Thickened Toenail (Gryphosis)
Thickened Toenail (Gryphosis)
These type of nails are caused by damage to the cells that grow the nail. This can be sudden acute damage such as dropping a heavy object onto the toe or can be due to a gradual damage over the years with the toes impacting into the toe box of the shoes or with various sporting activities. This Gryphosis can be mistaken for a fungal infection of the nail and treated with expensive drugs inappropriately (see signs of fungal nail infections below).
The Treatment for the thickened toenail depends on the severity and whether it causes you any pain or difficulty with wearing shoes. Fundamentally the treatment is to reduce the thickness by cutting and filing the nail so that it is more manageable in future. Ultimately the nail can be removed under local analgesia, but the nail root matrix has to be destroyed since the damaged cells will continue to produce a thick new toenail if the nail is just removed and the nail root (Germinal Matrix) is left intact.
Surgical procedures which involve cutting the germinal matrix out used to be common place but this quite often left remnants of the matrix which could regenerate a nail across some parts of the area which leads to small spikes of growing nail popping out across the surface of the old nail area.
More commonly now the technique of using a saturated solution of Phenol after the nail is removed is used as it is a liquid the treatment reaches all parts of the germinal matrix and has a high success rate. The disadvantages lie with an increased healing time and care must be taken not to allow the phenol to damage surrounding skin
A Gryphotic nail just one day after removal (Total Nail Ablation) and phenol was applied to the germinal matrix of the nail bed.
6 weeks after the operation.