UKH

So I have had manky dead yellow toenails for ages, I tried to use lockdown to clear them up, using softening stuff, scraping out, allowing to re-grow. It didn't work. Now I'm putting tight climbing shoes on again, and its too painful to climb. I have a swollen side of the nail where I don't have much nail above the skin, and I think it is ingrown out to the side, under the side-skin.

My instinct says I should go in with scissors and cut out as much as possible from under the side-skin to stop it swelling, but NHS/ long term view says that cutting is bad as it can't grow out. Should I just leave it and see a doctor? How has the DIY approach worked for anyone?

In reply to danieleaston:

Obviously you know that putting tight climbing shoes on is a bad idea, and the NHS say cutting is a bad plan.

Having got that over, it is possible your climbing shoes have shrunk when not in use, or your feet have swelled because its warmer.

If I was you, and still wanted to climb, I would get some inexpensive bigger shoes, Decathlon are pretty good for this, and seek medical advice, maybe a pharmacist.

In reply to danieleaston:

I suffered for years, lately severely restricting my climbing. Last summer I had a chiropodist remove both my big toe nails, problem solved and I can wear my best climbing shoes again 

In reply to danieleaston:

Dead, manky, yellow?

Ask your gp for terbinafine in tablet form. It’s an anti-fungal. Will take a number of months to work (enough for your toes to grow out) but it does work!

In reply to kevin stephens:

Ditto. I solidly recommend removal and then treating the nail bed so it doesn't grow back.

I only got 1 toenail removed permanently. You can climb again in something like sandals if you are careful after a week or two. From memory I think it was a month or maybe 2 before I wore climbing shoes again.

In reply to kevin stephens:

Same here - they didn't remove the whole nail, just took a few mm off each side and treated the nail bed to make it permanently narrow. That was about 15 years ago and I've not had any problems since - previously I was using the DIY scissors / pliers approach every few weeks.

I ended up getting it done privately - I think in principle you can have it done on the NHS if you can get your GP to refer you to the right person.

In reply to robhorton:

I did exactly the same a couple of years ago - well worth it. I was out of climbing shoes for about a month.

In reply to robhorton:

Technically known as a "wedge resection".  I had it done a dozen or more years ago on the outside edge of my left big toenail.

My GP did it for me himself.

In reply to danieleaston:

When young I had an ingrowing  big toe nail removed several times. In the end I gave up on this approach and tried an old army trick.... shaved the nail to really thin it and rested it from any major bashing for a month. It grew back to full thickness OK and I've never had a problem with it since then. I must be clear my nail wasn't affected by a fungal infection....you should probably deal with that first.

In reply to kevin stephens: I am in the same position and was wondering how long it was until you could climb again? Did you get both done at the same time?

In reply to danieleaston:

I'll second HillSeeker.  I've bust-up two toenails in my life, one from climbing, one from football. My doctor told me there's a ubiquitous fungus that is on everyone's feet, however when you break a toenail, the fungus gets in and infects the toe, turning it yellow and mutating normal growth. Each time I was prescribed Terbinafine. Apparently it's very expensive for the NHS, so you may have to beg your doctor for it. It's one tablet a day for 8-12 months until the toe fully grows out!! Moreover, Terbinafine can cause kidney failure for a tiny percentage of the population, so you have to go twice in that period for blood tests! Whether it's worth all that hassle for normal looking toes is certainly open to debate.

In reply to danieleaston:

If they're ingrowing/painful then you're probably best off seeing a podiatrist rather than a doctor to sort this out initially. Locally people can self-refer to an NHS podiatrist, but elsewhere you may need to pay

The thickened/yellow part may suggest a fungal nail infection - these can be treated with anti-fungal tablets but would usually need confirmation by sending nail clippings off for microscopy. 3-6 month courses of medication are needed, and these aren't without potential side-effects.

Bear in mind that we're still in Covid mode so ingrowing nails will be low priority and services such as podiatry may be restricted.

In reply to mik82:

If a toe nail is thickening and yellowing but not causing any issues, would leaving it in peace and not bothering with medication be the logical thing? I've had a thickening toenail on my left foot for ages, and vaguely thought it could be worth looking at but it's not a hassle - is there another stage beyond this?

In reply to danieleaston:

When I had a toenail starting to in grow nearer the front, I was advised by my doctor to roll up a 'small sausage' of cotton wool and to put that under the end of the nail to encourage it not to dig in, I've been doing the same again recently with a big toe nail which I cut slightly too deeply on at one corner meaning the sideways edge is starting to be painful, I've just been using a tiny bit of kitchen roll and some finger tape to hold it in place actually, I don't know if this is possible but I've been checking that it's not going to somehow end up stuck under the nail too, replacing it periodically. It seems to be working.

In reply to danieleaston:

I actually persuaded my GP to remove one of my toenails once. I think he agreed because it was a bit of a challenge and a change for him after a busy morning clinic talking to old ladies. He did an OK job but it soon grew back worse than before.

As others have said, chiropody is your friend. Wait until the autumn though, so you can go after dark and no-one can see you... Both my big toenails are vile and thick - 3mm maybe - and my chiropodist attacked them with gusto. No contest.

And however manky your feet may be, they see much worse every day.

In reply to Timmd:

Yeah. if it's not bothering you and you don't want to do anything then leaving them alone is fine.

Some people try an over the counter nail lacquer (amorolfine) but it isn't particularly effective and as with the tablets needs to be used for several months.

In reply to mik82: That's good to hear, I can live with a big toe nail which has changed in colour and thickness.

In reply to danieleaston:

I read in an American climbing magazine about somebody damaging something toe related underneath their big toenail BTW, after scraping underneath their toenail with a knife to 'sort things out' as they saw it, possibly be careful in what you do.

In reply to marky:

Both done at the same time.  sandals or slippers for a week then normal shoes Changing dressings daily for a couple of weeks maybe.  I think it may have been around 4 weeks before using comfortable climbing shoes at the wall, then 2 or 3 more weeks before "best" climbing shoes

As an aside, the chiropodist applies phenol to kill the nail beds.  In my case this was not completely successful and after a year my big toe nails have grown back - however they are more the correct shape and thickness and don't cause me any problems like the old ones did.  I gather this regeneration is quite uncommon

In reply to danieleaston:

Beware hacking at your toe nails if you have diabetes.

However, if you’re not, then cutting a ‘v’ shape in the middle of the end of the nail( the most outermost bit) can help to draw the nail back to alignment.

In reply to mik82:

It was effective for me. However, as with Terbinafine, fungal infections often recur. Incidentally when I've been frequently  swimming in saltwater it seems to improve thing a lot, but no scientific basis, One could always try twice daily soaking in salted water for a few minutes.