How to manage pain and swelling at the corner of my big toe?

Hi,

Welcome to icliniq.com.

I completely understand your concern.

I am really sorry to hear about the pain you are going through. Based on your description and attached picture (attachments removed to protect patient identity) and the pain and swelling at the corner of the big toe that started about a month ago, with severe pain, slight bulging, no pus, no yellow discoloration, and a history of nail removal. All these symptoms are most suggestive of an ingrown toenail with surrounding inflammation, acute paronychia.

After nail removal, you are having the formation of granulation tissue at the nail corner, which appears as a small bulge and can be extremely painful even without visible pus. Since you are diabetic, even if your blood sugar is well controlled, healing can be slower and inflammation can persist longer, making this condition more painful and prone to complications.

Clotrimazole lotion alone is unlikely to help if the main problem is mechanical irritation, inflammation, and secondary bacterial involvement rather than a fungal infection.

1. First, you need to manage the acute condition for seven to ten days. At this stage, it is important to avoid tight shoes, keep the foot clean and dry, and avoid further self-trimming or manipulation of the nail or surrounding skin.
2. Warm (not hot) saline or diluted antiseptic soaks once daily will help reduce discomfort, but aggressive soaking or home remedies should be avoided.
3. To manage the acute flare or acute paronychia, please use Fusidic acid cream twice daily on the affected area for 10 to 14 days and take tablet Serratiopeptidase 10 mg twice a day for five days to reduce swelling, pain, and inflammation.
4. When it settles, then I would suggest you go for nail culture for long-term medicine for chronic paronychia.

I hope this helps, and always feel free to reach out to me at any time. I am always here to help.

Thank you.