Dr Bernadette Carr answers your questions on how to deal with an ingrown toenail and how to get a good night’s sleep.
Q. I’m in my late 30s and the toenails on my two big toes have been really painful of late. Also the skin beside the nail is red and inflamed. I have a habit of cutting my toenails very short, could this be an ingrown toenail?
A. Pain in the toenails can be very uncomfortable as you have found. Ingrown toenails (onchyocryptosis) are very common, particularly in the big toe and may affect one or both sides of the nail. Females and males are affected equally.
They occur when the side of the nail cuts into the skin bedside the nail and sometimes this skin can get infected and it becomes red and swollen.
Cutting the toenails very short is a common cause of ingrown toenails as is wearing tight-fitting shoes or socks.
Other causes include an injury to the toenail or a fungal nail infection such athlete’s foot.
As the skin beside your toenail is red, you need to make an appointment with your GP who can examine the nails and make a diagnosis. This is particularly important if the nail is infected.
To prevent an ingrown toenail here are some general suggestions:
Toenails should be cut straight across, do not cut too short or cut in at the sides.
Avoid wearing shoes or tights that are too tight.
Wear comfortable shoes that fit properly and have space around the toes without being too loose.
Practice good foot hygiene, wash your feet regularly and dry them thoroughly.
When you are at home, try going about with bare feet to keep pressure off the toes. I am sure that your GP will be able to reassure you and advise on the appropriate management.
Q. Recently I have noticed I am not sleeping as well as I should. I am waking up early and several times throughout the night. What can I do?
A. Sleep disturbance may be a sign of an underlying condition such as stress. Low mood or anxiety disorders may manifest as sleep disturbance.
It is important to consult your doctor if you feel that anxiety or mood issues are an issue for you. The amount of sleep needed by any individual may vary widely.
Current recommendations suggest the optimum amount is between seven-and-a-half to nine hours a night for a healthy adult.
Many natural strategies can be employed to help you improve the quality of the sleep you are getting.
Begin by taking a look at intake of caffeine in the diet in the form of coffee/tea /soft drinks can be helpful.
Avoid drinking these drinks from the evening onwards to ensure the body is sufficiently ‘wound-down’ to help you get a relaxing sleep.
Good sleep routines are important for the body. If possible it can be useful to set a time for bed and adhere to this. This will help establish a sleep pattern.
Avoiding use of technology immediately before going to bed also helps to relax the body and prepare for sleep. Keep TVs and computers out of the bedroom.
Ensuring the bedroom is in darkness will also help the body to produce melatonin — one of the hormones which regulates your sleep-wake cycle.
A hot milky drink before bed may also help sleep. The enzyme tryptophan, which is found in milk is believed to help induce sleep. Avoiding alcohol before bed will also help improve the quality of your sleep.
While alcohol may initially help you sleep it will ultimately reduce the quality of this sleep.
It is a good idea to avoid large meals before bed also, as this can contribute to heartburn and indigestion which may in turn disturb your sleep.
Exercise is important in contributing to the quality of sleep a person gets. Thirty minutes of exercise daily should also contribute to good sleep. The timing of this exercise can also be important.
Exercising too late in the evening can stimulate the body which may make it harder to wind down and get a satisfying night’s sleep.
Relaxation strategies such as practicing deep breathing or mindfulness techniques are also useful in helping the body to switch off and contribute to restful sleep.
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