How to treat swelling and pus due to an ingrown toenail?

Question

Hi doctor,

I am a 22-year-old woman who underwent the removal of a large toenail ten months ago. But it is still growing into an ingrowing toenail. My big toe is very swollen, full of pus, and bleeding.

What should I do? I am in severe pain and cannot bear it any longer. Complete nail removal was used to cure my past ingrown nail issues, but it did not help. I have taken Paracetamol and Ibuprofen for pain, which have not helped.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read the query, and I can understand your concern.

You are suffering from paronychia with ingrown nails. Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but may progress to a definite abscess. Acute paronychia can be a painful and purulent condition most frequently caused by the staphylococci bacteria.

A fungus infection that has persisted for six months causes chronic paronychia. To rule out bacterial causes, I suggest you perform Gram staining and bacterial culture tests. Also, do potassium hydroxide (KOH) 5% smears to rule out fungal causes.

In your case, mild soft tissue swelling is present without fluctuance. The infection may resolve with warm soaks three to four times daily. Incision and drainage must be done if an abscess has formed. I suggest you take oral antibiotics like Augmentin 625 mg (Amoxycillin and Clavulanic acid) thrice daily if not sensitive to penicillin, with topical Fusidic acid cream and Clotrimazole cream twice daily for five days.

Consult a specialist doctor, talk to them, and then take the medication. Do not cut toenails from the side, but can cut from the front. Side nails, when growing, pinch the skin and cause recurrent problems. Do a review after five days.

I hope this will help you.

Thank you.