Causes
The human nail consists of two main parts: the nail plateThe visible hard part which is commonly referred to as the “nail”. and the matrixThe root of the nail hidden underneath the skin and the base of the nail which continuously produces cells that become the nail plate..
These two parts are usually continuous. Retronychia refers to a disruption in the connection between these two parts and is caused by trauma or repeated microtrauma. It should not be confused with an ingrown toenail.
Ill-fitting shoes where the toe hits the end of the shoe with each step are often the cause.
In retronychia, the nail plate stays in place and degrades over time as it is no longer being replaced while the matrix continues to make new nail. The new nail is prevented from growing by the old nail plate, causing them to collide and induce pain and inflammation at the base of the nail. Sometimes, the new nail plate grows underneath or on top of the old one, resulting in several nails being stacked on top of each other.
Symptoms
Possible symptoms include:
- pain and inflammation at the base of the nail
- xanthonychiaYellow discolouration of the nail plate
- no nail growth
Treatment for retronychia
Mild forms may heal without intervention and activities that risk injuring the nail should be avoided. In other cases, surgery may be required. This intervention is usually performed as an outpatientYou will be discharged the same day as the procedure. procedure. It involves removing the old nail plate and cleaning the matrix area so that a new nail plate is able to grow. A new nail will form within a few months.
After the procedure, you will need to rest for three days and your dressings will be tended to by a nurse at your home for around 15 days. You will then attend a follow-up consultation one month after the procedure.
FAQs
- What types of imaging tests are required? None. The diagnosis is made by examining the nail.
- How do you tell the difference between an ingrown toenail and retronychia? An ingrown toenail involves one or both sides of the nail while retronychia affects the entire width of the base of the nail. Pyogenic granulomasSmall skin growths are also not seen in retronychia.
- Can it come back after the operation? Yes. The operation does not prevent recurrence. Avoiding microtrauma is essential to reduce this risk.
- Can both feet be operated on at the same time? Yes. In these cases, general anaesthetic is preferred.
- Will I be able to walk after the operation? Yes, you will be able to walk the day after the operation. Time spent standing should however be limited for three days.
- How much time will I need off work? Three to 10 days depending on your job.