Ingrown nails are a pain for many HIVers. Nurse says postpone the pedicure and start soaking.
They’re nasty, Nursie! My ingrown toenails are also bloody, pus-y, and too ugly to suck on. Any tips to help me walk more confidently in my oh-so-sassy sandals would be appreciated.
-Shrimpless in Seattle
Fellow shrimp lover:
Not only do you have Nurse’s sympathy (despite all those years in sensible shoes, she’s been there), but I’d rather die than let you roam the streets in sandals and socks. My immaculate reputation would be soiled beyond bleaching if I weren’t on hand, as it were, to help you out of your toe jam. So let’s get to work!
First, dear, and ugly fact of life: Podiatric problems in general—we’re talking foot fungus, neuropathy, plantar warts and more—among the AIDSy. Topping the list are gnarly nails, which can be the result from genetic (thanks, Mom and Dad) to ill-fitting shoes (duh!) to a protease side effect (Crixivan in particular). You did the right to write me. Shrimpless, as ingrown nails are nothing to laugh at. Serious cases can lead to bone infections requiring IV drugs or even—gulp! —amputation. (NB: People with diabetes or those whose feet are vascularly or neurological challenged should hoof it to their doc the minute they notice any nail nastiness.)
Treatments range from tender to tortured, so let me build to that bloodcurdling scream, will ya? First, try the lift-and-separate technique: Soak the toe in warm water and antibacterial soap until the nail is softened, then raise it slightly and insert a smudge of cotton between it and the adjacent skin. Drop a dab of antibacterial ointment (Neosporin’ll do) onto the afflicted skin. Repeat twice a day, and don’t forget to wear comfortable shoes—shun the stiletto, peaches—until healing is complete. If things don’t get better within a week, or if pus starts oozing out, visit doc, who will likely lance the skin, drain the pus and prescribe a topical antibiotic. But the potions don’t always work their magic for HIVers. Ready to scream? Serious cases may end in surgery to remove all or part of the offending nail. Post-op, it may be a while before you’re feeling like baring your soles, or at least that troubled tootsie: Toenails take anywhere from eight to 12 months to grow back (for fingernails, half as long).
Good grooming goes a long way when it comes to nail health. Soak your dogs before-a trimming, using clippers and cutting straight across—no scissors, enough nail to cover the delicate underlying tissue, and file down any sharp edges with an emory board. Overall nail health means getting the right amounts of protein (that’s what nails are made of) and minerals. And down your daily A (5,000 IU), B12 (1,000 mcg), zinc (15 to 30 mg), iron (100 mg) and essential fatty acids. For a nice-to-nails herbal drink, combine 15 to 20 drops each of the following tinctures in a cup of water: ginger, nettle, dandelion, horsetail, spearmint, and hawthorn. A balanced diet helps you make for nifty nails, so graze on plenty of nuts, seeds, whole grains, veggies, legumes, and cold-water fish. Even if, like Nurse, your greatest pleasures—sugar, alcohol, caffeine, processed foods, six-inch spikes—are your nails nemesis, think about cutting out or down.