Save money on ingrown toenails

What would you do if your toenail looked like this? 

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Ouch! 

If you’re lucky, this would be your first ingrown toenail. You might get by with conservative measures such as soaking the toe in hot, soapy water two or three times a day for 5 to 10 days and wearing only well-fitting shoes that don’t apply pressure to the area, thereby preventing additional injury and allowing your own immune system to fight the infection.  Occasionally (not often) prying out the tip of the nail edge is helpful.  

 

If the above works, you’ve saved a trip to the doctor and all that follows.  However, if this does not suffice, a round of inexpensive ($4) antibiotics may do the trick.  I’ve had many patients ward off surgery by taking generic cephalexin or erythromycin or similar antibiotic for 7 to 10 days. 

 

However, if you’re prone to recurrent or persistent ingrown nails, the answer is usually minor surgery. Sometimes it’s better to bite the bullet and get the definitive treatment rather than ‘monkeying around’ with several rounds of antibiotics.

 

Removing the edge of the nail that is below the skin line usually resolves the problem. This is done as an outpatient under local anesthesia. The image below shows how large a sliver may be growing underneath the skin fold. Clearly you would not want to dig this out yourself. The nail is not merely ingrown at the tip, but all along the edge. A family physician or podiatrist can perform this procedure for $100-$200. Insurance covers this the same as any other surgical procedure.

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 If it is only the tip that digs into the skin, elevating the offending corner may prevent a recurrence.  Using a toothpick, as demonstrated, may be effective when you’re barefoot, but a bit of stiff plastic would allow you to wear shoes. 

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Strangely, some people have both edges of both feet affected at the same time.  Antibiotics will probably not remedy this degree of a problem, but may cool things off until you can schedule surgery.  Most patients are unaware that insurance reimburses doctors less per toe when both toes are done at the same time (versus on separate days).  If you are self-pay, be sure to ask your doctor about a multiple-procedure or bilateral-procedure discount, which could save you 25-75% on the second toe.  

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Some doctors refer to a podiatrist or general surgeon for toenail excision.  You will want to check with your insurance to see if your coverage is better for one or the other.  It’s also fair to request a price ahead of time – the difference could be significant, possibly hundreds of dollars.  While you’re at it, ask if an initial examination fee is an additional charge, and whether you’ll need to have the procedure scheduled at a later date.  Some doctors do this procedure in a surgery center (or hospital), which is sure to cost more, so clarify this ahead of time, and ask whether an additional facility fee will be incurred. 

 

Image via Wikipedia

 

 

 

© Cynthia J Koelker, MD – All rights reserved
http://www.101waystosavemoneyonhealthcare.com/ 

 

 

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