Possible infection in the big toe

[Learner]

Podiatrist here. Got some pictures? Macro of the nail and one from the top of the foot standing (with good light) would be most helpful. I'll try to make some good guesses and recommendations for confirmation and treatment. Also let me know if you have any underlying health issues, as these may influence my opinions and recommendations.

Thank you for your kind offer, Yupo! And sorry that I saw it only now. I will try to get some pictures and upload them here.

A little general update: The nail continues to grow out while the surrounding tissue is still swollen. So I made an appointment with my doctor for coming Wednesday to get a test done and maybe to be sent to a specialist (which she will most likely do). Have continued with the footbaths, but have mostly only managed to do it once per day (and I have skipped a day once in a while).

Now I use mostly DMSO cream with tea tree oil on the toe before putting a plaster on it. Recently I tried essential thyme oil in the footbath as well as with the DMSO cream afterwards. It seems to do something, but I can't say for sure. Haven't put it on constantly, and maybe it works best in combination with some other stuff (which I have to figure out yet).

Hope your foot gets better soon, Learner, and that you can put to use the quarantine period either for healing, reading or whatever is best for you.

Thank you for your kind wishes, cassandra! I did some romance reading during this time (finished the Web series ), and I felt quite relaxed due to the feeling there were not so many expectations from the outside world from me during this time. In combination with the regular footbaths it almost felt like some additional wellness holiday

 

[Learner]

@Yupo: Here are some pictures of the toenail. They are about a week old, but not much hasn't changed in look since then. Sorry that it took longer to attain the pictures, but my mobile doesn't have a good camera. Thus I had to ask my father to use his and send them to me per email.

The pictures display the affected toe on the right (close up and overall), and the other one on the left. As you'll see the toenail in question is growing out, but the tissue around it keeps swollen. The nail on the left one has started to grow out as well although I didn't think there had been any issue with it.

The doctor's office had cancelled the appointment I had with them before but gave me a new one for this Wednesday.

As for underlying issues, it might be the case that I have some Candida issue, but I am not sure. Because I do crave sweet things and carbs pretty much and experience difficulties in keeping them off. Also, there might be some infection going on in the genital tract - maybe due to yeast and candida - and I would have to discuss this with my doctor as well.

Also, the toe seems to "act" related to weather - it's worse when it's hot and humid, and seems better if the weather is cool.

Pictures: I hope they help with the assessment. If you need them any other way, just tell me and I'll try to get new ones. Thank you again for your kind offer


PS: Sorry, I just found the pictures don't display properly. I have to re-upload them in the next post.

 

[Learner]

Here are the pictures:

The right toenail (close up):



The right toe (toenail & swelling):



Overall toes of right foot:



Toe with nail of left foot (toenail also started to grow out):

 

[Yupo]

The good news is that the new growth (proximal nail) looks translucent and healthy. To me, the nail folds look inflamed, probably because the distal nail is a bit wide, incurvated (curled down into the sides a bit) and thickened. Probably the diseased portion will slough off in time as it grows out, or it can be easily cut away by a podiatrist without an anesthetic. The margin between good and diseased nail can be treated short term with a topical anti-fungal if there appears to be any such issue at the time. Lots of options for this.
Then you'll have to see if the nail borders continue to get ingrown. That is easy for a podiatrist to fix if the case. Obviously, avoid tight shoes. Cutting out ingrown nails yourself usually makes them worse. Or maybe we just see the many cases that get worse.
I'm not a big fan of soaking for this. It makes the skin wet, contributing to breakdown and infections. It increases the chance of fungal nail infections.
It is best to think of an ingrown nail as a foreign body. If you leave them alone, they can slowly cut a new path/groove to the end of the toe and then problem solved, but this is a very painful way to go. Sometimes the underlying bone gets infected. Yours appears to be in no way as bad as that.
Every case is a bit different. We look at skin quality, general health, sensitivity, vascularity, gait patterns, shoe fit and such to figure out what is going on and the best lasting solution for the individual. While I tend to be conservative with the knife, I'm also a big believer in fixing simple problems to prevent worse stuff down the road when critical health issues (like vascularity) may be worse.
If you have Diabetes or Arterial disease, you should absolutely be under the care of a podiatrist for such as this.
Hope that helps.

 

[Learner]

Hope that helps.

Thank you for your explanations, Yupo! It helps, though I am not sure if I understand all of it, being a non-podiatrist and a non-native English speaker

So, in summary, it doesn't sound too bad. Don't have diabetes or arterial disease or any other serious chronical disease. Well, it just comes to mind that I forgot to mention that there's a tendency for connective tissue weakness and proneness to varicose veins. Don't know if this factors into this issue in any way.

I see a podiatrist about once a month, she uses to cut my toenails and treats my feet with a salve. Will also see what the doctor says on Wednesday.

I'm not a big fan of soaking for this. It makes the skin wet, contributing to breakdown and infections. It increases the chance of fungal nail infections.

Do you mean footbaths? I am still doing them almost daily with tee trea oil, then put DMSO cream on the right toenail and a plaster to protect it. Is it better to not do that, then?

It is good you mention shoes. For a couple of years I was wearing shoes that were not very comfortable for work (working in a concert hall where we need to follow a dress code), but after falling there last year I am now wearing comfortable ones without heels. They do not really follow the dress code, but better take care of one's feet than being sorry (again). Will take them to my podiatrist though so she can give an assessment.

Also, have to wear a fine pantihose on my legs for work (4-5 times a week), and am not sure how that contributes to this toe issue.

 

[Yupo]

Thank you for your explanations, Yupo! It helps, though I am not sure if I understand all of it, being a non-podiatrist and a non-native English speaker

So, in summary, it doesn't sound too bad. Don't have diabetes or arterial disease or any other serious chronical disease. Well, it just comes to mind that I forgot to mention that there's a tendency for connective tissue weakness and proneness to varicose veins. Don't know if this factors into this issue in any way.

I see a podiatrist about once a month, she uses to cut my toenails and treats my feet with a salve. Will also see what the doctor says on Wednesday.


Do you mean footbaths? I am still doing them almost daily with tee trea oil, then put DMSO cream on the right toenail and a plaster to protect it. Is it better to not do that, then?

It is good you mention shoes. For a couple of years I was wearing shoes that were not very comfortable for work (working in a concert hall where we need to follow a dress code), but after falling there last year I am now wearing comfortable ones without heels. They do not really follow the dress code, but better take care of one's feet than being sorry (again). Will take them to my podiatrist though so she can give an assessment.

Also, have to wear a fine pantihose on my legs for work (4-5 times a week), and am not sure how that contributes to this toe issue.

Yes, I mean that I would avoid moisture/wetness and especially occlusion (tape, bandaid, plaster, and such) which can macerate (water log) the area. There is less chance of infection if the nail and surrounding tissues are dry. Skin is a good barrier only if intact. You can reduce the thickness of the distal nail with an emery board or file, a little at a time.
If you're wearing stockings, especially compression/support type hosiery, make sure they have a lot of extra room at the toes so they don't cause pressure.
Are you female, needing to wear dress shoes? Look for a shoe with a large toe box. Most people wear shoes that are too small, especially dress shoe styles. If you choose something with a quarter or t-strap, it can be plenty roomy and still stay on your foot.
These are just my opinions.
Here is one example of a shoe that has a raised toe box and a quarter strap, but there are many others.

 

[Redrock12]

You could also paint the toe with lugol's iodine to disinfect the area in general (although it will make the toe appear more yellow than normal).

I don't know if this info is helpful for you Learner but here's my experience with an infected toe. Maybe it will benefit someone else.
Due to an ingrown right big toe nail, I had it removed by my family GP. He wrapped in in a godawful bandage and it got infected, probably because I got it wet. When I removed the bandage a couple of days later the nail bed was all yellow with pus (looked real yucky). So I put 3-4 drops of Lugol's 5% iodine on it. For about 5 seconds it felt like someone was squeezing my toe really hard, but it did the trick and completely cleared up the infection.
FWIW

 

[Learner]

Yes, I mean that I would avoid moisture/wetness and especially occlusion (tape, bandaid, plaster, and such) which can macerate (water log) the area. There is less chance of infection if the nail and surrounding tissues are dry.

Thank you for the clarification, Yupo! So better say goodbye to footbaths and plasters for now (I liked the warmth of the footbaths and the smell of tea tree oil ).

If you're wearing stockings, especially compression/support type hosiery, make sure they have a lot of extra room at the toes so they don't cause pressure.

I will look out for that, thanks. So will buy them a size larger than I actually am, or with material that guarantees more size.

Are you female, needing to wear dress shoes? Look for a shoe with a large toe box. Most people wear shoes that are too small, especially dress shoe styles. If you choose something with a quarter or t-strap, it can be plenty roomy and still stay on your foot.

Yes, I'm female. At work we have to wear high heels with no strap, but since we can wear trousers (as part of a female suit) aside from skirts, and after falling there last year, I now wear comfortable shoes from the Clarks company. They not only are heel-less, but have straps which can be hidden by the seam of the trousers. But I think to take them to my podiatrist to have a look, just to be sure.

When I removed the bandage a couple of days later the nail bed was all yellow with pus (looked real yucky). So I put 3-4 drops of Lugol's 5% iodine on it. For about 5 seconds it felt like someone was squeezing my toe really hard, but it did the trick and completely cleared up the infection.

Thank you for chiming in too, Redrock! Good to hear that Lugol's was of help in your case. I still happen to have a little bottle of a 5 % solution. Will apply that one around the nail folds and see what happens, then report back.

 

[bianca etezete]

I second the DMSO, and also the Lugol, maybe colloidial silver spray could help aswell. Do you have lavender oil? I can imagine that that might help aswell

 

[Learner]

I second the DMSO, and also the Lugol, maybe colloidial silver spray could help aswell. Do you have lavender oil? I can imagine that that might help aswell

I have DMSO cream which I apply regularly. But the cream is moist, so do not know how to go with this one for now. Essential lavender oil has been on my wishlist for some time, maybe now an incentive to get it

 

[bianca etezete]

I have DMSO cream which I apply regularly. But the cream is moist, so do not know how to go with this one for now. Essential lavender oil has been on my wishlist for some time, maybe now an incentive to get it ,

what I would do is pour 98% DMSO on the toe, and then add whatever you think is needed. I literally wash my hands from time to time in the 98% DMSO, no negative effects. That is what I would do. It is no recommendation.

 

[Learner]

I have been to the doctor last week and she relegated me to a dermatologist to do a swab, and to an angiologist for checking blood flow. Because the right toe seemed cooler to her and also different in complexion (more reddish-blueish) than the left toe. So she assumes that blood flow might be impaired. I wonder if this goes for the left toe for some extent as well since the toenail is growing out there too.

She recommended to continue the footbaths with tee tree oil and oak bark (which is offered in pharmacies). Another way is to go for a kinesiologic treatment, which her colleague - who also is a homeopath - offers, to get some more clues. To that effect, I am going to look into some homeopathic remedies as well to have them tested then.

The doctor suggested some relation to the gut, especially if it is more of a microbial issue than an angiological one. The former can be realized via scatoscopy; but since it's quite pricey the alternative would be a probiotic remedy which covers much of the cultures in the gut. It would probably help with my craving of sweet things (which I try to counter with fennel seeds and a tincture of bitters).

Also, she suggested to have another blood analysis to check for inflammation markers, which according to her can also give hints on what's going on with my feet. As for the hosies, due to my problems with connective tissue and varicose veins, I started to wear supportive ones that are as large as possible to give space to the toe while not too large (to keep them around my body ).

That's it for now. Thank you again for reading!

 

[Metrist]

For a infection, I use hot water with salt in it. You lance the infection, squeeze out the puss, and then dip your toe in the hot water - pinching your toe to deaden the nerve. Do it fast at first, because you need to see how hot it is, then as you do it over and over, you adjust.
The idea is to get your toe throbbing as to pump blood into the toe. Your pain threshold will tell you to pull out of the water, and will hurt, so do it fast at first, then as the water cools and you get accustomed to the heat, you get the benefit of the most heat - getting the blood pumping into the infected area.
You don't want to scald yourself, so just experiment, gradually using hotter water. Hot tap water is usually hot enough. Soaking is good too, but this is in case soaking isn't enough and is just for the infected toe.