everyone is insured. I do know that its something i would never ever want to do myself. I have had ingrown toe nails and they hurt a lot. But now i don't have any problems anymore.

[Jingthing]

This guy is my hero.

He looks like an idiot to me. There are doctors and hospitals and anaesthetics for this sort of thing.

Is he into DIY brain surgery also? Maybe he tried that before he started on his feet?

Some things you can do yourself and of course not everyone is insured. I do know that its something i would never ever want to do myself. I have had ingrown toe nails and they hurt a lot. But now i don't have any problems anymore.

How did you solve the problem?

[robblok]

This guy is my hero.

He looks like an idiot to me. There are doctors and hospitals and anaesthetics for this sort of thing.

Is he into DIY brain surgery also? Maybe he tried that before he started on his feet?

Some things you can do yourself and of course not everyone is insured. I do know that its something i would never ever want to do myself. I have had ingrown toe nails and they hurt a lot. But now i don't have any problems anymore.

How did you solve the problem?

Cutting.. and it grew back good. But maybe my case was not as severe as those cases. I do know it was grown in and all swollen and had some pus (yellow stuff). But my cutting was not as extreme as in those video's. I did have it a number of times and now it just does not return.

I would have never thought to have gone to a Dr for this, even though i carry insurance.

[Jingthing]

You were lucky then if only cutting fixed it. For others with less severe cases, I do suggest at least TRYING the cotton or floss REDIRECTING method. It won't work in severe cases or more advanced INFECTION.