Podiatrist (Foot and Ankle Specialist) Questions Ingrown Toenail

Ingrown toenail surgery now have thick ridged nails

Last year I had ingrown toe nail surgery on both big toes where both sides of the nails were removed from the beds, While it corrected the problem and I no longer get ingrown toenails, my nails have grown back totally different and are now extremely thick, yellow, and also ridged. It is aesthetically very unpleasing and embarrassing. Why would this happen, and is there anything I can do?

29 Answers

Have the nail tested to see if it's just damage to the nail, or if there is also fungal involvement. Then you can discuss options with your doc to see if anti-fungal treatment is warranted.
Sometimes you can get fungus in your nails, there is a simple test a podiatrist or a dermatologist can do. If they are fungal nails you can treat it. If they are not fungal nails you can use a product with urea in it to help thin you nails out.
The doctor who did this procedure, sounds like he or she did a poor job by touching the matrix of the nail which is under the cuticle. Unfortunately, you could only cover the nail with a fake nail.
Thank you for your question. I am happy to hear you do not continue to have ingrown nails. With that said it seems like your nails have grown back ‘dystrophic’ or infected with fungus. Normally I recommend several treatment options for fungal nails which include topical and oral anti-fungals, laser treatments and complete nail removal. There are many treatment protocols I implement based on the individual patient. If you have additional questions please feel free to call the office during normal buisness hours. Thank you so much for your inquiry.
Sometimes the nail is deformed over time depending on shoes and activity. Yes there are different antifungal and softeners to apply.
The thickening and ridging maybe a result of shoe trauma ( ie: either hitting the top or front of the shoe) when walking. The yellow maybe a fungal infection. I would recommend seeing your Podiatrist for an accurate assessment.
Ingrown painful toe nail surgery is very important in relieving the chronic symptoms from this common problem. Sometimes, the nail edges from the offending borders do regrow with edges. The nail bed is probably infected with nail fungus. This may be treated with a good topical debridement agent.
Sometimes, fungus develops in the toenail. The nail gets thick yellow, then discolored. A fungal nail culture test of the thick, yellowed nail can demonstrate if there is fungal nail disease. Fungal nail disease can be treated topically, orally or with a laser.
Is it only the big toes that are thick and yellow? There are a couple of reasons why it happened. 1) If the nail matrix (root) is damaged in anyway it will grow back different. Possibly thick, yellow and such. 2) It would be a fungal infection. The best way to know for sure would to have a biopsy of the nail which is just a simple clipping. There are different treatments out there for either case. Hope this helped.
I have been prescribing the following "Kerasal or FungiNail topical antifungal medications to my patients with a very successful outcome and resolution of the fungal nail condition. The topical antifungal medication must be applied twice daily and it may take some considerable time to eradicate the fungal toe nail condition. Also, if you have an Athletes Fungal infection on the bottom of the feet and between your web spaces, then theses issue must be treated to prevent recurrent fungal nail condition. All the topical antifungal medications can be purchased over the counter without a prescription.
It could be fungal infiltration to the area or to the nail bed . After or during the removal of an ingrown nail , the area must be kept clean and sterile during the procedure .
To confirm the fungus you can do fungal lab testing and will be treated by either tincture such as Penlac
The likelihood is that you may have had fungus introduced into the toenail, possibly from the surgery, or from healing after the surgery. Go to your local Podiatrist, have a nail biopsy, and see if you can take the oral medication Lamisil to eliminate the fungus in the nail. Though the treatment is only for 3 months, it takes a minimum of 9 months to clear the fungus in the nail after you start taking the medication
Whenever there is a procedure performed on a nail, it is still considered trauma to the nail. The nail bed is the tissue that is underneath of the nail. The matrix is tissue at the base (bottom) of the nail; the nail grows from the matrix. Whenever the nail or part of the nail is removed the matrix is disturbed which can change the growth pattern of the nail. After nail trauma the nail can grow thickened, deformed, or with discoloration. This weakens the nail making it vulnerable to the fungus as well. You can have nail cultures taken by your local podiatrist to check for fungus. There are treatments that can sometimes help improve the nails if fungus is a factor. Sometimes after the matrix has been affected the nail never grows back the way it was before.
Yellowing of the nail could be from multiple causes. A common one is fungal. Whenever the nail bed is interrupted the protective barrier is also interrupted and could allow for fungus to spread and change the nail. Inflammation from surgery can also change the thickness of the nail, making it opaque. Nails are thin and translucent, if this is lost through thickness the nail may appear yellow. I think a sample sent to pathology, look under a microscope could help identify a cause. Hope this helps, and please feel free to follow up on your concern.
Sometimes during nail surgery there is movement to the central portion of the nail. When this occurs the nail matrix can become damaged and is susceptible to a fungus infection. Response to therapy is not very good. Have your podiatrist take nail samples and send them out for verification that this is a nail fungus. Hopefully he will prescribe Lamisil tablets for 3 months and it clears up. Good luck!!
Without seeing the nail or doing a biopsy of the nail it is hard to say with certainty what is causing the nails to look like this. The two most probable causes that some to mind would be:
1) That after removal of the nail there was some damage to the nail matrix (the "root" of the nail). The matrix cells are now arranged such that they will continually grow put abnormal appearing nail due to previous damage.
The solution to this problem would be removing this portion of nail again and applying a chemical to prevent this portion of the nail from ever growing back (a matrixectomy). This is done in office and is almost exactly like the procedure you had done previously.
2)This could be a bacterial or fungal nail infection. If this is the case you would have a nail sample tested to see which organisms are causing the infection and treat with an appropriate topical and/or oral medication.

I hope this answer was helpful,

It sounds like you could have picked up a fungal nail infection. There are many OTC products you can use however your best bet would be to see a podiatrist and have the nail clippings sent to the lab for testing.
Typically a very thick, yellow nail can be an indication of a nail fungus. The fungus is a germ that has worked its way into the nailbed ( the skin underneath the nail ) and the nail plate. This happens naturally and is in no way the fault of the patient and is not connected in any way to the nail surgery you had last year. In fact almost all people who develop nail fungus never had any nail or other type of foot surgery. See your podiatrist for advice for this new condition.
The changes in your toenail are consistent with a possible fungal infection. Fungal infections can occur in a nail plate following ingrowing toenail procedures which causes nail to become discolored, thick and sometimes with ridges. The best way to determine if it is a fungus is to have a biopsy of the nail plate to determine if there is a fungus. If there is a fungus it can be treated with topical medication, oral medication or laser.
Your toenail should be tested for fungal infection. If it comes back positive than it is possible to re-grow healthy looking toenail.  
Probably fungus nails. Cut them as short as possible and apply Vicks vaporub daily, if they don't grow back normal sell professional help.
I suggest Biotin 10 mg each day. It will take 6 months to see the difference.
Sadly nails can become disfigured and "scarred" with any type of trauma to include ingrown nail surgery. This can be very challenging to restore. It is possible you acquired a secondary fungal infection. Nail specimen can be obtained to assess for fungal presence and appropriately treat with the best option being an oral systemic. I have also found that with several nail growth cycles which take 6 to 8 months one can appreciate return of an improved toenail. So you may simply want to be patient and perform good hygienic management of nail trimming and see if with time things improve.

It is a frustrating disorder and unfortunately no definitive treatment to guarantee return of your normal nail appearance.
A thickened black nail is probably a fungal infection or mycotic nail. When the edges of the nail are removed, it opens the undersurface of the nail to the fungal infection. The best chance of cure is to remove the nail completely and take an oral antifungal medication supplemented with a topical nail antifungal preparation. This is a lengthy process and may take months to achieve a normal nail. The major side effect of this has been possible liver damage due to the antifungal oral medication.
Though nail care is not a part of my practice, I feel obliged to answer your question. It sounds like you developed fungal toenails (onychomycosis) which would leave you with greenish - brown, thickened discoloration to your nails. There are very few tried and true treatments to eliminate this unsightly condition, despite how common it is. Some of these treatments range from oral medications to topical treatments to laser nail removal. I would research a local podiatrist in your area that performs routine care such as this for evaluation and recommendations. I hope that helps you!

Dr. Overley
Unfortunately, after both margins of an ingrown toenail are fixed, the nail has been subjected to trauma and the way your nail has grown back is probably a result of that trauma. This does not happen to everyone's nails, but in about 10 percent of cases, it can. There is not much you can do to change the appearance of the nail except you can try an over-the-counter medication called NuVail, which may enhance the nail's appearance.
The other option, while being more radical, is to completely remove the nail, kill the root, and once it is healed, you can apply a false nail or a nail polish with nail bed adherent.
If you choose that option, there will be no functional deficit as other then cosmetics, the nails in humans serve no functional purpose.
Hope this helps.
It is possible that you are developing a fungus infection in your toenail secondary to the trauma created from the ingrown toenail procedure. I would follow-up with your podiatrist as soon as possible for further evaluation.
Thickened toe nails are usually caused by either fungal infection (termed onychomycosis) or trauma (such as stubbing the toe or microtrauma from tight shoes). In your case, the nail procedure that was performed for ingrown toe nails may have traumatized the nail bed (where the nail grows out from), subsequently affecting the appearance of the nail itself. Or, you may have picked up a fungal infection in the nails (very common - 38 million Americans have nail fungus).
The only way to truly know if your nails have fungus is to go to your podiatrist, have a nail sample taken and submitted to a lab for identification. The lab will be able to differentiate whether there is fungus present in the nail or not. If there is no fungus, your nail bed was damaged by the nail procedure and may take time to improve, or may never improve. If there is fungus present, it is harmless (an estimated 38 million Americans have nail fungus), but can be treated with either topical antifungal medication or oral antifungal medication.

There are usually 3 reasons why you could have developed this problem:
1. If the nail bed had been damaged during the procedure.
2. If you had suffered any injury to the nail bed during the healing, until the new nail grows back fully.
3. If you had developed nail fungus infection to the nail bed during the time of healing.

There are multiple things you could try to improve the appearance of the nails, but first you need to have nail biopsy performed to determine if there is actual fungal infection. Nail bed reconstruction could be performed if there is no toe nail infection. If there is fungal infection, then you have options of topical antifungal meds, oral meds, laser treatment, total nail removal with nail bed reconstruction.

I hope this was helpful. Let me know if you have anymore questions.

Dr. Biren Shah